Abstract
Incidence and clinical manifestation of cow's milk protein intolerance (CMPI) were studied in 1158 unselected newborn infants followed prospectively from birth to 1 year of age. No food changes were required in 914 infants who were used as healthy controls. When CMPI was suspected (211 infants), diagnostic dietary interventions according to a standard protocol were performed. After exclusion of lactose intolerance, two positive cow's milk elimination/challenge tests were considered diagnostic of CMPI. Two hundred and eleven symptomatic infants were examined for possible CMPI. A large group of 80 infants improved on a lactose reduced formula. In 87/211 infants CMPI was excluded (sick controls). Finally CMPI was proven in 26 infants. The calculated incidence rate for CMPI was 2.8%. The principal symptoms in infants with CMPI were gastrointestinal, dermatological and respiratory in 50%, 31% and 19% respectively. A positive family history for atopy (first or second degree relatives) was more frequent in either CMPI infants (65%), or sick controls (63%) when compared to either healthy controls (35%) or infants improving on a low lactose formula (51%). Differences between patients with CMPI and sick controls were only found for the presence of atopy in at least 2 first degree relatives [(5/26 in CMPI infants and 4/87 in sick controls (P<0.05)] and for multiorgan involvement [10/26 infants with CMPI as opposed to 12/87 in the sick control group (P<0.02)]. These statistical differences are too weak to be of clinical value.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- CMPI:
-
cow's milk protein intolerance
References
Armitrage P, Berry G (1987) Statistical methods in medical research; second edition. Blackwell, Oxford
Bachman KD, Dees SC (1957) Milk allergy. Observations on incidence and symptoms of allergy to milk in allergic infants. Pediatrics 32:400–407
Barr RG, Clogg LJ, Wooldridge JA, Tansey CN (1987) Carbohydrate intolerance has no effect on infant crying behaviour: a randomized controlled trial. Am J Dis Child 141:391
Bishop JM, Hill DJ, Hosking CS (1990) Natural history of cow milk allergy: clinical outcome. J Pediatrics 116:862–867
Clein N (1958) Cow's milk allergy in infants and children. Int Arch Allergy 13:245–256
Collins Williams C (1956) The incidence of milk allergy in pediatric practice. J Pediatr 48:39–47
Cookson WOCM, Hopkin JM (1989) Dominant inheritance of atopic immunoglobulin-E responsiveness. Lancet I:86–88
Douwes AC, Weert-Waltman ML van, Folkertsma K, Fagel JFM, Verboom WSW (1988) Prevalence of foodallergies in Amsterdam infants (in Dutch). Ned Tijdschr Geneesk 132:1392–1396
Emery AEH, Rimoin DL (1990) Principles and practice of medical genetics, 2nd edn. Churchill Livingstone, Edinburgh London Melbourne New York
Gerrard JW, MacKenzie JWA, Goluboff N, Garson JZ, Maningas CS (1973) Cow's milk allergy: prevalence and manifestations in an unselected series of newborns. Acta Peadiatr Scand [Suppl] 234:1–21
Goldman A, Anderson DW, Sellers WA, Saperstein S, Kniker WT, Halpern SR (1963) Milk allergy: I Oral challenge with milk and isolated milk proteins in allergic children. Pediatrics 32:425–443
Halpers SR, Sellars WA, Johnson RB, Anderson DW, Saperstein S, Reisch JS (1973) Development of childhood allergy in infants fed breast, soy or cow milk. J Allergy Clin Immunol 51:139–151
Illingworth RS (1988) Infantile colic revisited. Arch Dis Child 60:981–985
Jakobsson I, Lindberg T (1979) A prospective study of cow's milk intolerance in Swedish infants. Acta Paediatr Scand 68:853–859
Liebman W (1981) Infantile colic association with lactose and milk intolerance. JAMA 245:732–733
Lothe L, Lindberg T (1989) Cow's milk whey protein elicts symptoms of infantile colic in colicky formula fed infants: a double blind crossover study. Pediatrics 83:262–266
Loveless MH (1950) milk allergy: a survey of its incidence: experiments with a masked ingestion test. J Allergy Clin Immunol 21:489–499
Moore DJ, Robb TA, Davidson GP (1988) Breath hydrogen response to milk containing lactose in colicky and non colicky infants. J Pediatr 113:979–984
Mueller HL, Weiss RJ, O'Leary D, Murray AB (1963) The incidence of milk sensitivity and the development of allergy in infants. N Engl J Med 268:1220–1224
Schrander JJP, Oudsen S, Forget PP, Kuijten RH (1992) Follow up study of cow's milk protein intolerant infants. Eur J Pediatr 151:783–785
Stahlberg MR, Savilathi E (1986) Infantile colic and infant feeding. Arch Dis Child 61:1232–1233
Stintzing G, Zetterström R (1979) Cow's milk allergy, incidence and pathogenetic role of early exposure to cow's milk formula. Acta Paediatr Scand 68:383–387
Taubman B (1988) Parenteral counseling compared with elimination of cow's milk or soy milk protein for the treatment of infantile colic syndrome: a randomized trial. Pediatrics 81:756–761
Ventura A, Greco L (1988) Cow's milk allergy in the first year of life: an Italian collaborative study. Acta Paediatr Scand 348 [Suppl]:3–14
Verkasalo M, Kuitunen P, Savalahti E, Tilikainen A (1981) Changing pattern of cow's milk intolerance: an analysis of the occurrence and clinical course in the 60s and mid-70s. Acta Paediatr Scand 70:289–295
Vitoria J, Sojo A, Rodriguez-Soriana J (1990) Changing pattern of cow's milk protein intolerance. Acta Paediatr Scand 79:566–567
Wilson NW, Hamburger RN (1988) Allergy to cow's milk in the first year of life and its prevention. Ann Allergy 61:323–327
Wood C (1986) How common is food allergy. Acta Paediatr Scand [Suppl] 323:76–83
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Schrander, J.J.P., van den Bogart, J.P.H., Forget, P.P. et al. Cow's milk protein intolerance in infants under 1 year of age: A prospective epidemiological study. Eur J Pediatr 152, 640–644 (1993). https://doi.org/10.1007/BF01955238
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01955238