Editor,—In their very stimulating paper, Cavataioet al reported their experience concerning gastro-oesophageal reflux (GOR) associated with cows’ milk protein allergy (CMPA).¹ In a series of 47 cases of GOR, they found a very high prevalence of CMPA: 14 cases (30%); they also stressed the possibility of recognising these cases from characteristic ‘phasic’ pH tracing.

We evaluated a series of 112 infants (65 boys and 47 girls; median age 3.7 months) with GOR confirmed by oesophageal 24 hour pH monitoring. Using the results of an elimination diet followed by an open challenge test, we found CMPA dependent GOR in 18 patients (16%), a rate significantly lower than that found by Cavataio et al, but similar to that of other authors.²Moreover, we failed to find any characteristic oesophageal pH-metric pattern distinguishing patients with GOR plus …