You are here

Article Text

Article menu

This article has a correction. Please see:

Review
Guidelines for the diagnosis and management of cow’s milk protein allergy in infants
  1. Yvan Vandenplas1,
  2. Martin Brueton2,
  3. Christophe Dupont3,
  4. David Hill4,
  5. Erika Isolauri5,
  6. Sibylle Koletzko6,
  7. Arnold P Oranje7,
  8. Annamaria Staiano8
  1. 1
    Department of Paediatrics, Universitair Ziekenhuis Brussel Kinderen, Vrije Universiteit Brussel, Brussels, Belgium
  2. 2
    Chelsea and Westminster Hospital, London and Child Health at Imperial College Faculty of Medicine, University of London, London, UK
  3. 3
    Neonatology and Nutrition Department, Université René Descartes Paris V, Hospital Cochin Saint Vincent de Paul, Paris, France
  4. 4
    Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Victoria, Australia
  5. 5
    University of Turku, Turku, Finland
  6. 6
    Dr. v. Haunersches Kinderspital, Ludwig Maximillians-Universität, Munich, Germany
  7. 7
    Department of Dermatology and Venereology, Erasmus MC, University Medical Centre (Sophia Children's Hospital) Rotterdam, Rotterdam, The Netherlands
  8. 8
    University Federico II of Naples, Naples, Italy
  1. Professor Yvan Vandenplas, Department of Paediatrics, Vrije Universiteit Brussel, Laarbeeklaan 101, Brussels, Belgium; yvan.vandenplas{at}uzbrussel.be

Abstract

Our aim was to develop guidance for general paediatricians and primary care physicians in diagnosing and managing cow’s milk protein allergy in infants. The guidelines were developed by discussion based on existing national recommendations and standards, clinical experience and, whenever possible, evidence from the literature. Separate algorithms cover breast-fed and formula-fed infants. The recommendations emphasise the importance of comprehensive history taking and careful physical examination. Patients with severe symptoms need to be referred to a specialist. Elimination of cow’s milk protein from the infant’s or mother’s diet and challenges are the gold standard for diagnosis. This guidance is intended as a basis for local discussion, implementation and prospective evaluation. The algorithms should be regularly assessed using clinical audit standards. Once validated, the diagnostic framework could provide a standardised approach in epidemiological and therapeutic studies.

http://dx.doi.org/10.1136/adc.2006.110999

Statistics from Altmetric.com

    View Full Text

    Supplementary materials

    • In the original figure, there were two arrows pointing from the box "open challenge with cow's milk formula under clinical observation" to the bow just below "no CMPA symptoms; resume CMP and monitor". The right arrow should point to the box to the right "CMPA symptoms" (there was no arrow pointing to this box in the orginal figure).

      Files in this Data Supplement:

    Footnotes

    • Funding: The consensus panel, the literature search and the drafting of the manuscript were funded by a grant from SHS/Nutricia. The paper was drafted by Mark Greener, a medical writer. SHS International Ltd and Nutricia did not have any editorial control over the final manuscript, which remains entirely the responsibility of the authors.

    • Competing interests: DH, CD, MB, SK and YV declare they have received support for clinical research projects from SHS/Nutricia and the same authors and MB declare they have presented lectures at SHS/Nutricia-sponsored meetings. Also, SK has presented lectures at sponsored meetings and received support for scientific work from Mead Johnson and Nestle. YV has received support from Janssen Pharmaceuticals, Astra, Wyeth, Biocodex and Nestle. None of the other authors made any declarations relevant to the preparation of this manuscript. The authors declare the absence of competing interests and confirm their independence regarding the content of this manuscript.

    • Yvan Vandenplas and Sibylle Koletzko are joint lead authors.

    • Abbreviations:
      AAF
      amino acid formula
      CMP
      cow’s milk protein
      CMPA
      cow’s milk protein allergy
      eHF
      extensively hydrolysed formula
      GORD
      gastro-oesophageal reflux disease
      IgE
      immunoglobulin E
      RAST
      radioallergosorbent test
      SPT
      skin prick test

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Copyright information:

    2007 BMJ Publishing Group & Royal College of Paediatrics and Child Health

    Linked Articles

    • Corrections
      Corrections
      BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
      Archives of Disease in Childhood 2007; 93 93-93 Published Online First: 21 Dec 2007.