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Dietary treatment of cows' milk protein allergy in childhood: a commentary by the Committee on Nutrition of the French Society of Paediatrics.
Br J Nutr 2012; 107(3):325-38BJ

Abstract

The diagnosis of cows' milk protein allergy (CMPA) requires first the suspicion of diagnosis based on symptoms described in the medical history, and, second, the elimination of cows' milk proteins (CMP) from the infant's diet. Without such rigorous analysis, the elimination of CMP is unjustified, and sometimes harmful. The elimination diet should be strictly followed, at least until 9-12 months of age. If the child is not breast fed or the mother cannot or no longer wishes to breast feed, the first choice is an extensively hydrolysed formula (eHF) of CMP, the efficacy of which has been demonstrated by scientifically sound studies. If it is not tolerated, an amino acid-based formula is warranted. A rice protein-based eHF can be an alternative to a CMP-based eHF. Soya protein-based infant formulae are also a suitable alternative for infants >6 months, after establishing tolerance to soya protein by clinical challenge. CMPA usually resolves during the first 2-3 years. However, the age of recovery varies depending on the child and the type of CMPA, especially whether it is IgE-mediated or not, with the former being more persistent. Once the child reaches the age of 9-12 months, an oral food challenge is carried out in the hospital ward to assess the development of tolerance and, if possible, to allow for the continued reintroduction of CMP at home. Some children with CMPA will tolerate only a limited daily amount of CMP. The current therapeutic options are designed to accelerate the acquisition of tolerance thereof, which seems to be facilitated by repeated exposure to CMP.

Authors+Show Affiliations

Service d'Explorations Fonctionnelles Digestives Pédiatriques, Hôpital Necker-Enfants Malades, Université Paris Descartes, 149 rue de Sèvres, Paris, France. christophe.dupont@nck.aphp.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Practice Guideline
Review

Language

eng

PubMed ID

22115523

Citation

Dupont, C, et al. "Dietary Treatment of Cows' Milk Protein Allergy in Childhood: a Commentary By the Committee On Nutrition of the French Society of Paediatrics." The British Journal of Nutrition, vol. 107, no. 3, 2012, pp. 325-38.
Dupont C, Chouraqui JP, de Boissieu D, et al. Dietary treatment of cows' milk protein allergy in childhood: a commentary by the Committee on Nutrition of the French Society of Paediatrics. Br J Nutr. 2012;107(3):325-38.
Dupont, C., Chouraqui, J. P., de Boissieu, D., Bocquet, A., Bresson, J. L., Briend, A., ... Turck, D. (2012). Dietary treatment of cows' milk protein allergy in childhood: a commentary by the Committee on Nutrition of the French Society of Paediatrics. The British Journal of Nutrition, 107(3), pp. 325-38. doi:10.1017/S0007114511004831.
Dupont C, et al. Dietary Treatment of Cows' Milk Protein Allergy in Childhood: a Commentary By the Committee On Nutrition of the French Society of Paediatrics. Br J Nutr. 2012;107(3):325-38. PubMed PMID: 22115523.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary treatment of cows' milk protein allergy in childhood: a commentary by the Committee on Nutrition of the French Society of Paediatrics. AU - Dupont,C, AU - Chouraqui,J P, AU - de Boissieu,D, AU - Bocquet,A, AU - Bresson,J L, AU - Briend,A, AU - Darmaun,D, AU - Frelut,M L, AU - Ghisolfi,J, AU - Girardet,J P, AU - Goulet,O, AU - Hankard,R, AU - Rieu,D, AU - Vidailhet,M, AU - Turck,D, AU - ,, Y1 - 2011/11/25/ PY - 2011/11/26/entrez PY - 2011/11/26/pubmed PY - 2012/3/10/medline SP - 325 EP - 38 JF - The British journal of nutrition JO - Br. J. Nutr. VL - 107 IS - 3 N2 - The diagnosis of cows' milk protein allergy (CMPA) requires first the suspicion of diagnosis based on symptoms described in the medical history, and, second, the elimination of cows' milk proteins (CMP) from the infant's diet. Without such rigorous analysis, the elimination of CMP is unjustified, and sometimes harmful. The elimination diet should be strictly followed, at least until 9-12 months of age. If the child is not breast fed or the mother cannot or no longer wishes to breast feed, the first choice is an extensively hydrolysed formula (eHF) of CMP, the efficacy of which has been demonstrated by scientifically sound studies. If it is not tolerated, an amino acid-based formula is warranted. A rice protein-based eHF can be an alternative to a CMP-based eHF. Soya protein-based infant formulae are also a suitable alternative for infants >6 months, after establishing tolerance to soya protein by clinical challenge. CMPA usually resolves during the first 2-3 years. However, the age of recovery varies depending on the child and the type of CMPA, especially whether it is IgE-mediated or not, with the former being more persistent. Once the child reaches the age of 9-12 months, an oral food challenge is carried out in the hospital ward to assess the development of tolerance and, if possible, to allow for the continued reintroduction of CMP at home. Some children with CMPA will tolerate only a limited daily amount of CMP. The current therapeutic options are designed to accelerate the acquisition of tolerance thereof, which seems to be facilitated by repeated exposure to CMP. SN - 1475-2662 UR - https://www.unboundmedicine.com/medline/citation/22115523/Dietary_treatment_of_cows'_milk_protein_allergy_in_childhood:_a_commentary_by_the_Committee_on_Nutrition_of_the_French_Society_of_Paediatrics_ L2 - https://www.cambridge.org/core/product/identifier/S0007114511004831/type/journal_article DB - PRIME DP - Unbound Medicine ER -