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Cow's Milk Protein Allergy



Cow’s milk protein allergy (CMPA) often presents with diverse and non-specific symptoms, making it challenging to diagnose and manage. At Nestlé Health Science, we understand this challenge and are committed to supporting healthcare professionals, patients and caregivers in caring for infants with CMPA.


KEY FACTS ABOUT COW’S MILK PROTEIN ALLERGY

WHAT IS COW’S MILK PROTEIN ALLERGY?
INCIDENCE AND PREVALENCE OF CMPA
THE IMMUNE IMPACT OF CMPA
THE IMPORTANCE OF NUTRITIONAL SUPPORT
FOOD ALLERGY OR NON-ALLERGIC FOOD HYPERSENSITIVITY
LACTOSE INTOLERANCE SHOULD NOT BE CONFUSED WITH CMPA




NESTLÉ HEALTH SCIENCE: SUPPORTING COW’S MILK PROTEIN ALLERGY DIAGNOSIS AND MANAGEMENT


CMPA can be a challenge to diagnose given the large variability in number and severity of the symptoms, and the fact that some of them are perfectly normal for infants to experience.

We understand this challenge and are committed to provide expert-developed tools, nutritional solutions and support for healthcare professionals to help facilitate the earlier diagnosis and appropriate management of infants and young children with CMPA.


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SIGNS AND SYMPTOMS

Inconsolable crying, colic, skin rashes, vomiting, diarhoea, and constipation are all common signs and symptoms of CMPA, especially in early infancy.



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CONSIDER CMPA

Leading experts have developed the Cow’s Milk-related Symptom Score (CoMiSS®) to help healthcare professionals recognize and assess non-specific signs and symptoms that could be indicative of CMPA.



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CLARIFY THE DIAGNOSIS

Diagnosis of CMPA can be challenging, and few tests are available to help assess the presence of CMPA. The gold standard for diagnosing CMPA is the elimination diet, which is free from cow’s milk protein, followed by a food challenge.






OUR RANGE OF TAILOR-MADE NUTRITIONAL SOLUTIONS



Nestlé Health Science has a range of nutritional solutions that are tailor-made to meet the specific needs of infants with CMPA. Our formulas are hypoallergenic and nutritionally complete to support normal growth and development, and are supplemented with HMO* (2’FL and LNnT) to support growing immune systems.





NESTLÉ’S HEALTH SCIENCE’S COMMITMENT TO CMPA EDUCATION


Nestlé Health Science is dedicated to developing and sharing leading scientific information and educational tools to support in the identification and management of CMPA for healthcare professionals and caregivers.


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EXPERT CORNER: CMPA DIAGNOSIS

Leading experts in paediatric gastroenterology and food allergy answer common questions related to the diagnosis of CMPA in our online video series.

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CASE STUDIES

Understand some of the diagnostic and management challenges - from the initial symptom presentation to diagnosis followed by the dietery management in a series of case studies.

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SUPPORT FOR PARENTS AND CAREGIVERS

Information and tools are available for parents to support them along their CMPA journey.


* Structurally identical Human Milk Oligosaccharides (HMO) are not sourced from human milk



REFERENCES



  1. Koletzko S, et al. Diagnostic Approach and Management of Cow’s-Milk Protein Allergy in Infants and Children: ESPGHAN GI Committee Practical Guidelines. J Pediatr Gastroenterol Nutr 2012;55(2):221-229.
  2. Prescott SL, et al. A global survey on changing patterns of food allergy burden in children. World Allergy Organ J. 2013;6(1) :21.
  3. Høst A. Cow’s milk protein allergy and intolerance in infancy. Some clinical, epidemiological and immunological aspects. Pediatr Allergy Immunol. 1994;5:1-36.
  4. Jalonen T. Identical intestinal permeability changes in children with different clinical manifestations of cow’s milk allergy. J allergy Clin Immunol 1991;88(5):737-742.
  5. Crittenden RG and Bennett LE. Cow’s Milk Allergy: A Complex Disorder. J Am Coll Nutr 2005;24(6suppl):582S–591S.
  6. Thompson-Chagoyan OC, et al. Faecal Microbiota and Short-Chain Fatty Acid Levels in Faeces from Infants with Cow‘s Milk Protein Allergy. Int Arch Allergy Immunol 2011;156(3):325–332.
  7. Azad MB, et al. Infant gut microbiota and food sensitization: associations in the first year of life. Clin Exp Allergy 2015;45(3):632-643.
  8. Chin AM, et al. Morphogenesis and maturation of the embryonic and postnatal intestine. Semin Cell Dev Biol 2017;66:81-93.
  9. Tanaka M and Nakayama J. Development of the gut microbiota in infancy and its impact on health in later life. Allergol Int 2017;66(4):515-522.
  10. Dzidic M, et al. Gut Microbiota and Mucosal Immunity in the Neonate. Med Sci (Basel). 2018;6(3):56.
  11. Juntti H, et al. Cow’s Milk Allergy is Associated with Recurrent Otitis Media During Childhood. Acta Otolaryngol 1999;119(8):867-873.
  12. Tikkanen S, et al. Status of children with cow’s milk allergy in infancy by 10 years of Age. Acta Paediatr 2000; 89(10):1174-1180.
  13. Woicka-Kolejwa K, et al. Food allergy is associated with recurrent respiratory tract infections during childhood. Postepy Dermatol Alergol 2016;33(2):109-113.
  14. Meyer, R. Nutritional disorders resulting from food allergy in children. Pediatr Allergy Immunol. 2018; 29:689– 704.
  15. ASCIA 2017 – Food Allergy Clinical Update for Dietitians. Received from https://etrainingdiet.ascia.org.au/login/index.php on 5th June 2019.
  16. Robbins et al. Milk allergy is associated with decreased growth in U.S. children. J Allergy Clin Immunol. 2014 December; 134(6):1466-1468.
  17. Christie L, Hine RJ, Parker JG, Burks W. Food allergies in children affect nutrient intake and growth. J Am Diet Assoc 2002: 102: 1648.
  18. US FDA. Food Allergies: What You Need to Know. Available at: https://www.fda.gov/food/buy-store-serve-safe-food/what-you-need-know-about-food-allergies (accessed August 2020).
  19. Heyman MB, et al. Committee on Nutrition. Lactose intolerance in infants, children, and adolescents. Pediatrics. 2006;118(3):1279-86.
  20. Francavilla R et al. Effect of lactose on gut microbiota and metabolome of infants with cow’s milk allergy. Pediatr Allergy Immunol 2012;23:420-427.
  21. NIH. Lactose intolerance. Available at: https://ghr.nlm.nih.gov/condition/lactose-intolerance#statistics (accessed August 2020).

IMPORTANT NOTICE:


Mothers should be encouraged to continue breastfeeding even when their babies have cow’s milk protein allergy. This usually requires qualified dietary counseling to completely exclude all sources of cow’s milk protein from the mothers’ diet. If a decision to use a special formula intended for infants is taken, it is important to follow the instructions on the label. Unboiled water, unboiled bottles or incorrect dilution can make babies ill. Incorrect storage, handling, preparation and feeding can eventually lead to adverse effects on the health of babies. Formula for special medical purposes intended for infants must be used under medical supervision.