Management of cow's milk protein allergy in infants and young children: an expert panel perspective

J Paediatr Child Health. 2009 Sep;45(9):481-6. doi: 10.1111/j.1440-1754.2009.01546.x. Epub 2009 Aug 21.

Abstract

Cow's milk protein allergy is a condition commonly managed by general practitioners and paediatricians. The diagnosis is usually made in the first 12 months of life. Management of immediate allergic reactions and anaphylaxis includes the prevention of accidental food ingestion and provision of an adrenaline autoinjector, if appropriate. By contrast, the clinical course of delayed food-allergic manifestations is characterised by chronicity, and is often associated with nutritional or behavioural sequelae. Correct diagnosis of these non-IgE-mediated conditions may be delayed due to a lack of reliable diagnostic markers. This review aims to guide clinicians in the: (i) diagnostic evaluation (skin prick testing or measurement of food-specific serum IgE levels; indications for diagnostic challenges for suspected IgE- and non-IgE-mediated food allergy), (ii) dietary treatment, (iii) assessment of response to treatment, (iv) differential diagnosis and further diagnostic work-up in non-responders, (v) follow-up assessment of tolerance development and (vi) recommendations for further referral.

Publication types

  • Review

MeSH terms

  • Anaphylaxis
  • Animals
  • Australia
  • Cattle
  • Child, Preschool
  • Clinical Protocols
  • Humans
  • Hypersensitivity, Immediate / chemically induced
  • Infant
  • Infant, Newborn
  • Milk Hypersensitivity / diagnosis
  • Milk Hypersensitivity / drug therapy*
  • Milk Hypersensitivity / physiopathology
  • Milk Proteins / adverse effects*

Substances

  • Milk Proteins