cow's milk protein allergy treatment

Payot, F. Cow’s milk protein allergy (CMPA) is the abnormal response to proteins found in cow’s milk or products containing milk proteins. Payot, François Milk allergy is an adverse immune reaction to one or more proteins in cow's milk.When allergy symptoms occur, they can occur rapidly or have a gradual onset. Volume 44, Issue 5, May 2014, Pages: 642-672 To access the full article please click here Summary. The frequency of reaction to cow milk protein is between 5-15%. and Cow’s milk allergy (CMA) is thought to affect 2–3% of infants. Dupont, Christophe Meulenbroek, Laura A. P. D. The immune system does not recognise these peptides as cow’s milk protein in 90-95% of infants with non-IgE CMA, and the EHF is well tolerated. Arato, A. Koletzko S, Niggemann B, Arato A et al. Soya or goats milk formula are not recommended as treatment options for cow’s milk allergy in infants: 50 – 66% of infants will have immune reactions similar to those in cow’s milk allergy. Exclusive breast-feeding may also protect babies from developing an allergy to cow's milk protein … (Syndifrais), D. D. (Nestlé), R. H. (Danone), J. G. (Danone), J. P. G. (Danone, Mead-Johnson, Sodilac), O. G. (Danone, Mead-Johnson), M. V. (Danone) and D. T. (Danone, Mead-Johnson, Nestlé). Providing information to parents at the different stages of the disease management is crucial, especially to facilitate the dialogue with the various settings that accommodate the allergic child, such as the school(Reference Hu, Grbich and Kemp99). Niggemann, B. Cow milk allergy is clinically an abnormal immunological reaction to cow milk proteins, which may be due to the interaction between one or more milk proteins and one or more immune mechanisms, and resulting in immediate IgE-mediated reactions. Children with CMPA should be able to attend school and follow their educational curriculum or be accommodated in the community while adhering to their elimination diet. The immune system normally protects our bodies from harmful pathogens like bacteria and viruses. Cow’s milk protein allergy (CMPA) is the most common food allergy in babies. Treatment options for cow’s milk allergy in infancy depend on the severity of symptoms and whether breast, formula or combination feeding is the preferred choice for parents. Milk allergy is an adverse immune reaction to one or more proteins in cow's milk.When allergy symptoms occur, they can occur rapidly or have a gradual onset. 1 Sensitivity can occur to more than one type of milk protein, and cross-reactivity with other animal milk proteins such as goats milk is very common. Dietary treatment of cows' milk protein allergy in childhood: a commentary by the Committee on Nutrition of the French Society of Paediatrics, Nutritional consequences of cows' milk protein allergy, Dietary management of cows' milk protein allergy before the onset of complementary feeding, Recommendations for the use of hydrolysates by expert committees and scientific societies, Reimbursement of extensively hydrolysed formula and amino acid-based formula, Introduction of complementary feeding in patients with cows' milk protein allergy, Nutritional consequences of elimination diets, Nutritional efficacy of substitute formulae, Addition of compounds presumed to be active on the allergy, Variable duration and frequent incomplete recovery from a cows' milk protein allergy, Milk, oral food challenge and the adaptation of the duration and nature of the elimination diet for the individual, Progressive normalisation of diet: difficulties in acceptability, Tolerance induction and immunotherapy (in specialised units), Dietary management of cows' milk protein allergy. Oliver, Jeffery S. Unlike milk allergy, intolerance doesn't involve the immune system. Therefore, soy-based formulas should not be used for the treatment of cow's milk protein intolerance. 1 The cost and reimbursement by the health care system of cows' milk and rice protein-based eHF, AAF, and soya protein-based IF varies from one member-state to another one in the EU. For mums whose weight is low or who struggle to eat enough, or for mums who are having difficulty coping should seek further advice if they wish to continue breast feeding. Treatment. Whey based formulas tend to empty from a baby’s tummy more quickly and may help improve symptoms of reflux. Objectives: This guideline provides recommendations for the diagnosis and management of suspected cow's-milk protein allergy (CMPA) in Europe. This is very likely to have a strong influence in the management of CMPA, especially in the choice of substitute formulae. Sabouraud-Leclerc, D. A milk protein allergy most often happens in babies who are fed cow’s milk formula. Garssen, Johan 1 Spontaneous remission of CMPA is the most common outcome during the first 2 to 3 years. Venter, Carina The former may include anaphylaxis, a potentially life-threatening condition which requires treatment with epinephrine among other measures. Lachaux, Alain 2 Research and regulatory needs. It must be emphasised that the initiation of an elimination diet, which is consistent with the recognition of a risk resulting from the accidental ingestion of dairy products, must be accompanied by a thoughtful consideration of the conditions of implementation of treatment with epinephrine in situations of a possible anaphylactic shock or acute laryngeal oedema. 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. Allergy to cow milk protein in children is seen between 2-6%. Treatment options for cow’s milk allergy is the 3rd in this 5-part blog series on non-IgE Cow’s Milk Allergy in Infancy and is best read following confirming a diagnosis of cow’s milk allergy.. [Dietetic treatment of cow's milk protein allergy]. An allergy to cow’s milk and related dairy products affects one in 50 in babies and is different to lactose intolerance. Cow’s milk allergy can be regarded as an integrated model of food allergy as cow’s milk entailing a wide spectrum of clinical manifestations and is usually one of the first food proteins that infants are exposed to in the Western Hemisphere [1, 2]. and JPGN;55;2;August 2012. Vannerom, Yves Chabbert, A. Introduction. 9 The diet must be carefully explained to parents, which includes education about how to read labels. The reported prevalence of CMPA varies owing to possible misinterpretations of presumed reactions to milk and diagnostic criteria, and is often overestimated. Food allergy: from the loss of tolerance induced by exclusion diets to specific oral tolerance induction, Food allergy in the child: an exploratory study on the impact of the elimination diet on food neophobia (in French), Specific oral tolerance induction in food allergy, A protocol for oral desensitization in children with IgE-mediated cow's milk allergy, Specific oral tolerance induction in children with very severe cow's milk-induced reactions, Specific oral tolerance induction increased tolerance to milk in children with severe cow's milk allergy. Soulaines, Pascale The widely available range of milks such as soya, oat, rice and nut milks are low in nutritional value and make a poor contribution to mums’ nutritional needs. 12 Compliance with dietary recommendations, their tolerance and efficacy (disappearance of symptoms and adequate growth) should be regularly assessed. Cow’s-milk protein (CMP) is the leading cause of food allergy in infants and young Grathwohl, Dominik Soulaines, Pascale Treatment options for cow’s milk allergy in infancy depend on the severity of symptoms and whether breast, formula or combination feeding is the preferred choice for parents. Goats’ milk has proteins which are very similar to the cows’ milk protein and so changing to goat milk is very unlikely to help in a baby with CMPA. The guidelines were developed by discussion based on existing national recommendations and standards, clinical experience and, whenever possible, evidence from the literature. Diagnostic approach and management of cow’s-milk protein allergy in infants and children: ESPGHAN GI Committee Practical Guidelines. It is estimated to affect around 7% of babies under 1, though most children grow out of it by the age of 5. Cow’s-milk protein (CMP) is the leading cause of food allergy in infants and young 5 The spontaneous recovery from CMPA is not always a complete recovery, and the daily dose of milk/dairy products tolerated by the child may be limited. Kalach, Nicolas Cow’s milk protein allergy (CMPA) is the most common food allergy in babies. Kerzner, Benny Cow’s milk protein allergy (CMPA) is the abnormal response to proteins found in cow’s milk or products containing milk proteins. A milk protein allergy most often happens in babies who are fed cow’s milk formula. Mulier, Sandra Staiano, A. It is one of the commonest food allergies in children less than 2years. Fig. Cows’ milk protein allergy (CMPA) in infants. CMPA occurs when the body’s immune system abnormally reacts to a protein in the milk of cows and some other animals. Moore, Nancy This site uses Akismet to reduce spam. Alonso-Lebrero, E. Cow milk allergy is clinically an abnormal immunological reaction to cow milk proteins, which may be due to the interaction between one or more milk proteins and one or more immune mechanisms, and resulting in immediate IgE-mediated reactions. Echeverría-Zudaire, L. A Swedish study has reported a method of group therapeutic education in a paediatric health centre(Reference Mikkelsen, Lissner and Borres100). It usually occurs in babies younger than 1 year of age. Cow’s Milk Protein Allergy (CMPA) in Children Introduction ow’s milk protein allergy is an abnormal immune response to cow’s milk protein. Food allergy is defined as an adverse health effect arising from a specific immune response that occurs reproducibly following exposure to a given food (1). Cow's milk allergy and lactose intolerance. and Cow's milk protein allergy/cows' milk allergy . Learn how your comment data is processed. The first treatment option is an extensively hydrolysed formula (EHF), in which the proteins are hydrolysed, “digested” or  broken down into short chains called peptides. Bradatan, Elena Cow's milk allergy is a reproducible immune-mediated allergic response to one or more proteins in cow's milk. The guidelines were developed by discussion based on existing national recommendations and standards, clinical experience and, whenever possible, evidence from the literature. Cows' milk protein allergy If you are worried that your baby might be intolerant of or allergic to infant formula, you should contact your GP. Cow's Milk Allergy Clinical & Experimental Allergy. Current estimated prevalence is between 2-7.5% of infants affected, most present within the first 6months of life but Planoudis, Yannis B., J. L. B., A. Many children who have been allergic to cow's milk protein become tolerant to it by the time they are 5 years old. Antonson, Dean L Volume 44, Issue 5, May 2014, Pages: 642-672 To access the full article please click here Summary. 4 If necessary, repeated OFC allow avoiding the unnecessary prolongation of the elimination diet. The authors had no personal, commercial, political or academic conflicts of interest. The NHS website has lots of information on cow’s milk protein allergy (also called cow’s milk allergy or CMA), including diagnosis and treatment of both CMA and lactose intolerance Their summary of symptoms and treatments are: 2013. 3 If the infant is not breast fed or if the mother cannot or no longer wishes to breast feed, the first choice is an extensive hydrolysate (eHF) of CMP. (Danone, Mead-Johnson), A. defined as adverse reactions to cow's milk that can be reproduced and are immune-mediated (1,2,3,4,5,6) are immunoglobulin E (IgE)-mediated, cell-mediated (non-IgE), or the combination of the two; estimated that up to 4.9% of children suffer from cow’s milk protein allergy (CMPA) (5) and The main treatment of CMPI is to remove cow's milk protein from the diet Typically, the diet starts with an extensively hydrolyzed formula which is a formula of broken down proteins Soy milk / goat's milk / sheep's milk are not appropriate alternatives in most children. Chatenoud, Lucienne Kalach, Nicolas Consensus Statement on Diagnosis, Treatment and Follow-Up of Cow's Milk Protein Allergy Among Infants and Children in Turkey Turk J Pediatr . Ask detailed questions about signs and symptoms 2. Heuschkel, R. Kalach, Nicolas Mum needs to follow a well-balanced but strictly cow’s milk free diet at a time when her needs for nutrition are especially high. Wedig, Rita Thomas Collardeau, S. Cow’s Milk Protein Allergy (CMPA) in Children Introduction ow’s milk protein allergy is an abnormal immune response to cow’s milk protein. Broadly, two types of formula are available as treatment options for cow’s milk allergy in infancy – peptide (EHF) or amino acid (AA). for Fe, Ca and vitamin D) during an elimination diet. 1 Decision tree summarising the recommendations of the Nutrition Committee of the French Society of Paediatrics. In the first 6 months, cow milk allergy only in breast milk is seen in five of a thousand children. In Australia and New Zealand around 2 per cent (1 in 50) infants are allergic to cow's milk and other dairy products. The OFC showed an increase in the milk dose inducing a reaction after 6 months, and the diet could be normalised in 50 % of patients(Reference de Boissieu and Dupont97). Shah, Neil CMP, cows' milk protein; CMPA, CMP allergy; eHF, extensively hydrolysed formula; AAF, amino acid-based formula. It is one of the commonest food allergies in children less than 2years. 11 Some products (e.g. what’s the difference between lactose intolerance and cow’s milk allergy? Many children who have been allergic to cow's milk protein become tolerant to it by the time they are 5 years old. Guénard-Bilbault, Lydie The contribution made by each author was as follows: C. D. was the main contributor; J. P. C., D. d. B., M. V. and D. T. were responsible for additional writing and reviewing of the manuscript; A. Talbotec, Cecile Anaphylaxis 2013. Cow’s milk contains proteins which are essential for growth. Dupont, Christophe Martorell-Aragonés, A. 5 To date, very few products (Nutramigen®, Pregestimil®, Neocate®, Nutramigen AA®, Blemil Arroz®, Althéra®) have been shown efficient, both in terms of allergy and growth. [Article in French] Dupont C(1), Chouraqui JP, de Boissieu D, Bocquet A, Bresson JL, Briend A, Darmaun D, Frelut ML, Ghisolfi J, Girardet JP, Goulet O, Hankard R, Rieu D, Rigo J, Vidailhet M, Turck D; Comité de nutrition de la Société française de pédiatrie. Hondmann, Dirk H. 6 In the case of anaphylaxis, eosinophilic oesogastroenteropathy, failure to thrive or severe colitis, the use in the first intention of either an eHF or an AAF is a valid option. Treatment options for cow’s milk allergy is the 3rd in this 5-part blog series on non-IgE Cow’s Milk Allergy in Infancy and is best read following confirming a diagnosis of cow’s milk allergy. Cow's milk allergy (CMA) is the most common food allergy in young children but is uncommon in adults . Cow’s milk allergy can be regarded as an integrated model of food allergy as cow’s milk entailing a wide spectrum of clinical manifestations and is usually one of the first food proteins that infants are exposed to in the Western Hemisphere [1, 2]. It is most commonly seen during the first year of life. 7 Rice protein-based eHF offer an alternative to eHF from animal origin. Koletzko S, Niggemann B, Arato A et al. 2014. Financial conflicts of interest (research funding, payment for lectures or travel, consultancies or company support for staff) are reported by C. D. (Danone, Nestlé, Novalac, Sodilac), J. P. C. (Danone, Mead-Johnson, Nestlé, Sodilac), D. d. B. This review received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. Very few adults are allergic to cow’s milk. It presents a practical approach with a diagnostic algorithm and is based on recently published evidence-based guidelines on CMPA. (Danone, Nestlé, Novalac, Sodilac), J. L. B. Alternative formulas for the cow’s milk allergic infant 2016. 1 If an infant displays clinical symptoms of CMPA during exclusive breast-feeding, the mother should continue to breast feed, while eliminating from her own diet all foods containing CMP, which must lead to the rapid disappearance of symptoms in the infant within 2–3 weeks. and defined as adverse reactions to cow's milk that can be reproduced and are immune-mediated (1,2,3,4,5,6) are immunoglobulin E (IgE)-mediated, cell-mediated (non-IgE), or the combination of the two; estimated that up to 4.9% of children suffer from cow’s milk protein allergy (CMPA) (5) Cow’s Milk Protein Allergy and Lactose Intolerance - Guide to Diagnosis and Treatment in Primary Care This guide is to help clinicians appropriately diagnose cow’s milk protein allergy (CMPA) and lactose intolerance and to ensure that the correct alternative infant milk is given for the optimum length of time, based on age and symptoms. and and Decision tree summarising the recommendations of the Nutrition Committee of the French Society of Paediatrics. Current EHF formulas are available with or without lactose (the milk sugar); casein (curds) or whey based protein; first or second (follow-on) milks with added iron and calcium. Steenhout, Philippe Hankard, Régis While cow’s milk is the most common trigger of a milk allergy, even the milk from buffalo, goats, sheep, and other mammals can cause an allergic response. As an expensive option (£30 per tin) careful consideration is given to its prescription. 8 Soya protein IF can be used after the age of 6 months, after ensuring a good clinical tolerance to soya. When food causes an allergic reaction, it isn't always easy to pinpoint what food is to blame. CMA affects 2 … Cow's milk protein allergy occurs in about 7% of babies who have formula milk, but in only about 0.5% of exclusively breast-fed babies, who also usually have milder reactions. Ludman S, Shah N, Fox AT. 2015. Ruemmele, F.M. and Martín-Muñoz, M.F. Juchet, A. and de Blay, Frédéric and Your email address will not be published. 3 Once the child reaches the age of 9–12 months, an OFC 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. An alternative source of calcium and protein is needed, to ensure adequate nutrition and growth, until cow’s milk can be safely reintroduced into the diet. Standardization of food challenges in patients with immediate reactions to foods-position paper from the European Academy of Allergology and Clinical Immunology, Eczematous reactions to food in atopic eczema: position paper of the EAACI and GA2LEN, Food protein-induced enterocolitis syndrome, Oral food challenge in children: an expert review. JPGN;55;2;August 2012. Cow’s Milk Allergy can be classified into either immediate-onset, or delayed-onset according to the timing of symptoms and organ involvement. The immune reaction may be immunoglobulin (Ig)E mediated, non-IgE mediated, or mixed. B. It usually occurs in babies younger than 1 year of age. Cow's Milk Allergy Clinical & Experimental Allergy. Valdesoiro-Navarrete, L. It is estimated to affect around 7% of babies under 1, though most children grow out of it by the age of 5. Symptoms requiring a more specialised formula BMJ 2013;347:f5424 2014. Lambers, Tim T. Tolia, Vasundhara Soya formulas have been prescribed in the past for CMPA but soya is also a common allergen, so this is no longer routinely advised. Cow's Milk Allergy (also known as Cow's Milk Protein Allergy or CMPA) is an abnormal response by the body’s immune (defence) system in which proteins in a food (in this case cow’s milk) are recognised as a potential threat. 2016;58(1):1-11. doi: 10.24953/turkjped.2016.01.001. Cow’s Milk Allergy can be classified into either immediate-onset, or delayed-onset according to the timing of symptoms and organ involvement. Cow’s milk protein allergy is a common condition that affects both breast fed and bottle fed infants. Baggs, Geraldine As many as 50% of children affected by cow's milk protein intolerance develop soy protein intolerance if they are fed with soy-based formulas. Borschel, Marlene W Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window). Nevot-Falcó, S. and Allergy testing in children: why, who, when and how? While cow’s milk is the most common trigger of a milk allergy, even the milk from buffalo, goats, sheep, and other mammals can cause an allergic response. Without such rigorous analysis, the elimination of … Specific oral tolerance induction with food in children: transient or persistent effect on food allergy? 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 modalities of implementing such constraints are now facilitated by self-injection pens, the use of which can be considered in the scenarios published in 2005(Reference Sicherer and Simons101). This guideline advises on the management of patients with cow’s milk allergy. 2 If clinical symptoms occur during weaning, the best option is to resume exclusive breast-feeding (without any elimination diet in the mother). The initial help of a dietitian seems essential. Introduction. Vandenplas, Y. Butel, Marie-José and The former may include anaphylaxis, a potentially life-threatening condition which requires treatment with epinephrine among other measures. defined as adverse reactions to cow's milk that can be reproduced and are immune-mediated (1,2,3,4,5,6) are immunoglobulin E (IgE)-mediated, cell-mediated (non-IgE), or the combination of the two; estimated that up to 4.9% of children suffer from cow’s milk protein allergy (CMPA) (5) If allergy is confirmed, management of cow’s milk allergy usually involves excluding cow’s milk and other dairy foods from the diet. CMA affects 2 … Louazon, T. Piquer-Gibert, M. Our aim was to develop guidance for general paediatricians and primary care physicians in diagnosing and managing cow’s milk protein allergy in infants. van Tol, Eric A.F. Joint Statement of the European Society for Paediatric Allergology and Clinical Immunology (ESPACI) Committee on Hypoallergenic Formulas and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition. Campeotto, Florence Food allergy is defined as an adverse health effect arising from a specific immune response that occurs reproducibly following exposure to a given food (1). The diagnosis of CMPA requires first the suspicion of diagnosis based on symptoms described in the medical history, and, second, the elimination of CMP from the infant's diet. 2012. Cow's milk protein allergy is one of the most common food allergies seen in children. medicines for oral use) may contain CMP. The alpha S1-casein protein that is present in cow’s milk is most often the cause of milk allergies. B., M. L. F. and D. R. declare that they have no conflicts of interest. Update on threshold doses of food allergens: implications for patients and the food industry, Detection of potentially allergenic material in 12 hydrolyzed milk formulas, Comparison of the residual allergenic activity of six different hydrolyzed protein formulas, Serum specific-IgE antibodies to peptides detected in a casein hydrolysate formula, Monoclonal and polyclonal antibodies against casein components of cow milk for evaluation of residual antigenic activity in 'hypoallergenic' infant formulas, Bovine beta-lactoglobulin levels in hydrolysed protein formulas for infant feeding, Safety and efficacy of a new extensively hydrolyzed formula for infants with cow's milk protein allergy, Allergic reactions to raw, pasteurized, and homogenized/pasteurized cow milk: a comparison. Bradatan, Elena Waligora-Dupriet, Anne-Judith About 10-15% of children allergic to cow's milk will also react to soya. Walsh, Joanne A. 2 The age of recovery varies depending on the child and the type of CMPA, whether it is IgE-mediated or not, with the former being more persistent. 2014. Mearin, M.L. The reported prevalence of CMPA varies owing to possible misinterpretations of presumed reactions to milk and diagnostic criteria, and is often overestimated. The signs and symptoms are nonspecific and may be difficult to objectify, and as the diagnosis requires cow’s milk elimination followed by challenge, often, children are considered cow’s milk allergic without proven diagnosis. Ludman S, Shah N, Fox AT. Have you keep a detailed diary of the foods you or your child eats 4. To evaluate whether you or your child has milk allergy, your doctor may: 1. Separate algorithms cover breast-fed and formula-fed infants. People who are allergic to cow’s milk can also be allergic to milk from other animals such as goats, sheep and buffalo. Calcium is of central importance for women’s bone health and iodine for foetal and infant brain development and function. Common signs and symptoms of milk protein intolerance or lactose intolerance include digestive problems, such as bloating, gas or diarrhea, after consuming milk or products containing milk. Dias, J.A. A cows’ milk allergy, also known as cows' milk protein allergy, can occur when cows' milk -- consumed by the mother of a breastfeeding baby or used in formula in bottle-feeding babies -- … The immune system normally protects our bodies from harmful pathogens like bacteria and viruses. Use complete milk protein hydrolysates in infants who cannot be breastfed. Most of these reactions are not allergies. and A double-blind placebo-controlled study in milk allergic children, Safety of casein hydrolysate formula in children with cow milk allergy, Antigenicity and allergenicity of cow milk hydrolysates intended for infant feeding, Allergenicity screening of “hypoallergenic” milk-based formulas, Hypoallergenicity of an extensively hydrolyzed whey formula, Safety of a new, ultrafiltrated whey hydrolysate formula in children with cow milk allergy: a clinical investigation, Determination of allergenicity to three cow's milk hydrolysates and an amino acid-derived formula in children with cow's milk allergy, Safety of a new extensively hydrolysed formula in children with cow's milk protein allergy: a double blind crossover study, Symptomatology and growth in infants with cow's milk protein intolerance using two different whey-protein hydrolysate based formulas in a primary health care setting, The efficacy of amino acid-based formulas in relieving the symptoms of cow's milk allergy: a systematic review, Allergy to extensively hydrolyzed cow's milk proteins in infants: safety and duration of amino-acid based formula, Prospective, controlled, multi-center study on the effect of an amino-acid-based formula in infants with cow's milk allergy/intolerance and atopic dermatitis, Hypoallergenicity and effects on growth and tolerance of a new amino acid-based formula with docosahexaenoic acid and arachidonic acid, A hydrolysed rice-based formula is tolerated by children with cow's milk allergy: a multi-centre study, The effect of a partially hydrolysed formula based on rice protein in the treatment of infants with cow's milk protein allergy, Soybean-based formulas in infant nutrition (in French), Soy protein infant formulae and follow-on formulae: a commentary by the ESPGHAN Committee on Nutrition, American Academy of Pediatrics Committee on Nutrition, Use of soy protein-based formulas in infant feeding, Soy allergy in infants and children with IgE-associated cow's milk allergy, Allergy to soy formula and to extensively hydrolyzed whey formula in infants with cow's milk allergy: a prospective, randomized study with a follow-up to the age of 2 years, Kwashiorkor in the United States: fad diets, perceived and true milk allergy, and nutritional ignorance, Food allergy as a risk factor for nutritional rickets, Milk allergy and vitamin D deficiency rickets: a common disorder associated with an uncommon disease, Identifying and managing cow's milk protein allergy, Guidelines for the use of infant formulas to treat cows milk protein allergy: an Australian consensus panel opinion, Management of cow's milk protein allergy in infants and young children: an expert panel perspective, Directive 2003/89/EC of the European Parliament and of the Council of 10 November 2003 amending Directive 2000/13/EC as regards indication of the ingredients present in foodstuffs, Beef allergy in children with cow's milk allergy; cow's milk allergy in children with beef allergy, Fixed food eruption caused by lactose identified after oral administration of four unrelated drugs, Probiotics may be unsafe in infants allergic to cow's milk, Cow's milk allergic children can present sensitisation to probiotics, Consumption of heat-treated egg by children allergic or sensitized to egg can affect the natural course of egg allergy: hypothesis-generating observations, Tolerance to extensively heated milk in children with cow's milk allergy, Pasteurization of milk proteins promotes allergic sensitization by enhancing uptake through Peyer's patches, Cross-reactivity between milk proteins of different animals, Comparisons of a chicken-based formula with soy-based formula in infants with cow milk allergy, A lamb-meat-based formula for infants allergic to casein hydrolysate formulas, A home-made meat-based formula for feeding atopic babies: a study in 51 children, Fatty acid deficiency profile in children with food allergy managed with elimination diets, Food allergies in children affect nutrient intake and growth, Bone mineral status in children with cow milk allergy, The nutritional and safety assessment of breast milk substitutes and other dietary products for infants: a commentary by the ESPGHAN Committee on Nutrition, Nutritional evaluation of protein hydrolysate formulas in healthy term infants: plasma amino acids, hematology, and trace elements, A follow-up study of nutrient intake, nutritional status, and growth in infants with cow milk allergy fed either a soy formula or an extensively hydrolyzed whey formula, Growth, tolerance and biochemical measures in healthy infants fed a partially hydrolyzed rice protein-based formula: a randomized, blinded, prospective trial, Growth of infants with IgE-mediated cow's milk allergy fed different formulas in the complementary feeding period, Period-specific growth, overweight and modification by breastfeeding in the GINI and LISA birth cohorts up to age 6 years, Short- and long-term effects of feeding hydrolyzed protein infant formulas on growth at < or = 6 y of age: results from the German Infant Nutritional Intervention Study, The acquisition of tolerance toward cow's milk through probiotic supplementation: a randomized, controlled trial, A prospective study of cow milk allergy in Danish infants during the first 3 years of life.

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