Diagnostic approach and management of cow's-milk protein allergy in infants and children: ESPGHAN GI Committee practical guidelines

Journal of Pediatric Gastroenterology and Nutrition
S KoletzkoEuropean Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Abstract

This guideline provides recommendations for the diagnosis and management of suspected cow's-milk protein allergy (CMPA) in Europe. It presents a practical approach with a diagnostic algorithm and is based on recently published evidence-based guidelines on CMPA. If CMPA is suspected by history and examination, then strict allergen avoidance is initiated. In certain circumstances (eg, a clear history of immediate symptoms, a life-threatening reaction with a positive test for CMP-specific IgE), the diagnosis can be made without a milk challenge. In all other circumstances, a controlled oral food challenge (open or blind) under medical supervision is required to confirm or exclude the diagnosis of CMPA. In breast-fed infants, the mother should start a strict CMP-free diet. Non-breast-fed infants with confirmed CMPA should receive an extensively hydrolyzed protein-based formula with proven efficacy in appropriate clinical trials; amino acids-based formulae are reserved for certain situations. Soy protein formula, if tolerated, is an option beyond 6 months of age. Nutritional counseling and regular monitoring of growth are mandatory in all age groups requiring CMP exclusion. REEVALUATION: Patients should be reevaluated every 6 to 12 ...Continue Reading

References

Aug 6, 1992·The New England Journal of Medicine·H A SampsonJ P Rosen
Jan 1, 1993·Dermatology : International Journal for Clinical and Investigative Dermatology
Nov 14, 1997·Acta Paediatrica·D de BoissieuC Dupont
Oct 15, 1998·The New England Journal of Medicine·G IaconoA Carroccio
Dec 16, 1998·The American Journal of Clinical Nutrition·K D SetchellJ E Heubi
Jan 8, 1999·The Journal of Pediatrics·E IsolauriT Arvola
May 6, 1999·The Journal of Pediatrics·R S ZeigerG Wilson
May 10, 2001·The Journal of Allergy and Clinical Immunology·H A Sampson
Oct 9, 2001·Pediatrics·P L Lucassen, W J Assendelft
Dec 14, 2001·The Journal of Allergy and Clinical Immunology·B NiggemannU Wahn
Feb 14, 2002·The Journal of Allergy and Clinical Immunology·Jonathan M SpergelChris A Liacouras
Aug 17, 2002·The Journal of Pediatrics·Delphine de Boissieu, Christophe Dupont
Apr 12, 2003·Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology·Arne HøstKarin Plesner
Jan 8, 2005·The Journal of Allergy and Clinical Immunology·Scott H Sicherer
Mar 24, 2005·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·S Celik-BilgiliB Niggemann
Sep 17, 2005·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·A VerstegeB Niggemann
Oct 4, 2005·The British Journal of Nutrition·Kirsi LaitinenErika Isolauri
Apr 28, 2006·Journal of Pediatric Gastroenterology and Nutrition·UNKNOWN ESPGHAN Committee on NutritionDominique Turck
May 4, 2006·Current Opinion in Allergy and Clinical Immunology·Ralf G Heine
Oct 13, 2006·The Journal of Allergy and Clinical Immunology·Anne MehlBodo Niggemann
Feb 28, 2007·Hematology·M FerraraL Capozzi
May 10, 2007·Current Opinion in Allergy and Clinical Immunology·Jonathan M Spergel
Jun 15, 2007·Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology·Carlo AgostoniMarcello Giovannini
Jul 14, 2007·The Journal of Allergy and Clinical Immunology·Roberto J RonaCharlotte Madsen
Oct 16, 2007·The Journal of Allergy and Clinical Immunology·Justin M SkripakRobert A Wood
Nov 22, 2007·Journal of Pediatric Gastroenterology and Nutrition·Bodo Niggemann, Kirsten Beyer
Dec 29, 2007·Journal of Pediatric Gastroenterology and Nutrition·Carlo AgostoniJohannes van Goudoever
Jan 3, 2008·Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology·B NiggemannU Wahn
Jan 22, 2008·The Medical Journal of Australia·Andrew S KempUNKNOWN Australian consensus panel
May 3, 2008·Pediatrics·Jatinder BhatiaUNKNOWN American Academy of Pediatrics Committee on Nutrition
Jul 8, 2008·The Journal of Allergy and Clinical Immunology·Ute StadenKirsten Beyer

❮ Previous
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Citations

Aug 13, 2013·Current Allergy and Asthma Reports·Merja NermesErika Isolauri
Oct 1, 2013·Nutrients·Carlo CatassiAlessio Fasano
Apr 5, 2014·Current Opinion in Allergy and Clinical Immunology·Carina Venter, Marion Groetch
May 24, 2014·International Archives of Allergy and Immunology·Stefano Miceli SopoSerena Monaco
Jan 16, 2014·Clinical Reviews in Allergy & Immunology·Yitzhak KatzPedro Alarcon
Sep 29, 2015·Expert Review of Gastroenterology & Hepatology·Yvan Vandenplas, Bruno Hauser
Dec 19, 2015·The World Allergy Organization Journal·Y Vandenplas
Dec 19, 2015·The World Allergy Organization Journal·Sten Dreborg
Mar 18, 2015·The British Journal of Nutrition·Christophe DupontUNKNOWN Cow's Milk Allergy Modified by Elimination and Lactobacilli study group
Mar 18, 2015·Clinical and Translational Allergy·Rosan MeyerNeil Shah
Jul 9, 2014·Mediators of Inflammation·Juandy JoElena Sandalova
Apr 12, 2016·Pediatric Annals·Hetu Parekh, Sami L Bahna
Sep 14, 2016·Iranian Red Crescent Medical Journal·Esma Altinel AcogluSaliha Senel
Jul 22, 2016·Journal of Medical Economics·Mauro Batista de MoraisAna Paula Moschione Castro
May 10, 2015·The Journal of Allergy and Clinical Immunology·Anna Nowak-WęgrzynSibylle Koletzko
Dec 22, 2016·Nature Reviews. Gastroenterology & Hepatology·Anna Nowak-WegrzynGideon Lack
Feb 24, 2016·JPEN. Journal of Parenteral and Enteral Nutrition·Sara DiLauroDeborah L O'Connor
Oct 22, 2016·Journal of Pediatric Gastroenterology and Nutrition·Jon VanderhoofDelphine de Boissieu
Jul 21, 2016·Journal of Pediatric Gastroenterology and Nutrition·Roberto Berni CananiCarlo Agostoni
Mar 5, 2017·Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology·George Du ToitGideon Lack
Jun 10, 2014·Allergy·A MuraroUNKNOWN EAACI Food Allergy and Anaphylaxis Guidelines Group
Jul 26, 2014·Pediatric Gastroenterology, Hepatology & Nutrition·Yvan VandenplasPaul-Henri Torbey
Apr 11, 2017·Korean journal of pediatrics·Goun JeongSon Moon Shin
Sep 2, 2016·Clinical Pediatrics·Grace Mousan, Deepak Kamat
Nov 3, 2017·Journal of Pediatric Gastroenterology and Nutrition·François PayotNicolas Kalach
Aug 10, 2017·Nutrients·Alessandra MazzocchiCarlo Agostoni
Sep 19, 2017·Journal of Pediatric Gastroenterology and Nutrition·Noora HelinLaura Merras-Salmio
Feb 27, 2018·Journal of Pediatric Gastroenterology and Nutrition·Janne A KvammenChristine Henriksen
Nov 4, 2017·European Journal of Gastroenterology & Hepatology·Chaowapong JarasvaraparnKaren D Crissinger

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