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Misdiagnosed cow’s milk allergy in infants ‘potentially harmful’ - study

By Mark Astley+

30-May-2013

Parents and doctors must be more aware of the importance of objectively diagnosing milk allergies in infant to “prevent potential nutritional deficiencies,” according to a team of Israeli researchers.

The researchers - from the Assaf Harofeh Medical Center at the Sackler School of Medicine in Zerifin, Israel - studied a cohort of more than 13,000 Israeli infants from birth for between two to five years.

Through their research they identified 381 infants that were avoiding cow’s milk protein (CMP), of which 243 were found not to have a cow’s milk allergy (CMA).

According to the research report, Mislabelled cow’s milk allergy in infants: a prospective cohort study, misdiagnosing a case of CMA in an infant can lead to the adoption of “unwarranted and potentially harmful elimination diets.”

“Although cow’s milk allergy (CMA) is one of the most common food allergies, mislabelling non-allergic infants as being allergic to cow’s milk is more common,” said the study, which was published in the journal, Archives of Disease in Childhood.

“Better parental and physician awareness of the importance of objectively diagnosing milk allergy is required to avoid mislabelling of infants as being allergic to cow’s milk and to prevent potential nutritional deficiencies,” it said.

The researchers – led by Dr Arnon Elizur from the Institute of Allergy, Asthma and Immunology at the Assaf Harofeh Medical Center - identified infants with any possible adverse reaction to cow’s milk from a cohort of 13,019 Israeli infants.

The team contacted parents three months after birth, and every second month after that, to monitor feeding patterns.

Parents were also asked to contact an allergy clinic after any adverse reaction suspected of being related to maternal or infant consumption of CMP. Any parent noting a possible adverse reaction to CMP was invited for further evaluation.

Through this process, the researchers identified 381 infants that were avoiding CMP. Of these, tests found that 138 had an adverse health condition related to CMP, including 66 with an antibody-confirmed milk allergy. The remaining 243 were branded “mislabelled CMA.”

Parents of these “mislabelled” infants were encouraged to resume CMP-based feeding, and the infants were monitored for signs of CMA.

Elizur, A., Cohen, M., Goldberg, M. R., Rajuan, N., Katz, Y. Mislabelled cow's milk allergy in infants: a prospective cohort study. Arch. Dis. Child. 2013;98:408-412

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