Cow's milk protein intolerance in infants under 1 year of age: a prospective epidemiological study.
Incidence and clinical manifestation of cow's milk protein intolerance (CMPI) were studied in 1158 unselected newborn infants followed prospectively from birth to 1 year of age. No food changes were required in 914 infants who were used as healthy controls. When CMPI was suspected (211 infants), diagnostic dietary interventions according to a standard protocol were performed. After exclusion of lactose intolerance, two positive cow's milk elimination/challenge tests were considered diagnostic of CMPI. Two hundred and eleven symptomatic infants were examined for possible CMPI. A large group of 80 infants improved on a lactose reduced formula. In 87/211 infants CMPI was excluded (sick controls). Finally CMPI was proven in 26 infants. The calculated incidence rate for CMPI was 2.8%. The principal symptoms in infants with CMPI were gastrointestinal, dermatological and respiratory in 50%, 31% and 19% respectively. A positive family history for atopy (first or second degree relatives) was more frequent in either CMPI infants (65%), or sick controls (63%) when compared to either healthy controls (35%) or infants improving on a low lactose formula (51%). Differences between patients with CMPI and sick controls were only found for the presence of atopy in at least 2 first degree relatives [(5/26 in CMPI infants and 4/87 in sick controls (P < 0.05)] and for multiorgan involvement [10/26 infants with CMPI as opposed to 12/87 in the sick control group (P < 0.02)]. These statistical differences are too weak to be of clinical value.
Schrander
J J
JJ
Department of Paediatrics, Academic Hospital Maastricht, The Netherlands.
van den Bogart
J P
JP
Forget
P P
PP
Schrander-Stumpel
C T
CT
Kuijten
R H
RH
Kester
A D
AD
D006801:Humans; D006967:Hypersensitivity / Q000235:genetics; D007223:Infant; D016269:Milk Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology*; D008894:Milk Proteins / Q000009:adverse effects* / Q000276:immunology; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies
D008894:Milk Proteins