title: How mothers interact with children with suspected cow's milk allergy symptoms.
abstract: OBJECTIVE
  To characterize mother-child interaction in children with suspected gastrointestinally manifested cow's milk allergy (GI-CMA) and to explore factors associated with the parentally perceived symptoms.
  
  
  METHODS
  We invited a randomly selected group of children with suspected GI-CMA and their mothers to take part in a video recording of them playing together. The mother-child interaction was rated using the Emotional Availability Scales (EAS, 4th edition) and compared with national normative data.
  
  
  RESULTS
  Video recordings were conducted with 24 patients (15 girls and nine boys) with a median age of 10.1 months (range 2.1-20.5 months) undergoing a double-blind, placebo-controlled food challenge for cow's milk allergy. The EAS profile in the challenge negative group (17/24) was significantly different from the normative data. The scores for maternal sensitivity (p = 0.0049) and nonintrusiveness (p = 0.0192), together with child responsiveness (p = 0.0053) and involvement of mother (p = 0.0085), were all significantly lower when compared to the normative data. The dimensions of maternal nonhostility and structuring, as well as the scores of the challenge positive group, did not differ from the normative data.
  
  
  CONCLUSIONS
  Dysfunctional mother-child emotional interaction was frequent in young children with suspected GI-CMA ruled out by the cow's milk challenge. Appropriate psychological support should be considered.
authors.affiliation: Division of Pediatric Gastroenterology, Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Laura
authors.initials: L
authors.lastname: Merras-Salmio
authors.forename: Saara
authors.initials: S
authors.lastname: Salo
authors.forename: Anna S
authors.initials: AS
authors.lastname: Pelkonen
authors.forename: Mikael
authors.initials: M
authors.lastname: Kuitunen
authors.forename: Eeva T
authors.initials: ET
authors.lastname: Aronen
authors.forename: Mika J
authors.initials: MJ
authors.lastname: Mäkelä
authors.forename: Kaija-Leena
authors.initials: KL
authors.lastname: Kolho
mesh_terms: D000328:Adult; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology / Q000523:psychology*; D006801:Humans; D007223:Infant; D008297:Male; D008425:Maternal Behavior; D016269:Milk Hypersensitivity / Q000150:complications / Q000523:psychology*; D009034:Mother-Child Relations; D011446:Prospective Studies; D055815:Young Adult
keywords: Cow's milk allergy; Excessive crying; Food challenge; Mother-child interaction; Non-IgE-mediated CMA