[A survey of milk reintroduction in children with cow milk protein allergy in pediatric departments of French hospitals].
The outcome of cow milk allergy (CMA) usually progresses to acquisition of tolerance, allowing a normal diet. This study conducted in France aimed to survey practices of milk reintroduction after an exclusion diet. A questionnaire was sent to 278 pediatric centers, exploring the reintroduction procedure in the 3 main types of CMA and in patients with persistent allergy. The response rate was 27%, 53% for tertiary centers and 23% for secondary centers. Cow's milk is reintroduced at a median age of 12months, and after 6months of exclusion diet whatever the type of allergy. In about half the centers, Prick-Tests and specific IgE are tested before milk reintroduction, but the procedure in case of a positive test differs between centers. Procedures are similar regarding the type of milk, the quantity, the place (home or hospital), the presence of an intravenous line, and the time before a second reintroduction. A desensitization procedure is proposed in 43% of centers in case of persistent allergy, after 2 reintroduction failures, and at a median age of 2.5years. Milk reintroduction procedures are similar to those for oral challenge for the diagnosis of CMA but with differences between centers.
Gastro-entérologie et nutrition pédiatriques, hôpital des Enfants, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
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Gastro-entérologie et nutrition pédiatriques, hôpital des Enfants, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France; Inserm U897 ISPED, unité d'épidémiologie de la nutrition, université Bordeaux 2, 33077 Bordeaux, France. Electronic address: thierry.lamireau@chu-bordeaux.fr.
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D000818:Animals; D002648:Child; D002675:Child, Preschool; D005602:France; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007223:Infant; D008892:Milk / Q000009:adverse effects*; D016269:Milk Hypersensitivity / Q000276:immunology*; D008894:Milk Proteins / Q000009:adverse effects*; D010372:Pediatrics; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012882:Skin Tests / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
D008894:Milk Proteins; D007073:Immunoglobulin E