title: Cow's milk allergy: evidence-based diagnosis and management for the practitioner.
abstract: This review summarizes current evidence and recommendations regarding cow's milk allergy (CMA), the most common food allergy in young children, for the primary and secondary care providers. The diagnostic approach includes performing a medical history, physical examination, diagnostic elimination diets, skin prick tests, specific IgE measurements, and oral food challenges. Strict avoidance of the offending allergen is the only therapeutic option. Oral immunotherapy is being studied, but it is not yet recommended for routine clinical practice. For primary prevention of allergy, exclusive breastfeeding for at least 4 months and up to 6 months is desirable. Infants with a documented hereditary risk of allergy (i.e., an affected parent and/or sibling) who cannot be breastfed exclusively should receive a formula with confirmed reduced allergenicity, i.e., a partially or extensively hydrolyzed formula, as a means of preventing allergic reactions, primarily atopic dermatitis. Avoidance or delayed introduction of solid foods beyond 4-6 months for allergy prevention is not recommended.
  
  
  CONCLUSIONS
  For all of those involved in taking care of children's health, it is important to understand the multifaceted aspects of CMA, such as its epidemiology, presentation, diagnosis, and dietary management, as well as its primary prevention.
authors.affiliation: Hospital Italiano de Buenos Aires, Buenos Aires, Argentina, Carlos.lifschitz@hospitalitaliano.org.ar.
authors.forename: Carlos
authors.initials: C
authors.lastname: Lifschitz
authors.forename: Hania
authors.initials: H
authors.lastname: Szajewska
mesh_terms: D000818:Animals; D002648:Child; D002675:Child, Preschool; D019317:Evidence-Based Medicine; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007167:Immunotherapy; D007223:Infant; D041943:Infant Formula / Q000737:chemistry; D007231:Infant, Newborn; D008892:Milk / Q000009:adverse effects*; D016269:Milk Hypersensitivity / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy*; D012882:Skin Tests
chemical_list: D007073:Immunoglobulin E