Acta Paediatr. 2015 Dec 15.
Cow’s milk protein allergy and common gastrointestinal symptoms in infants.
In their review on the management of functional gastrointestinal disorders and cow’s milk protein allergy (CMPA) in infants (1), Vandenplas et al discuss infantile colic, regurgitation and constipation and the relationship between these symptoms, which are common in infants, to CMPA. The group starts by stating that CMPA can only be diagnosed by a double blind placebo controlled food challenge. However, this can be replaced by an open challenge in infants as long as the challenge is performed under the supervision of an experienced team (2, 3). The authors acknowledge that sensitisation to cow’s milk indicates possible CMPA and the need for a challenge to reach a proper diagnosis of CMPA. But then they make some some statements that I feel blur the message (1).
Constipation; Cow’s milk protein allergy; Extensively hydrolysed formula, Infantile colic; Regurgitation