Cow's Milk Allergy (CMA) Symptoms

What is a common symptom of cow's milk allergy (CMA) affecting the gastrointestinal tract?

What is an essential first step in diagnosing cow's milk allergy?

How long may it take for symptoms to improve in infants with non-IgE mediated CMA following a diagnostic elimination diet?

Which of the following formulas is supported by evidence for use in a diagnostic elimination diet for CMA?

Under what condition might infants with severe atopic dermatitis see improvement after dietary changes?

What factors should be included in the patient's history when assessing for CMA?

What can trigger reactions in cow's milk allergy aside from milk ingestion?

What is a potential risk of over-diagnosis of cow's milk allergy in children?

Symptoms and Signs of Cow's Milk Allergy (CMA)

Symptoms span multiple systems: skin (urticaria, angioedema, eczema), gastrointestinal (vomiting, abdominal pain, constipation), and respiratory (rhinorrhea, sneezing, dyspnea).
Severe reactions can lead to systemic issues like cardiovascular collapse.
Reactions primarily occur after milk ingestion, but can also result from inhalation or skin contact with milk.

Diagnosis of CMA

Diagnosis begins with an allergy-focused clinical history and a thorough physical examination.
Important to collect information about the infant’s feeding practices and any personal or family history of allergic diseases.

Elimination Diet Techniques

Non-IgE mediated CMA requires a diagnostic elimination diet lasting 2–4 weeks before reintroduction of milk.
IgE-mediated allergies may have a shorter elimination period of 1–2 weeks.
Recovery is typically faster in IgE-mediated allergies compared to non-IgE mediated cases.

Improvement Timelines

Improvement in infants with severe atopic dermatitis may take 6 to 8 weeks, aligning with natural disease progression.

Evidence for Formulas in CMA Management

Cow's milk-based extensively hydrolyzed formulas (eHFs) are recommended for diagnostic elimination diets.
Hydrolyzed rice formulas (HRFs) and soy formulas may also be beneficial, but lack sufficient evidence for recommendation.

Over-Diagnosis Concerns

Over-diagnosis of CMA can occur in children who exhibit symptoms due to other conditions, leading to unnecessary elimination diets and potential harm.

This quiz covers the various symptoms and signs associated with Cow's Milk Allergy (CMA). Participants will learn about the effects on skin, gastrointestinal, and respiratory systems, as well as potential systemic reactions. Understanding these symptoms is crucial for proper diagnosis and management of CMA.