Researchers are alarmed that too many European directives lead many parents to think that their baby is allergic to cow’s milk when this is not the case.
- Many parents think their baby has a milk allergy when it’s not.
- Common symptoms like crying or spitting up are often mistaken for signs of allergy
In children under two years of age, milk allergy is most common. It is divided into two categories: IgE-mediated allergies and non-IgE-mediated allergies. In the first case, it involves a component of the immune system known as IgE. Symptoms range from vomiting and hives to – very rarely – breathing difficulties called anaphylaxis. Non-IgE-mediated reactions may include vomiting, diarrhea, or excessive crying. However, according to a study recently published in the journal JAMA Pediatrics, these symptoms are often mistaken for normal reactions of many non-allergic babies. Also, if up to 14% of families think that their baby is allergic to cow’s milk, this is the case in only 1% of cases, alert the researchers who question the official directives in force in many countries. Europeans.
To reach these conclusions, researchers from Imperial College London (UK) and Sechenov University (Moscow, Russia) analyzed nine official guidelines on cow’s milk allergy published between 2012 and 2019 in various countries, mainly European. They then discovered that many guidelines cited symptoms such as excessive crying, regurgitation of milk and loose stools as indications of cow’s milk allergy. However, these are very common symptoms in healthy babies, scientists warn.
“Of the nine guidelines we studied, seven of them suggested including milder symptoms as an indication of non-IgE cow’s milk allergy, such as regurgitating milk, crying and rash, but many of these symptoms are present normally in babies, and will subside over time”comments Dr. Daniel Munblit, associate professor of pediatrics at Sechenov University and first author of the article.
Several conflicts of interest
What’s more, according to a recent study that followed more than 12,000 infants in nine European countries, less than 1% of them were allergic to cow’s milk. However, some studies have shown that up to 14% of families think their baby is allergic.
Expert analysis also shows that the prescription of specialized formulas for babies allergic to cow’s milk increased significantly between 2000 and 2018 in countries such as Australia and England, without there being any evidence of an increase in cow’s milk allergy. However, they discovered that eight out of ten authors of guidelines on the subject declared a conflict of interest.
Finally, the researchers’ analysis of 13 studies on the composition of breast milk suggests that less than one millionth of cow’s milk protein, beta-lactoglobulin, passes into breast milk, which would be too little to trigger a reaction in most allergic children.
A misdiagnosis with serious consequences
“Many infants labeled as being allergic to milk do not have this condition. Having a child suspected of being allergic to milk can be a stressful time for any family. A misdiagnosis of milk allergy can lead to the absence of another condition with similar symptoms, or to mothers abandoning breastfeeding by following an unnecessarily restrictive diet, or even complete cessation of breastfeeding. It can also lead families to pay unnecessarily for expensive specialized formulas”comments Dr. Robert Boyle, allergy consultant and senior author of the research from the National Heart and Lung Institute at Imperial College.
“Infant formula manufacturers may have an interest in promoting increased diagnosis of cow’s milk allergy, encouraging practitioners and parents to use specialized formula instead of cheaper formula, and potentially undermining trust women in breastfeeding, so that specialized formulas are used instead of breast milk”he continues.
“We must not only critically evaluate our current guidelines and decouple guideline development from those who might benefit from them, but also ensure that we give each family the best possible care by avoiding overdiagnosis of allergy to cow milk.”
How to diagnose milk allergy in France?
In France, an allergy to cow’s milk proteins with acute manifestations is identified by means of a blood test looking for specific immunoglobulins E (IgE), ie antibodies against cow’s milk proteins. A skin test can also be carried out at the office of the pediatrician or an allergist who will prick the skin superficially through a drop of milk and observe the reactions of itching, redness and swelling typical of the allergy. However, these two tests are most often negative for people with chronic allergies.
Another skin test, called a cow’s milk atopy test, studies delayed reactions. The principle of this test, available in pharmacies, is to put the milk in contact with the skin for 48 hours and to read the results after 72 hours.
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