Background: While cow’s milk allergy is one of the most common food allergies, mislabelling non-allergic infants as having
cow’s milk allergy (CMA) is more common. Despite that, characteristics of families and infants with mislabeled-CMA are lacking.
Methods: Using a prospective population-based study, infants with any possible adverse reaction to cow’s milk (n=381) were identified from a cohort of 13,019 infants followed from birth. Infants underwent a detailed history, skin prick tests and oral food
challenge when indicated. Infants with symptoms in which the causative relationship to cow’s milk protein was excluded were compared to infants with IgE-mediated cow’s milk allegy and to a control group and followed for 2-5 years.
Results: Overall 243 infants (1.87%) with mislabelled CMA were identified. Compared to 66 infants with IgE-mediated, those with
mislabeled-CMA presented earlier, and with symptoms involving usually a single organ system. MD-diagnosed atopic dermatitis was associated with mislabelled CMA (p<0.001), primarily with skin rashes, compared to control infants. Higher maternal and paternal education were also associated with mislabelled CMA (p=0.007 and p=0.035, respectively) compared to control infants, manifesting primarily in non-specific symptoms.
Conclusions: Mislabelled CMA typically presents within the first 3 months of life involving a single organ. Infant’s atopic dermatitis and higher parental academic education are associated with misalbelled reactions. Better parental and physician awareness of the importance in objectively diagnosing milk allergy is required to avoid mislabelling infants as cow’s milk allergic and to prevent potential nutritional deficiencies.
This research was published in Arch Dis Child 2013;98(6):408-12
