Cow's milk allergy in children

doi:10.1136/bmj.b2275

Published 3 July 2009, doi:10.1136/bmj.b2275
Cite this as: BMJ 2009;339:b2275

Practice

Easily missed?

Cow’s milk allergy in children

John R Apps, foundation year 1, academic foundation programme¹, R Mark Beattie, consultant paediatric gastroenterologist²

¹ North Central Thames Foundation School Barnet and Chase Farm NHS Trust, Enfield, London EN2 8JL, ² Paediatric Medical Unit, Southampton General Hospital, Southampton SO16 6YD

Correspondence to: R M Beattie Mark.beattie@suht.swest.nhs.uk

The first 150 words of the full text of this article appear below.

A 3 month old infant, previously breastfed, presented with a urticarial rash, irritability, and vomitingshortly after introduction of cow’s milk formula. He wasreferred to a paediatric allergy clinic where skin prick testingand specific IgE testing were positive for cow’s milkprotein. The mother did not wish to continue breast feeding.The formula was changed to an extensively hydrolysed proteinfeed, and the symptoms resolved rapidly. Re-challenge with cow’smilk was deferred until 12 months and proceeded uneventfully.

An otherwise well and thriving 6 week old breast fed infantpresented with frequent stools, irritability, and perianal redness.Because physical examination was otherwise unremarkable andstool virology and culture were negative, he was referred tothe paediatric (gastroenterology) outpatients department. Dietaryprotein induced proctocolitis was suspected. Because cow’smilk is the most common allergen implicated in this condition,the mother was advised to stop taking all dairy products, . . . [Full text of this article]

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