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Overdiagnosis and industry influence: how cow’s milk protein allergy is extending the reach of infant formula manufacturers

BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k5056 (Published 05 December 2018) Cite this as: BMJ 2018;363:k5056

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Re: Overdiagnosis and industry influence: how cow’s milk protein allergy is extending the reach of infant formula manufacturers

This article and accompanying editorial on the overdiagnosis of CMPA rightly identifies a growing issue. One factor not mentioned is that the extensively-hydrolysed or amino-acid based formula milk often used in the management of CMPA are only available via prescription, which is course makes them free to infants in the UK.

CMPA can be difficult to diagnose with symptoms overlapping other conditions such as gastro-oesophageal reflux disease and infantile colic, and therefore a change in milk can be trialed with subsequent assessment of response based in part on parental feedback. Given a diagnosis of CMPA will save parents of formula-fed babies the expense of buying milk, estimated between £28 and £97 per month (1), there is a significant conflict of interest which could well be contributing to the increasing diagnoses.

1 – Costs of infant milks marketed in the UK, Published February 2017 by First Steps Nutrition Trust. Accessed online on 10/12/18 https://nhsforthvalley.com/wp-content/uploads/2014/03/Costs_of_Infant_Mi...

Competing interests: No competing interests

10 December 2018
Stuart D Barfield
Paediatric Registrar
Sheffield