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expert reaction to study looking at overdiagnosis of milk allergies in babies

A study published in Clinical & Experimental Allergy looks at frequency of guideline-defined cow’s milk allergy symptoms in infants.


Prof Adnan Custovic FMedSci, Professor of Paediatric Allergy, Imperial College London, said:

“Importantly, the figures in the press release do not reflect the prevalence of genuine milk allergies in babies –they are the artefact of a number of ‘symptoms’ which are perfectly normal in early life (e.g., colics, abdominal discomfort, reflux, pruritus) being potentially attributed in some of the guidelines to ‘cow’s milk allergies’.

“Add to this eczema, and you end up with most perfectly normal babies being potentially ‘labelled’ as allergic to cow’s milk. This is inappropriate (in my opinion, and in I believe opinion of the majority in the paediatric allergy community). So, I do agree with the authors, and I believe they provide important and convincing data to quantify the potential problem.  I particularly like this paragraph, it’s spot on:

The ‘seed of suspicion’ of a potential non- IgE- mediated cow’s milk allergy is likely to result in increasing prescriptions of unwarranted specialized formula milks, with concomitant expense and the seeking of unvalidated allergy tests. In addition, the inference that the transmission of cow’s milk protein via breast milk might be inducing symptoms carries the real danger of undermining a mother’s confidence in breastfeeding and her willingness to continue with it.”

“However, I would be very surprised if the majority of babies described as having ‘multiple mild-to-moderate milk allergy symptoms’ would actually be given the clinical diagnosis of milk allergy in the real world.”



‘Frequency of guideline-defined cow’s milk allergy symptoms in infants: Secondary analysis of EAT trial data’ by Rosie Vincent et al. was published in in Clinical & Experimental Allergy at 05:01 UK Time Wed 8 December 2021.

DOI: 10.1111/cea.14060



Declared interests

None received.

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