Download Diapositiva 1 - Italian Journal of Pediatrics

Children < 1 year fed with regular cow’s milk formula and suspected severe CMPA
Immediate reactions:
•Laryngeal edema
•Acute asthma with severe
respiratory distress
•Anaphylaxis
Elimination diet: soy (if >6
months) or extensively
hydrolyzed formula or amino
acid formula (for 2 wks then
continue with soy or extensively
hydrolyzed formula) *.
Cow’s milk challenge test in a
clinical setting after 12 months of
age and not before 6-12 months
from the reaction.
*Introduce extensively hydrolyzed
formula or soy under medical
supervision. Amino acid formula
should be given if this is not
feasible.
Infants should be referred
to a specialized clinic.
SPT and/or specific IgE
should be performed
Late reactions:
•Chronic diarrhoea,chronic
vomiting, food refusal,with poor
growth
•Bloody stools with iron deficiency
anaemia
•Protido-losing enteropathy with
hypoalbuminemia
•Eosinophilic
esophagogastroenteropathy
confirmed by biopsy
•Extensively hydrolised formula or amino acid
formula.
•In case of poor growth, anaemia,
hypoabuminemia: elimination diet for 10 days-6
weeks with amino acid formula (to switch to
extensively hydrolyzed formula).
Improves ?
No
Regular
cow’s milk
formula
Yes
Cow’s milk
challenge test
after 6-12
months of
avoidance and
1year of age in a
clinical setting.