Cows milk protein allergy PDF
Preview Cows milk protein allergy
Managing Cow’s Milk Allergy Beyond Infancy Thursday 27th April Rachel De Boer Paediatric Allergy Dietitian “Managing Cow’s Milk Allergy Beyond Infancy” Webinar The speaker had sole editorial control over the content in this slide deck. Any views, opinions or recommendations expressed in the slides are solely those of the speaker and do not necessarily represent those of Nutricia. Cows milk protein allergy Dietary management of the older cow’s milk allergic child Rachel de Boer Paediatric Allergy Dietitian 27th April 2017 Webinar Outline Prevalence and natural history of CMA • Dietary management of the older child with CMA • Growth and CMA • Factors that increase nutritional risk in CMA • CMA and micronutrients • Practical management • Growth assessment • Milk alternatives/formulas over the age of 1 • Case studies • § CMPA incidence CMPA affects 1.9% - 4.9% of infants in the 1st year of life • New data from Europrevall suggests lower incidence: Challenge proven • CMPA 0.54% Overall prevalence increasing as more children remaining allergic for • longer, with more severe disease 1.Luyt D et al 2014. BSACI guideline for the diagnosis and management of cow’s milk allergy. Cli Exp Allergy; 44: 642-672 2.Venter C, Pereira B, Voigt K et al. Prevalence and cumulative incidence of food hypersensitivity in the first 3 years of life. Allergy 2008;63(3):354-9. 3. A. A. Schoemaker, Allergy 2015 Aug; 70(8): 963-72 Outgrowing milk allergy Remission Age Follow N Diagnosis up age IgE Non-IgE (Yr) (Yr) Milk Danneus A (1981) 47 <2 6 29% 74% Host A(1997) 39 <1 3 76% 100% 100 <2 5 67% 86% Bishop J (1990) 807 <2 4 19% - Skripac (2008) Natural History of IgE mediated milk allergy Resolution of CMPA n=807 90 81 By age 4 only 19% had outgrown cmpa, Average in this pop. between 8 -12 years. 68 58 45 36 % allergic to CMP 21 23 0 <4 yrs <8 yrs <12 yrs <16 yrs Skripak JM et al. The Natural History of IgE mediated Cow’s Milk Allergy. JACI Nov 2007. Dietary management of the older child with CMPA Relationship of CMPA to growth N = 439 • Children > 2 yrs, avoiding milk - • smaller in height and weight compared to counterparts Close monitoring of growth • important for children with food allergy particularly CMA. Mehta H J Pediatr 2014;165:842-8
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