Login
Communauté Vinci
Extérieur
Si votre nom d'utilisateur ne se termine pas par @vinci.be ou @student.vinci.be, utilisez le formulaire ci-dessous pour accéder à votre compte de lecteur.
Titre : | Assessment of evidence about common infant symptoms and cows milk allergy (2020) |
Auteurs : | Daniel Munblit ; Michael R. Perkin ; Debra J. Palmer ; Katie J. Allen ; Robert J. Boyle |
Type de document : | Article |
Dans : | Midwifery Digest (Midirs) (Vol. 30, n° 3, September 2020) |
Article en page(s) : | p. 386-398 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Hypersensibilité alimentaire ; Lait humain ; Nutrition ; Pédiatrie ; Préparation pour nourrissons ; Recommandations ; Vache |
Résumé : |
Importance : Sales of specialized formula for managing cows milk allergy (CMA) have increased, triggering concern that attribution of common infant symptoms, such as crying, vomiting, and rashes, to CMA may be leading to overdiagnosis, which could undermine breastfeeding.
Objective : To understand whether CMA guideline recommendations might promote CMA overdiagnosis or undermine breastfeeding. Evidence Review : We reviewed recommendations made in CMA guidelines and critically appraised 2 key recommendations. First, we reviewed relevant literature summarizing whether maternal or infant dietary exclusion of cows milk is effective for managing common infant symptoms. Second, we reviewed published data on breastmilk composition and thresholds of reactivity in CMA to estimate the probability that cows milk protein in human breastmilk can trigger symptoms in infants with CMA. We also documented the level of commercial involvement in CMA guidelines. Findings : We reviewed 9 CMA guidelines published from 2012 to 2019. Seven suggest considering CMA as a cause of common infant symptoms. Seven recommend strict maternal cows milk exclusion for managing common symptoms in breastfed infants. We found CMA proven by food challenge affects approximately 1% of infants, while troublesome crying, vomiting, or rashes are each reported in 15% to 20% of infants. We found clinical trials do not provide consistent support for using maternal or infant cows milk exclusion to manage common symptoms in infants without proven CMA. We estimated that for more than 99% infants with proven CMA, the breastmilk of a cows milkconsuming woman contains insufficient milk allergen to trigger an allergic reaction. Three CMA guidelines were directly supported by formula manufacturers or marketing consultants, and 81% of all guideline authors reported a conflict of interest with formula manufacturers. Conclusions and Relevance : Recommendations to manage common infant symptoms as CMA are not evidence based, especially in breastfed infants who are not directly consuming cows milk. Such recommendations may cause harm by undermining confidence in breastfeeding. |
Disponible en ligne : | Non |
Exemplaires (1)
Cote | Support | Localisation | Section | Disponibilité |
---|---|---|---|---|
Midwifery Digest (Midirs). Vol. 30, n° 3 (September 2020) | Périodique papier | Woluwe | Espace revues | Consultation sur place uniquement Exclu du prêt |