Detection and management of milk allergy: Delphi consensus study
| Autor: | Hilary I. Allen, Ursula Pendower, Miriam Santer, Marion Groetch, Mitchell Cohen, Simon H. Murch, Hywel C. Williams, Daniel Munblit, Yitzhak Katz, Neeraj Gupta, Sabeen Adil, Justine Baines, Eefje G. P. M. de Bont, Matthew Ridd, Victoria L. Sibson, Alison McFadden, Jennifer J. Koplin, Josephine Munene, Michael R. Perkin, Scott H. Sicherer, Robert J. Boyle |
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| Přispěvatelé: | Family Medicine, RS: CAPHRI - R5 - Optimising Patient Care |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Allergy
Delphi Technique breastfeeding Immunology DIAGNOSIS GUIDELINES overdiagnosis FOOD ALLERGY Cow's milk allergy 1117 Public Health and Health Services fluids and secretions Humans Immunology and Allergy Child FORMULA Science & Technology food and beverages Infant Reproducibility of Results Allergens Milk Proteins Infant Formula Delphi consensus 1107 Immunology Child Preschool 1111 Nutrition and Dietetics Female Milk Hypersensitivity Life Sciences & Biomedicine |
| Zdroj: | Allen, H I, Pendower, U, Santer, M, Groetch, M, Cohen, M, Murch, S H, Williams, H C, Ridd, M J & Boyle, R J 2022, ' Detection and management of milk allergy : Delphi consensus study ', Clinical and Experimental Allergy, vol. 52, no. 7, pp. 848-858 . https://doi.org/10.1111/cea.14179 Clinical and Experimental Allergy, 52(7), 848-858. Wiley-Blackwell |
| ISSN: | 0954-7894 1365-2222 |
| DOI: | 10.1111/cea.14179 |
| Popis: | BackgroundThere is significant overdiagnosis of milk allergy in young children in some countries, leading to unnecessary use of specialized formula. This guidance, developed by experts without commercial ties to the formula industry, aims to reduce milk allergy overdiagnosis and support carers of children with suspected milk allergy.MethodsDelphi study involving two rounds of anonymous consensus building and an open meeting between January and July 2021. Seventeen experts in general practice, nutrition, midwifery, health visiting, lactation support and relevant areas of paediatrics participated, located in Europe, North America, Middle East, Africa, Australia and Asia. Five authors of previous milk allergy guidelines and seven parents provided feedback.FindingsParticipants agreed on 38 essential recommendations through consensus. Recommendations highlighted the importance of reproducibility and specificity for diagnosing milk allergy in children with acute or delayed symptoms temporally related to milk protein ingestion; and distinguished between children directly consuming milk protein and exclusively breastfed infants. Consensus was reached that maternal dietary restriction is not usually necessary to manage milk allergy, and that for exclusively breastfed infants with chronic symptoms, milk allergy diagnosis should only be considered in specific, rare circumstances. Consensus was reached that milk allergy diagnosis does not need to be considered for stool changes, aversive feeding or occasional spots of blood in stool, if there is no temporal relationship with milk protein ingestion. When compared with previous guidelines, these consensus recommendations resulted in more restrictive criteria for detecting milk allergy and a more limited role for maternal dietary exclusions and specialized formula.InterpretationThese new milk allergy recommendations from non-conflicted, multidisciplinary experts advise narrower criteria, more prominent support for breastfeeding and less use of specialized formula, compared with current guidelines. |
| Databáze: | OpenAIRE |
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