Milk allergy guidelines may be causing overdiagnosis in babies and children

  • JAMA Pediatr
  • 13 Apr 2020

  • curated by Dawn O'Shea
  • UK Medical News
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Current medical guidelines for diagnosing cow’s milk allergy in babies and young children may be linked to overdiagnosis of the condition. This is the finding of a new analysis from Imperial College London and Sechenov First Moscow State Medical University.

In a review published in JAMA Pediatrics, the team found that around 1 per cent of children have cow’s milk allergy, but up to 14 per cent of families believe their child to have the condition.

The researchers analysed nine official guidelines for cow’s milk allergy published between 2012 and 2019. The guidelines were from a range of medical organisations in a number of countries, predominantly in Europe.

The team found that many of the guidelines named symptoms such as excessive crying, regurgitating milk and loose stools as indications of cow’s milk allergy, but the authors argue that these symptoms are very common in normal, healthy babies.

The analysis also found that the prescription of specialist formulas for babies with cow’s milk allergy increased significantly between 2000 and 2018 in countries such as Australia and England, without any evidence for an increase in cow’s milk allergy.

Three guidelines were directly supported by formula manufacturers or marketing consultants, and 81 per cent of all guideline authors reported a conflict of interest with formula manufacturers.

Lead author, Dr Robert Boyle, consultant allergy specialist from Imperial’s National Heart and Lung Institute, said: “Formula manufacturers may gain from promoting increased cow’s milk allergy diagnosis by influencing practitioners and parents to use a specialised formula in place of a cheaper formula, and by potentially undermining women’s confidence in breastfeeding, so that specialised formula is used in place of breastmilk.”