April 1986

Cow's Milk Allergy-Reply

Author Affiliations

Department of Pediatrics Emory University School of Medicine 69 Butler St SE Atlanta, GA 30303

Am J Dis Child. 1986;140(4):330. doi:10.1001/archpedi.1986.02140180064024

In Reply.—It is clear that cow's milk has the potential to contribute to respiratory symptoms by both immunologic and nonimmunologic mechanisms. The former are accurately designated as allergy, although misuse of this term has made it nearly useless.1 Clinical experience suggests that nonimmunologically mediated adverse reactions are important, and we and others currently are studying possible mechanisms to explain these reactions. However, Bahna and Heiner2 emphasize the need for caution in diagnosing allergic (or other adverse) reactions to cow's milk lest "overzealousness" obscures appropriate diagnosis and treatment. A rational approach to the possibility of adverse reactions to foods has been outlined and certainly hinges on double-blind challenges.3

The role of cow's milk—induced respiratory symptoms was considered in many of the patients we described.4 None who had undergone immediate hypersensitivity skin testing had positive responses to cow's milk, and none had been noted to have a

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