Cow's milk is probably the most common allergen for infants, with an estimated prevalence ranging from 0.5% to 7.5%.1 However, the prevalence may even be as high as 25% in selected patient groups, such as children with atopic dermatitis.2,3 The diagnosis of allergy to cow's milk is often missed because of the nonspecificity of the symptoms.1,4 Vomiting or colic is frequently attributed to formula intolerance and/or milk allergy and is treated empirically by formula changes, ie, without documentation of specific sensitivity, soy protein formulas are often substituted for cow's milk.5 This may further increase the chances of sensitization in a susceptible infant.6 Although nonspecific symptoms and signs of milk allergy are very frequent, and physicians often treat these with empiric formula changes, there are no data to guide physicians in detecting or preventing serious reactions to the feedings tried. Since 1985, there have been
Tarim O, Anderson VM, Lifshitz F. Fatal Anaphylaxis in a Very Young Infant Possibly Due to a Partially Hydrolyzed Whey Formula. Arch Pediatr Adolesc Med. 1994;148(11):1224–1228. doi:10.1001/archpedi.1994.02170110110026
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