Abstract
Cow’s milk allergy is a common food allergy in children with an incidence of 1–3%. The gold standard to diagnose cow’s milk allergy is a double-blinded placebo-controlled food challenge (DBPCFC). Previous studies show that reintroduction of cow’s milk is unsuccessful in 10–12% of patients. The aim of this retrospective study is to evaluate the effect of follow-up on the reintroduction of cow’s milk. We analyzed the data of patients with a negative DBPCFC for cow’s milk between 2014 and 2016 in three different departments. Questionnaires were used to compare the three ways of follow-up (no follow-up, follow-up in person or by telephone). Of the 336 children with a negative DBPCFC for cow’s milk, 128 questionnaires (41%) were returned. Reintroduction of cow’s milk was unsuccessful in 13.3% of the patients. There was no significant difference found between children with (73.8%) or without (26.2%) follow-up, or between follow-up by phone or personally. Whether this finding is caused by small numbers within this retrospective study should be investigated in future prospective studies.
Conclusion: Follow-up does not influence the reintroduction success rate of cow’s milk after a negative double-blinded placebo-controlled food challenge.
What is Known: Diagnosis of cow’s milk allergy by double-blinded placebo-controlled food challenge is the gold standard. • After a negative double-blinded placebo-controlled food challenge, reintroduction of cow’s milk in the child’s diet is unsuccessful in 10–12% of the children. • Recurrence of symptoms, aversion to the examined food, and fear are seen as the main reasons for unsuccessful introduction. | |
What is New: • Reintroduction after a negative double-blinded placebo-controlled food challenge is not influenced by different ways of follow-up. |
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Abbreviations
- CMA:
-
Cow’s milk allergy
- DBPCFC:
-
Double-blinded placebo-controlled food challenge
- CHC:
-
Child health care center
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Author 1 collected the data, performed the analysis and wrote the paper. Author 2 and 3 conceived and designed the analysis. Author 4 conceived and designed the analysis and wrote the paper.
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This study was submitted to the Medical Ethical Committee of the Maxima Medical Centre for approval. The Committee concluded that no Ethical Approval was required as it concerned a retrospective study.
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Schrijvers, M., Hendriks, T., Mars, H. et al. The effect of follow-up after a negative double-blinded placebo-controlled cow’s milk challenge on successful reintroduction. Eur J Pediatr 178, 1113–1117 (2019). https://doi.org/10.1007/s00431-019-03385-w
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DOI: https://doi.org/10.1007/s00431-019-03385-w