Elimination diet may help manage cow's milk protein allergy in infants

Cow's milk protein allergy (CMPA), although difficult to diagnose in young children, shows a causative relationship to otolaryngic symptoms. A new study in the August journal, Otolaryngology-Head and Neck Surgery suggests an elimination diet may help manage such conditions in children under two and reduce the need for more serious upper airway tests and interventions.

"Early recognition of CMPA in association with upper airway disease may subsequently reduce the economic burden and number of procedures required in affected infants," report the authors.

The authors reviewed the charts of 191 patients younger than 2 years with CMPA. Within this group, 141 patients showed symptoms of upper gastrointestinal disease such as vomiting, choking, poor weight gain, and irritability. Ninety-two patients qualified for sufficient follow-up and showed improvement when dairy was removed from their diet. Within this group, 25 patients also had otolaryngologic symptoms, the most common of which were airway congestion and difficulty swallowing.

Many patients underwent significant diagnostic testing and treatment before the elimination diet proved successful. Identifying and managing this group of patients, the authors state, may help avoid unnecessary testing and surgery.

The authors conclude, "This study raises the question of whether early management of CMPA could reduce the need for some surgical intervention of upper aerodigestive disorders in young children. The ability to identify CMPA early in infancy will have important benefits."