Frequency of gastrointestinal manifestations among infants with cow's milk protein allergy, Egypt

Background: Cow's milk is known to be the most frequent food allergen in infants in the first years of life. Eliminating cow milk protein from diets and reintroducing it with a challenge test are the main methods for sure diagnosis. Cow's Milk-related Symptom Score (CoMiSS) has been developed for primary health care providers to improve their knowledge about CMPA. Objective: This study was conducted to prescribe clinical presentation of cow's milk allergy among infants. Methods: A cross-sectional study was conducted at Gastroenterology and Nutrition Unit, University Children Hospital, from the 1st of January 2020 to the 31st of December 2020. Forty infants, complaining of recurrent or persistent gastrointestinal manifestations, were included in our study (28 males and 12 females). Those infants were subjected to detailed medical and social patient history, comprehensive physical exam, and CoMiSS scoring as an awareness tool to suspect underlying cow milk allergy. Infants with a CoMiSS of more than 12 points and positive elimination rechallenge test were regarded as eligible to be part of our study. Results: This study showed that the most frequently occurring gastrointestinal manifestations associated with CMPA were regurgitation (92%), diarrhea (80%), colic (75%), vomiting (67.5%), and lastly constipation which represents only (5%). Conclusion: Regurgitation and diarrhea are the commonest presentations for infants proved to have cow milk allergy with CoMiSS score and elimination rechallenge test, where constipation is the least common presentation for those infants.