Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Retrospective and Prospective Determination of the Cow's Milk-Related Symptom Score (CoMiSSTM) Values in Symptomatic Infants

  • Received : 2021.02.24
  • Accepted : 2021.05.15
  • Published : 2021.07.15
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Abstract

Purpose: The Cow's Milk-related Symptom Score (CoMiSSTM) was developed as an awareness tool for evaluating cow's milk-related symptoms in otherwise healthy children. Using a convenience sample of participants, this cross-sectional study aimed to determine CoMiSSTM values of symptomatic infants based on retrospectively or prospectively obtained information. Methods: CoMiSSTM values were determined in infants aged <12 months with symptoms suggestive of cow's milk protein allergy or functional gastrointestinal disorders. The exclusion criteria were previous diagnosis with acute or chronic disease, treatment with a therapeutic formula, and in case of breastfeeding, an elimination diet followed by the mother. Two CoMiSSTM values were assessed. A retrospective collection was defined as the collection of data after initial contact with the medical center but before the first medical consultation. A prospective collection was defined as the collection of data within 24 hours from the time of medical consultation but before starting any therapeutic intervention. The CoMiSSTM total and individual component scores obtained retrospectively or prospectively were compared between groups using the Wilcoxon signed-rank test. Results: This study was performed between August and November 2019. Data of 110 children (62 males and 48 females), with a mean±standard deviation age of 18.2±11.7 weeks, were obtained. The total CoMiSSTM value (p<0.001) and some individual component scores (crying, regurgitation, and stool) were significantly lower when collected prospectively than when collected retrospectively. Conclusion: CoMiSSTM values were retrospectively and prospectively determined. Lower CoMiSSTM values were obtained during prospective evaluation. Possible differences should be considered when using CoMiSSTM in clinical practice.

Keywords

Acknowledgement

This study was fully funded by the Medical University of Warsaw.

References

  1. NIAID-Sponsored Expert Panel, Boyce JA, Assa'ad A, Burks AW, Jones SM, Sampson HA, et al. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol 2010;126(6 Suppl):S1-58. https://doi.org/10.1016/j.jaci.2010.10.007
  2. Schoemaker AA, Sprikkelman AB, Grimshaw KE, Roberts G, Grabenhenrich L, Rosenfeld L, et al. Incidence and natural history of challenge-proven cow's milk allergy in European children--EuroPrevall birth cohort. Allergy 2015;70:963-72. https://doi.org/10.1111/all.12630
  3. Nwaru BI, Hickstein L, Panesar SS, Roberts G, Muraro A, Sheikh A Prevalence of common food allergies in Europe: a systematic review and meta-analysis. Allergy 2014;69:992-1007. https://doi.org/10.1111/all.12423
  4. Heine RG, AlRefaee F, Bachina P, De Leon JC, Geng L, Gong S, et al. Lactose intolerance and gastrointestinal cow's milk allergy in infants and children - common misconceptions revisited. World Allergy Organ J 2017;10:41. https://doi.org/10.1186/s40413-017-0173-0
  5. Lifschitz C, Szajewska H. Cow's milk allergy: evidence-based diagnosis and management for the practitioner. Eur J Pediatr 2015;174:141-50. https://doi.org/10.1007/s00431-014-2422-3
  6. Munblit D, Perkin MR, Palmer DJ, Allen KJ, Boyle RJ. Assessment of evidence about common infant symptoms and cow's milk allergy. JAMA Pediatr 2020;174:599-608. https://doi.org/10.1001/jamapediatrics.2020.0153
  7. Pajno GB, Szajewska H. Cow's milk allergy guidelines promote overdiagnosis of cow's milk disease. Allergy 2020. doi: 10.1111/all.14729. [Epub ahead of print].
  8. Vandenplas Y, Dupont C, Eigenmann P, Host A, Kuitunen M, Ribes-Koninckx C, et al. A workshop report on the development of the Cow's Milk-related Symptom Score awareness tool for young children. Acta Paediatr 2015;104:334-9. https://doi.org/10.1111/apa.12902
  9. Vandenplas Y, Steenhout P, Grathwohl D; Althera Study Group. A pilot study on the application of a symptom-based score for the diagnosis of cow's milk protein allergy. SAGE Open Med 2014;2:2050312114523423. https://doi.org/10.1177/2050312114523423
  10. Vandenplas Y, Carvajal E, Peeters S, Balduck N, Jaddioui Y, Ribes-Koninckx C, et al. The cow's milk-related symptom score (CoMiSSTM): health care professional and parent and day-to-day variability. Nutrients 2020;12:438. https://doi.org/10.3390/nu12020438
  11. Vandenplas Y, Salvatore S, Ribes-Koninckx C, Carvajal E, Szajewska H, Huysentruyt K. The Cow Milk Symptom Score (CoMiSSTM) in presumed healthy infants. PLoS One 2018;13:e0200603. https://doi.org/10.1371/journal.pone.0200603
  12. Salvatore S, Bertoni E, Bogni F, Bonaita V, Armano C, Moretti A, et al. Testing the cow's milk-related symptom score (CoMiSSTM) for the response to a cow's milk-free diet in infants: a prospective study. Nutrients 2019;11:2402. https://doi.org/10.3390/nu11102402
  13. Vandenplas Y, Steenhout P, Jarvi A, Garreau AS, Mukherjee R. Pooled analysis of the Cow's Milk-related-Symptom-Score (CoMiSSTM) as a predictor for cow's milk related symptoms. Pediatr Gastroenterol Hepatol Nutr 2017;20:22-6. https://doi.org/10.5223/pghn.2017.20.1.22
  14. Prasad R, Venkata RSA, Ghokale P, Chakravarty P, Anwar F. Cow's Milk-related Symptom Score as a predictive tool for cow's milk allergy in Indian children aged 0-24 months. Asia Pac Allergy 2018;8:e36. https://doi.org/10.5415/apallergy.2018.8.e36
  15. Sampson HA. Utility of food-specific IgE concentrations in predicting symptomatic food allergy. J Allergy Clin Immunol 2001;107:891-6. https://doi.org/10.1067/mai.2001.114708
  16. Zeng Y, Zhang J, Dong G, Liu P, Xiao F, Li W, et al. Assessment of Cow's milk-related symptom scores in early identification of cow's milk protein allergy in Chinese infants. BMC Pediatr 2019;19:191. https://doi.org/10.1186/s12887-019-1563-y
  17. Vandenplas Y, Mukherjee R, Dupont C, Eigenmann P, Host A, Kuitunen M, et al. Protocol for the validation of sensitivity and specificity of the Cow's Milk-related Symptom Score (CoMiSS) against open food challenge in a single-blinded, prospective, multicentre trial in infants. BMJ Open 2018;8:e019968. https://doi.org/10.1136/bmjopen-2017-019968
  18. Szajewska H, Socha P, Horvath A, Rybak A, Zalewski BM, Nehring-Gugulska M, et al. [Nutrition of healthy term infants. Recommendations of the Polish Society for Paediatrics Gastroenterology, Hepatology and Nutrition]. Stand Med Pediatr 2021;18:7-24. Polish.
  19. Koletzko B, Hirsch NL, Jewell JM, Dos Santos Q, Breda J, Fewtrell M, et al. National recommendations for infant and young child feeding in the World Health Organization European Region. J Pediatr Gastroenterol Nutr 2020;71:672-8. https://doi.org/10.1097/MPG.0000000000002912
  20. Vandenplas Y, Leluyer B, Cazaubiel M, Housez B, Bocquet A. Double-blind comparative trial with 2 antiregurgitation formulae. J Pediatr Gastroenterol Nutr 2013;57:389-93. https://doi.org/10.1097/MPG.0b013e318299993e
  21. Zeskind PS. Cross-cultural differences in maternal perceptions of cries of low- and high-risk infants. Child Dev 1983;54:1119-28. https://doi.org/10.2307/1129668
  22. Dupont C, Bradatan E, Soulaines P, Nocerino R, Berni-Canani R. Tolerance and growth in children with cow's milk allergy fed a thickened extensively hydrolyzed casein-based formula. BMC Pediatr 2016;16:96. https://doi.org/10.1186/s12887-016-0637-3