Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Difference in Cow's Milk-Related Symptom Score (CoMiSSTM) Among Presumed Healthy Infants in Indonesia and Brazil

  • Received : 2024.06.17
  • Accepted : 2024.12.10
  • Published : 2025.03.15
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Abstract

Purpose: The Cow's Milk-related Symptom Score (CoMiSS) improves the recognition of cow milk allergy (CMA) symptoms. A score of ≥10 should raise awareness of CMA. The median CoMiSS in healthy European infants aged <6 months is 3. This study aimed to determine the impact of different regions on CoMiSS in healthy infants aged <12 months to evaluate regional and age-related differences. Methods: A prospective cross-sectional study was conducted at one hospital each in Indonesia (Jakarta) and Brazil (Sergipe). CoMiSS was assessed in healthy infants aged -12 months old. Results: In Jakarta, a total of 286 infants (50.7% boys) were included. The median (interquartile range) CoMiSS was 1.5 (0-4); the 95th percentile was 7. In Sergipe, 101 infants (60.4% boys) were included. The median (interquartile range) CoMiSS was 4 (4-6); the 95th centile was 10.9. Age (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.94-0.99; p<0.001) and country (OR, 2.40; 95% CI, 2.06-2.79; p<0.001) were significant independent predictors of changes in mean CoMiSS in a linear regression model (r2=0.27). Conclusion: Median CoMiSS in healthy infants differed between Jakarta and Sergipe (1.5 vs. 4.0). These findings highlight that the perceived normality of parents may be region-dependent.

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References

  1. Spolidoro GCI, Amera YT, Ali MM, Nyassi S, Lisik D, Ioannidou A, et al. Frequency of food allergy in Europe: An updated systematic review and meta-analysis. Allergy 2023;78:351-68. https://doi.org/10.1111/all.15560
  2. Vandenplas Y, Brough HA, Fiocchi A, Miqdady M, Munasir Z, Salvatore S, et al. Current guidelines and future strategies for the management of cow's milk allergy. J Asthma Allergy 2021;14:1243-56. https://doi.org/10.2147/JAA.S276992
  3. Vandenplas Y, Broekaert I, Domellof M, Indrio F, Lapillonne A, Pienar C, et al. An ESPGHAN position paper on the diagnosis, management and prevention of cow's milk allergy. J Pediatr Gastroenterol Nutr 2024;78:386-413. https://doi.org/10.1097/MPG.0000000000003897
  4. Setiabudiawan B, Sitaresmi MN, Sapartini G, Sumadiono , Citraresmi E, Sekartini R, et al. Growth patterns of Indonesian infants with cow's milk allergy and fed with soy-based infant formula. Pediatr Gastroenterol Hepatol Nutr 2021;24:316-24. https://doi.org/10.5223/pghn.2021.24.3.316
  5. Paquete AT, Martins R, Connolly MP, Hegar B, Munasir Z, Stephanus S. Managing cow's milk protein allergy in Indonesia: A cost-effectiveness analysis of hypoallergenic milk formulas from the private payers' perspective. J Health Econ Outcomes Res 2022;9:77-85. https://doi.org/10.36469/jheor.2022.36407
  6. Vieira MC, Morais MB, Spolidoro JV, Toporovski MS, Cardoso AL, Araujo GT, et al. A survey on clinical presentation and nutritional status of infants with suspected cow' milk allergy. BMC Pediatr 2010;10:25. https://doi.org/10.1186/1471-2431-10-25
  7. 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
  8. Vandenplas Y, Bajerova K, Dupont C, Eigenmann P, Kuitunen M, Meyer R, et al. The cow's milk related symptom score: the 2022 update. Nutrients 2022;14:2682. https://doi.org/10.3390/nu14132682
  9. Vandenplas Y, Althera Study G, Steenhout P, Grathwohl D. 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. EI-Shafie AM, Omar ZA, El Zefzaf HMs, Basma EM, Al Sabbagh NM, Bahbah WA. Evaluation of Cow's Milk Related Symptom Score [CoMiss] accuracy in cow's milk allergy diagnosis. Pediatr Res 2023;94:987-95. https://doi.org/10.1038/s41390-023-02539-9
  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;13:60200603. https://doi.org/10.1371/journal.pone.0200603
  12. Jankiewicz M, Ahmed F, Bajerova K, Carvajal Roca ME, Dupont C, Huysentruyt K, et al. Cow's Milkrelated Symptom Score (CoMiSS) values in presumed healthy European infants aged 6-12 months: a crosssectional study. Eur J Pediatr 2024;183:707-13. https://doi.org/10.1007/s00431-023-05334-0
  13. Bahbah WA, Knockaert N, El Zefzaf HMs, Huysentruyt K, Vandenplas Y. The cow's milk-related symptom score (CoMisSTM) in presumed healthy Egyptian infants. Nutrients 2024;16:2666. https://doi.org/10.3390/nu16162666
  14. Woods RK, Stoney RM, Raven J, Walters EH, Abramson M, Thien FC. Reported adverse food reactions overestimate true food allergy in the community. Eur J Clin Nutr 2002, 56:31-6. https://doi.org/10.1038/sj.ejcn.1601306
  15. Baaleman DF, Wegh CAM, de Leeuw TJM, van Etten-lamaludin FS, Vaughan EE, Schoterman MHC, et al. What are normal defecation patterns in healthy children up to four years of age? A systematic review and meta-analysis. IPediatr 2023;261:113559. https://doi.org/10.1016/j.jpeds.2023.113559
  16. Xiao F, Wang Y, Ludwig T, Li X, Chen S, Sun N, et al. Generation and application of a convolution a neural networks algorithm in evaluating stool consistency in diapers. Acta Paediatr 2023:112:1333-40. https://doi.org/10.1111/apa.16731
  17. Leung AK, Hon KL. Gastroesophageal reflux in children: an updated review. Drugs Context 2019;8:212591.
  18. Hegar B, Boediarso A, Firmansyah A, Vandenplas Y. Investigation of regurgitation and other symptoms of gastroesophageal reflux in Indonesian infants. World I Gastroenterol 2004:10:1795-7. https://doi.org/10.3748/wjg.v10.i12.1795
  19. Steer CD, Emond AM, Golding], Sandhu B. The variation in stool patterns from 1 to 42 months: a population-based observational study. Arch Dis Child 2009;94:231-3. https://doi.org/10.1136/adc.2007.130849
  20. van den Brink M, Bandell-Hoekstra EN, Abu-Saad HH. The occurrence of recall bias in pediatric headache: a comparison of questionnaire and diary data. Headache 2001;41:11-20. https://doi.org/10.1046/j.1526-4610.2001.111006011.x