Brill Herbert
Division of Gastroenterology and Nutrition, Department of Pediatrics, McMaster University, 1200 Main St W, Hamilton, ON L8S 3Z5.
Can Fam Physician. 2008 Sep;54(9):1258-64.
To provide a practical, evidence-based approach to the diagnosis and management of milk protein allergy in infants.
MEDLINE was searched from 1950 to March 2008 using the MeSH heading milk-hypersensitivity. Additional sources were derived from reviews found with the initial search strategy. Evidence was levels I, II, and III.
Milk protein allergy is a recognized problem in the first year of life; cow's milk protein allergy is the most common such allergy. Diagnosis is suspected on history alone, with laboratory evaluations playing a supporting role. Confirmation requires elimination and reintroduction of the suspected allergen. Management includes diet modification for nursing mothers and hydrolyzed formulas for formula-fed infants. Assessing the underlying immunopathology can aid in determining prognosis.
The therapeutic model presented allows rapid assessment of the presence of allergy, timely management, and surveillance for recurrence of symptoms. Breastfeeding can be continued with attentive diet modification by motivated mothers.
提供一种实用的、基于证据的方法来诊断和管理婴儿牛奶蛋白过敏。
使用医学主题词“牛奶超敏反应”对1950年至2008年3月的MEDLINE进行检索。其他来源来自于初始检索策略中找到的综述。证据级别为I、II和III级。
牛奶蛋白过敏是婴儿出生后第一年中一个公认的问题；牛奶蛋白过敏是最常见的此类过敏。仅根据病史怀疑诊断，实验室评估起辅助作用。确诊需要排除并重新引入可疑过敏原。管理包括对哺乳期母亲进行饮食调整以及对配方奶喂养的婴儿使用水解配方奶粉。评估潜在的免疫病理学有助于确定预后。
所提出的治疗模式允许快速评估过敏的存在、及时管理以及监测症状复发。有积极性的母亲通过注意饮食调整可以继续母乳喂养。
