Brand Paul L P, Rijk-van Gent Hanneke
Isala klinieken, Amalia Kinderafdeling, Zwolle, the Netherlands.
Ned Tijdschr Geneeskd. 2011;155(27):A3508.
Symptoms of cow's milk allergy are non-specific; as a result, suspected cow's milk allergy is far more common than proven allergy to cow's milk. Cow's milk allergy in infants is therefore most probably a fairly uncommon clinical picture; cow's milk allergy is estimated to occur in less than one per cent of infants. The only valuable additional diagnostic tool is food challenge, preferably double blind. Therapy consists of a formula free of cow's milk (preferably containing extensively hydrolysed whey protein) from the moment the mother ceases nursing her child until the age of 6-12 months. Solids can be introduced in the usual fashion; there is no scientific basis for introducing them in a step by step fashion. Prevention of cow's milk allergy by using hypoallergenic formula (partially hydrolysed cow milk protein) in the first year of life has been shown to be unsuccessful, and can no longer be recommended. In the future, oral immunotherapy may be a promising new treatment for cow's milk allergy.
牛奶过敏的症状不具有特异性;因此,疑似牛奶过敏远比经证实的牛奶过敏更为常见。所以,婴儿牛奶过敏很可能是一种相当不常见的临床症状;据估计,牛奶过敏在不到1%的婴儿中发生。唯一有价值的辅助诊断工具是食物激发试验,最好是双盲试验。治疗方法是从母亲停止母乳喂养孩子开始,直到孩子6至12个月大,使用不含牛奶的配方奶(最好含有深度水解乳清蛋白)。固体食物可以按常规方式添加;没有科学依据逐步添加。在生命的第一年使用低敏配方奶(部分水解牛奶蛋白)预防牛奶过敏已被证明是不成功的,因此不再推荐。未来,口服免疫疗法可能是治疗牛奶过敏的一种有前景的新方法。