Vlieg-Boerstra Berber J, Wensing Carry L, Kneepkens C M F Frank, Meijer Yolanda, de Vries Esther, Sprikkelman Aline B
Emma Kinderziekenhuis AMC, afd. Kinderpulmonologie en Allergie, Amsterdam.
Ned Tijdschr Geneeskd. 2013;157(38):A6311.
The aims of the new Dutch guideline 'Diagnosing Cow Milk Allergy in Children in the Netherlands' are to provide an evidence-based instrument for the reliable and safe diagnosis of cow milk allergy and to improve the collaboration between health care professionals at well-baby clinics, general practices and hospitals. The double-blind, placebo-controlled cow-milk provocation test is the only test available for establishing an allergy to cows' milk. The double-blind provocation test in children at a low risk of severe reactions may be performed at the better-equipped well-baby clinics and at all general practices, thereby shifting care from secondary to primary care. The use of extensively hydrolysed formulas based on whey protein as well as on casein can be advised for a cow-milk-free diet. The general practitioner and well-baby physician should collaborate in designating responsibilities during the diagnostic phase of cow milk allergy in primary care.
荷兰新指南《荷兰儿童牛奶过敏的诊断》的目标是提供一种基于证据的工具，用于可靠、安全地诊断牛奶过敏，并改善母婴诊所、全科诊所和医院医护人员之间的协作。双盲、安慰剂对照牛奶激发试验是唯一可用于确定牛奶过敏的检测方法。对于严重反应风险较低的儿童，双盲激发试验可在设备更完善的母婴诊所和所有全科诊所进行，从而将护理从二级护理转移到初级护理。对于无牛奶饮食，可建议使用基于乳清蛋白和酪蛋白的深度水解配方奶粉。在初级护理中牛奶过敏的诊断阶段，全科医生和母婴医生应协作明确各自职责。
