Department of Pediatrics, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Institute of Biostatistics and Analyses, Ltd., Brno, Czech Republic.
Eur J Pediatr. 2024 Oct;183(10):4329-4335. doi: 10.1007/s00431-024-05693-2. Epub 2024 Jul 30.
The Cow's Milk-related Symptom Score (CoMiSS™) is a scoring system that reflects the appearance and intensity of symptoms possibly related to consumption of cow's milk. The original tool was recently updated by changing the cut-off, and the stool scale and by adding angioedema. There is no data available regarding the natural evolution of CoMiSS in infants with no cow's milk allergy (no-CMA) or a comparison between original and updated CoMiSS values. We determined the original and the updated CoMiSS in infants not diagnosed with cow's milk allergy. The evolution of CoMiSS during the first year of life was assessed repetitively during predefined check-ups at 1.5, 3, 4, 6, 8, 10, and 12 months. The original and updated scores were compared with the Wilcoxon Signed-Rank Test. We also tested the impact of feeding type, age, gender, and order in the family on the CoMiSS. One hundred and twenty-two infants were included. CoMiSS values during the first year of life showed an inverse relation to age. The difference in CoMiSS between the original and updated versions was significant at 6,8,10, and 12 months (p < 0.001), related to the switch from the Bristol Stool Form Scale to the Brussels Infants and Toddlers Stool Scale (BITSS). The difference between both versions of CoMiSS was not significantly different in infants < 6 months (p = 0.999 at 1.5 and 4 months, and p = 0.586 at 3 months, respectively).Conclusion: CoMiSS decreases with age during the first year of life. While there is no difference between the two CoMiSS versions in healthy infants under 6 months of age, the CoMiSS value in the updated version is lower than the original 1 in infants aged 6 to 12 months. What is known? • The Cow's Milk-related Symptom Score (CoMiSS) is a validated awareness tool for cow's milk allergy (CMA). • A CoMiSS of ≥ 10 indicates a risk for cow's milk allergy. What is new? • The natural evolution of CoMiSS in infants not diagnosed with CMA (no-CMA) shows an inverse relation to age. • There is no difference between the original and the updated CoMiSS versions in no-CMA-infants under six months of age, but the updated CoMiSS is lower in infants 6-12 months than the original one.
牛奶相关症状评分（CoMiSS）是一种反映与牛奶消费相关的症状出现和严重程度的评分系统。该工具最近通过改变截断值、粪便评分和添加血管性水肿进行了更新。目前尚无关于无牛奶过敏（no-CMA）婴儿 CoMiSS 自然演变或原始和更新 CoMiSS 值之间比较的数据。我们确定了未被诊断为牛奶过敏的婴儿的原始和更新的 CoMiSS。在 1.5、3、4、6、8、10 和 12 个月的预定义检查期间，反复评估婴儿在生命的第一年期间 CoMiSS 的演变。原始和更新的分数通过 Wilcoxon 符号秩检验进行比较。我们还测试了喂养类型、年龄、性别和家庭顺序对 CoMiSS 的影响。共纳入 122 名婴儿。生命第一年的 CoMiSS 值与年龄呈反比。原始版本和更新版本之间的 CoMiSS 差异在 6、8、10 和 12 个月时具有统计学意义（p < 0.001），这与从布里斯托尔粪便形态量表切换到布鲁塞尔婴儿和幼儿粪便量表（BITSS）有关。在<6 个月的婴儿中，两个版本的 CoMiSS 之间的差异没有统计学意义（在 1.5 个月和 4 个月时 p = 0.999，在 3 个月时 p = 0.586）。结论：在生命的第一年中，CoMiSS 随年龄而降低。在<6 个月的健康婴儿中，两个版本的 CoMiSS 之间没有差异，但在 6-12 个月的婴儿中，更新版本的 CoMiSS 值低于原始版本的 1。已知？ • 牛奶相关症状评分（CoMiSS）是牛奶过敏（CMA）的一种有效的意识工具。 • CoMiSS ≥ 10 表示有患牛奶过敏的风险。新内容？ • 未被诊断为 CMA（无-CMA）的婴儿的 CoMiSS 自然演变与年龄呈反比。 • 在<6 个月的无-CMA 婴儿中，原始版本和更新版本的 CoMiSS 之间没有差异，但在 6-12 个月的婴儿中，更新版本的 CoMiSS 比原始版本低。
