Department of Pediatrics, Faculty of Medicine, Menoufia University, Shebin El-Kom 32511, Egypt.
KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium.
Nutrients. 2024 Aug 12;16(16):2666. doi: 10.3390/nu16162666.
The Cow's Milk-Related Symptom Score (CoMiSS) was created as an awareness tool for cow's milk-related symptoms. After different trials, a score of ≥10 was selected to raise awareness. The CoMiSS in healthy infants needs to be determined because the score does not return to 0 during a diagnostic elimination diet. This study aims to establish normal values in healthy Egyptian infants.
In this prospective cross-sectional study, pediatricians determined the CoMiSS in healthy infants ≤ 12 months. Infants seeking medical help due to cow's milk allergy (CMA) symptoms and infants with any known or suspected diseases, preterm delivery, medication, or food supplements were excluded.
A total of 808 infants were included with a median (Q1; Q3) age of 7 (3;10) months (50.7% boys). The median (Q1; Q3) CoMiSS was 5 (5;6). The 95th percentile was 7. There was no significant difference in the median CoMiSS according to gender ( = 0.621) or due to breastfeeding exclusively ( = 0.603). A significant difference was seen in the CoMiSS according to age, although all the age categories had a median CoMiSS of 5.
This study revealed the median CoMiSS is 5 in presumed healthy Egyptian infants aged 0-12 months. The CoMiSS was not dependent on feeding. The determination of the CoMiSS in healthy infants allows for the determination of a cut-off under which CMA is unlikely, and a cut-off to raise awareness of CMA, thereby preventing under- and overdiagnosis. Since the median CoMiSS was not different in European infants, the outcome suggests that the CoMiSS may be a reliable awareness tool for CMA independent of ethnicity. However, additional studies are needed to confirm the previous hypothesis.
牛奶相关症状评分（CoMiSS）是作为一种牛奶相关症状的意识工具而创建的。经过不同的试验，选择≥10 分来提高意识。由于在诊断性排除饮食期间评分不会恢复到 0，因此需要确定健康婴儿的 CoMiSS。本研究旨在确定埃及健康婴儿的正常值。
在这项前瞻性横断面研究中，儿科医生确定了≤12 个月健康婴儿的 CoMiSS。因牛奶过敏（CMA）症状寻求医疗帮助的婴儿和任何已知或疑似疾病、早产、用药或食物补充剂的婴儿均被排除在外。
共纳入 808 名婴儿，中位（Q1；Q3）年龄为 7（3；10）个月（50.7%为男孩）。中位（Q1；Q3）CoMiSS 为 5（5；6）。第 95 百分位数为 7。性别（ = 0.621）或纯母乳喂养（ = 0.603）对中位 CoMiSS 无显著差异。年龄对 CoMiSS 有显著影响，尽管所有年龄组的中位 CoMiSS 均为 5。
本研究揭示了 0-12 个月的埃及健康婴儿的中位 CoMiSS 为 5。CoMiSS 不受喂养方式的影响。在健康婴儿中确定 CoMiSS，可确定 CMA 不太可能的截断值，并确定提高 CMA 意识的截断值，从而避免过度诊断和漏诊。由于欧洲婴儿的中位 CoMiSS 无差异，因此结果表明 CoMiSS 可能是一种独立于种族的 CMA 可靠意识工具。然而，需要进一步的研究来证实之前的假设。
