Allen, HI;
Wing, O;
Milkova, D;
Jackson, E;
Li, K;
Bradshaw, LE;
Wyatt, L;
Haines, R;
Santer, M;
Murphy, AW;
et al.
Allen, HI; Wing, O; Milkova, D; Jackson, E; Li, K; Bradshaw, LE; Wyatt, L; Haines, R; Santer, M; Murphy, AW; Brown, SJ; Kelleher, M; Perkin, MR; Jay, N; Smith, TDH; Moriarty, F; Montgomery, AA; Williams, HC; Boyle, RJ
(2025)
Prevalence and risk factors for milk allergy overdiagnosis in the BEEP trial cohort.
Allergy, 80 (1).
pp. 148-160.
ISSN 1398-9995
https://doi.org/10.1111/all.16203
SGUL Authors: Perkin, Michael Richard
Abstract
BACKGROUND: Cow's milk allergy (CMA) overdiagnosis in young children appears to be increasing and has not been well characterised. We used a clinical trial population to characterise CMA overdiagnosis and identify individual-level and primary care practice-level risk factors. METHODS: We analysed data from 1394 children born in England in 2014-2016 (BEEP trial, ISRCTN21528841). Participants underwent formal CMA diagnosis at ≤2 years. CMA overdiagnosis was defined in three separate ways: parent-reported milk reaction; primary care record of milk hypersensitivity symptoms; and primary care record of low-allergy formula prescription. RESULTS: CMA was formally diagnosed in 19 (1.4%) participants. CMA overdiagnosis was common: 16.1% had parent-reported cow's milk hypersensitivity, 11.3% primary care recorded milk hypersensitivity and 8.7% had low-allergy formula prescription. Symptoms attributed to cow's milk hypersensitivity in participants without CMA were commonly gastrointestinal and reported from a median age of 49 days. Low-allergy formula prescriptions in participants without CMA lasted a median of 10 months (interquartile range 1, 16); the estimated volume consumed was a median of 272 litres (26, 448). Risk factors for CMA overdiagnosis were high practice-based low-allergy formula prescribing in the previous year and maternal report of antibiotic prescription during pregnancy. Exclusive formula feeding from birth was associated with increased low-allergy formula prescription. There was no evidence that practice prescribing of paediatric adrenaline auto-injectors or anti-reflux medications, or maternal features such as anxiety, age, parity and socioeconomic status were associated with CMA overdiagnosis. CONCLUSION: CMA overdiagnosis is common in early infancy. Risk factors include high primary care practice-based low-allergy formula prescribing and maternal report of antibiotic prescription during pregnancy.
Item Type: |
Article
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Additional Information: |
© 2024 The Author(s). Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
Keywords: |
cow's milk allergy, low‐allergy formula, overdiagnosis, primary care, cow's milk allergy, low-allergy formula, overdiagnosis, primary care, 1107 Immunology, Allergy |
SGUL Research Institute / Research Centre: |
Academic Structure > Population Health Research Institute (INPH) |
Journal or Publication Title: |
Allergy |
ISSN: |
1398-9995 |
Language: |
eng |
Dates: |
Date | Event |
---|
10 January 2025 | Published | 20 June 2024 | Published Online | 2 June 2024 | Accepted |
|
Publisher License: |
Creative Commons: Attribution 4.0 |
Projects: |
|
PubMed ID: |
38899450 |
Web of Science ID: |
WOS:001251941200001 |
 |
Go to PubMed abstract |
URI: |
https://openaccess.sgul.ac.uk/id/eprint/116617 |
Publisher's version: |
https://doi.org/10.1111/all.16203 |
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