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Milk allergy guidelines could lead to overdiagnosis in infants and kids

Experts are highlighting how common misdiagnoses are

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Food allergies are not to be taken lightly, but researchers have found that many consumers tend to overestimate whether or not they’re actually allergic to certain foods. 

Now, researchers from Imperial College London have found that current guidelines for cow’s milk allergies could lead many infants and young kids to receive allergy diagnoses that are incorrect. 

“Many infants who are labelled as having milk allergy don’t have the condition,” said researcher Dr. Robert Boyle. “Having a child with suspected milk allergy can be a stressful time for any family. Misdiagnosing milk allergy could lead to another condition with similar symptoms being missed, or breast-feeding mothers needlessly following restricted diets -- or even stop breast-feeding altogether.” 

Understanding the guidelines

The researchers analyzed guidelines for a cow’s milk allergy from various countries and medical organizations, all published between 2012 and 2019. 

The researchers explained that there are a wide range of symptoms to be aware of because there are different types of cow’s milk allergies. 

Allergies can either affect the immune system, which are known as IgE mediated allergies, or affect the gastrointestinal system, which are known as non-IgE mediated allergies. In the former group, allergies can appear as intensely as anaphylaxis, or more mildly in the form of hives or vomiting. 

Things tend to get complicated in cases of non-IgE mediated allergies when it comes to children. The researchers explained that the symptoms in these instances include extreme fussiness, vomiting, and diarrhea. However, these signs don’t always indicate an allergy. 

“In the nine guidelines we studied, seven of them suggested including milder symptoms as indication of non-IgE cow’s milk allergy, such as regurgitating milk, crying, and rashes -- but many of these symptoms are present normally in babies, and will get better in time,” said researcher Dr. Daniel Munbilt. “Non-IgE cow’s milk allergy affects less than one percent of infants whereas troublesome vomiting, crying, or eczema each affect 15-20 percent of babies.” 

Though cow’s milk allergies affect just one percent of infants, ambiguous guidelines can lead to an influx of misdiagnoses. Moving forward, the researchers hope that guidelines can be more straightforward for patients. 

“We must not only critically appraise our current guidelines, and dissociate the development of guidelines from those who may profit from them, but also ensure we are giving each family the best possible care by avoiding overdiagnosis of cow’s milk allergy,” said Boyle. 

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