Navigating the Cow’s Milk Allergy Journey: From Diagnosis to Nutritional Optimisation

Abstract

Cow’s milk allergy (CMA) currently ranks as one of the most common infant food allergies and requires timely diagnosis and appropriate management to mitigate the impact on growth and developmental outcomes and minimise patient/parent distress. During this symposium, chaired by Yvan Vandenplas, Emeritus at KidZ Health Castle, University Hospital Brussels, Belgium, leading experts in paediatric gastroenterology, allergy, and nutrition, discussed how best to navigate the CMA journey in clinical practice, from accurate differential diagnosis to nutritional optimisation. Annamaria Staiano, Professor of Paediatrics and Chief of the Department of Translational Medical Sciences at the University of Naples ‘Federico II’, Italy, discussed the complexities of differentiating disorders of gut–brain interaction (DGBI), previously known as functional gastrointestinal disorders, from CMA, and considered the potential role of the Cow’s Milk Related Symptom Score (CoMiSSTM) in ensuring infants follow the correct diagnostic pathway. Ralf Heine, Paediatric Gastroenterologist, Allergist, and Honorary Research Fellow at the Murdoch Children’s Research Institute in Melbourne, Australia, explored the immune-modulating effects of human milk oligosaccharides (HMO) and lactose on the gastrointestinal (GI) microbiota in infants, highlighting the importance of the early-life microbiome during the nutritional management of CMA. Rosan Meyer, Paediatric Dietitian and visiting Professor at both KU Leuven, Belgium, and the University of Winchester, UK, focused on the final phase of CMA management, the reintroduction of cow’s milk protein, and also examined new evidence to support the optimal timing and strategy for this key step in clinical practice.