Incidance of cow's milk protein allergy in infants aged 0-6 months

Aim: Cow's milk protein allergy (CMPA) is an immune response that occurs repetitively against cow's milk proteins by immunological mechanisms. Its Incidance varies between 0.5-3% and 1.9-4.9% depending on the characteristics of the host and the method used for diagnosis respectively. Cow's milk-related symptom score (COMiSS) was developed to predict CMPA. In this study, we aim to find the incidance of CMPA in infants aged 0-6 months, to determine the most suitable cutt-off value and the usability of COMiSS in Turkish children. Materials and Methods: The most appropriate cut-off value was determined by applying the Turkish version of the COMiS Scoring system to patients with a definite diagnosis of CMPA and the control group. Healthy newborns who were born in our hospital between 01 August 2019 and 31 March 2020, were questioned for complications that were related to CMPA monthly up to 6 months. Detailed anamnesis of the babies with complaints was obtained and physical examinations were performed. COMiSS were applied to the cases. Hemogram, total IgE, milk, and egg specific IgE, and skin prick tests were performed in patients who had had COMiSS above the cut-off value. The diagnosis of CMPA was confirmed with elimination and challenge diet. Results: 38 patients who were previously diagnosed with CMPA and 38 healthy subjects, as the control group, were included in the study. The age and gender characteristics of the CMPA group and the control group were similar. The mean values of the COMiSS of the CMPA and control groups were 13.52 ± 2.64 (13.5) and 6.71 ± 2.80 (7.0) (p <0.001), respectively. When the cut-off point was taken 10 for COMiSS, the sensitivity was 89.47% (95% CI 75.2-97.1%) and the specificity was 84.21% (95% CI 67.7-94.0%). CMPA diagnosis was made in 12 (%2.9) cases in the study. COMiSS at admission and after elimination diet mean ± SD was 13.33 ± 1.23 and 6.50 ± 1.50 (p <0.001), respectively. It was found that a family history of allergic disease (58.3% vs 15.5%, p = 0.001) increased the risk of CMPA. Conclusion: Incidance of cow's milk protein allergy in infants aged 0-6 months is 2.9%. The COMiSS is a very useful tool in predicting the CMPA. CMPA should be considered in patients with symptoms suggestive of the disease, a family history of allergic disease, and a COMiSS above point 10. Key Words: CMPA, COMiSS