Influence of dietary factors on duration of cow's milk allergy

Children with allergy to cow's milk often outgrow the condition, but the factors influencing this process are not yet understood. A research group in Italy have conducted a prospective analysis of symptomatic patients from the Milan Cow's Milk Allergy Cohort to assess the impact of diet on the duration of cow's milk allergy.

The researchers randomly switched the formula consumed by seventy-two children participating in the study (mean age at diagnosis was 14 months). The children were allocated one of three treatments: rice hydrolysate formula; extensively hydrolysed cow's milk formula; and soy-based formula. Follow-up continued for a median of twenty-six months.

In total, fifty-one of the children achieved tolerance to cow's milk, at a mean of 34 months. For those on milk hydrolysate formula, the mean duration of the disease was approximately 40 months, whereas those on rice and soy formula achieved tolerance to cow's milk at a mean age of 24 months.

The researchers found that those patients not exposed to cow's milk protein residue achieved tolerance to cow's milk earlier than those who had an extensively hydrolysed cow's milk diet. They proposed this may be due to residual antigenicity in hydrolysed milks. They found the effect of dietary intervention was greater in patients not co-sensitised to soy and therefore believe that the elimination of exposure to allergens in patients with multiple allergies may not be sufficient to reduce the duration of cow's milk allergy.

Reference: Terracciano et al. 2009. Clinical & Experimental Allergy. Doi: 10.1111/j.1365-2222.2009.03427.x