COWS MILK PROTEIN INTOLERANCE IN INFANTS UNDER 1-YEAR-OF-AGE - A PROSPECTIVE EPIDEMIOLOGIC-STUDY

Incidence and clinical manifestation of cow's milk protein intolerance (CMPI) were studied in 1158 unselected newborn infants followed prosp ectively from birth to 1 year of age. No food changes were required in 914 infants who were used as healthy controls. When CMPI was suspecte d (211 infants), diagnostic dietary interventions according to a stand ard protocol were performed. After exclusion of lactose intolerance, t wo positive cow's milk elimination/challenge tests were considered dia gnostic of CMPI. Two hundred and eleven symptomatic infants were exami ned for possible CMPI. A large group of 80 infants improved on a lacto se reduced formula. In 87/211 infants CMPI was excluded (sick controls ). Finally CMPI was proven in 26 infants. The calculated incidence rat e for CMPI was 2.8%. The principal symptoms in infants with CMPI were gastrointestinal, dermatological and respiratory in 50%, 31% and 19% r espectively. A positive family history for atopy (first or second degr ee relatives) was more frequent in either CMPI infants (65%), or sick controls (63%) when compared to either healthy controls (35%) or infan ts improving on a low lactose formula (51%). Differences between patie nts with CMPI and sick controls were only found for the presence of at opy in at least 2 first degree relatives [(5/26 in CMPI infants and 4/ 87 in sick controls (P < 0.05)] and for multiorgan involvement [10/26 infants with CMPI as opposed to 12/87 in the sick control group (P < 0 .02)]. These statistical differences are too weak to be of clinical va lue.