Next Article in Journal
Dietary Compounds for Targeting Prostate Cancer
Next Article in Special Issue
Statistical Approaches in the Studies Assessing Associations between Human Milk Immune Composition and Allergic Diseases: A Scoping Review
Previous Article in Journal
Human Milk Oligosaccharide, Phospholipid, and Ganglioside Concentrations in Breast Milk from United Arab Emirates Mothers: Results from the MISC Cohort
Previous Article in Special Issue
Oral Tolerance Induction to Newly Introduced Allergen is Favored by a Transforming Growth Factor-β-Enriched Formula
Open AccessArticle

Testing the Cow’s Milk-Related Symptom Score (CoMiSSTM) for the Response to a Cow’s Milk-Free Diet in Infants: A Prospective Study

1
Department of Pediatrics, Ospedale F. Del Ponte, ASST-Sette Laghi, Università dell’Insubria, 21100 Varese, Italy
2
Statistic and Economic Science, University of Bicocca, 20126 Milano, Italy
3
Department of Pediatrics, Vittore Buzzi Children’s Hospital-University of Milan, 20154 Milan, Italy
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(10), 2402; https://doi.org/10.3390/nu11102402
Received: 2 August 2019 / Revised: 24 September 2019 / Accepted: 29 September 2019 / Published: 8 October 2019
(This article belongs to the Special Issue Nutrition, Diet, and Allergic Diseases)
The diagnosis of cow’s milk allergy (CMA) is particularly challenging in infants, especially with non-Immunoglobulin E (IgE)-mediated manifestations, and inaccurate diagnosis may lead to unnecessary dietary restrictions. The aim of this study was to assess the accuracy of the cow’s milk-related symptom score (CoMiSSTM) in response to a cow’s milk-free diet (CMFD). We prospectively recruited 47 infants (median age three months) who had been placed on a CMFD due to persisting unexplained gastrointestinal symptoms. We compared data with 94 healthy controls (median age three months). The CoMiSSTM score was completed at recruitment and while on the exclusion diet. In 19/47 (40%) cases a response to the diet occurred. At recruitment CoMiSSTM was significantly higher in cases compared to controls (median score 8 vs. 3; p-value: <0.05), 9 cases had a score ≥12 and 8/9 normalized on CMFD. An oral milk challenge was performed in all 19 responders and six of these had a positive reaction to cow’s milk (CM). In eight infants IgE allergy tests were positive. The receiver operation characteristic (ROC) curve identified a CoMISSTM score of 9 to be the best cut-off value (84% sensitivity, 85% specificity, 80% positive (PPV) and 88% negative predictive value (NPV)) for the response to CMFD. We found CoMiSSTM to be a useful tool to help identify infants with persisting gastrointestinal symptoms and suspected CMA that would benefit from CMFD. View Full-Text
Keywords: cow’s milk allergy; regurgitation; CoMiSSTM; cow’s milk-free diet; infants; crying; hydrolysed formulas; gastrointestinal cow’s milk allergy; regurgitation; CoMiSSTM; cow’s milk-free diet; infants; crying; hydrolysed formulas; gastrointestinal
Show Figures

Figure 1

MDPI and ACS Style

Salvatore, S.; Bertoni, E.; Bogni, F.; Bonaita, V.; Armano, C.; Moretti, A.; Baù, M.; Luini, C.; D’Auria, E.; Marinoni, M.; Zuccotti, G.; Agosti, M. Testing the Cow’s Milk-Related Symptom Score (CoMiSSTM) for the Response to a Cow’s Milk-Free Diet in Infants: A Prospective Study. Nutrients 2019, 11, 2402.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop