Mislabelled cow's milk allergy in infants: a prospective cohort study

Background Although cow's milk allergy (CMA) is one of the most common food allergies, mislabelling non-allergic infants as being allergic to cow's milk is more common. Despite this, characteristics of families and infants with mislabelled CMA are lacking. Methods Using a prospective population-based study, we identified infants with any possible adverse reaction to cow's milk (n=381) from a cohort of 13 019 infants followed from birth. They had a detailed history taken, skin prick tests and an oral food challenge when indicated. Infants with symptoms for which the causative relationship to cow's milk protein was excluded were compared with infants with IgE-mediated CMA and with a control group, and followed for 2–5 years. Results Overall, 243 infants (1.87%) with mislabelled CMA were identified. Compared with 66 infants with IgE-mediated CMA, those with mislabelled CMA presented earlier and with symptoms usually involving a single organ system. Doctor-diagnosed atopic dermatitis (AD) was associated with mislabelled CMA (p