Navigating the Cow’s Milk Allergy Journey: From Diagnosis to Nutritional Optimization

There are many challenges when it comes to Cow’s Milk Allergy (CMA), and this NNI symposium at ESPGHAN 2024 allows experts to share new findings on how to make the process of diagnosis to management more efficient and effective to yield better results. Prof. Annamaria Staiano discusses the complexities of diagnosing FGID (now called Disorders of Gut Brain Interaction, DGBI) and CMA, the known prevalence, and its difficulty to distinguish. She introduces CoMiSS and its experience in supporting the diagnosis of CMA, how it could potentially help to distinguish between DGBI and CMA and to ensure that infants follow the correct diagnostic path to CMA if this is highly suspected. Dr. Ralf Heine addresses the next phase of CMA nutritional management once it has been diagnosed. His key message is that during this phase it is important to consider the infants microbiome, other aspects of adequate nutritional intake, as well as immune modulating factors. Dr. Rosan Meyer discusses the next phase of CMA management, when to start the re-introduction of Cow’s Milk protein, discussing the potential use of Milk Ladder approach for both non IgE and IgE mediated CMA. Evidence suggests that cow’s milk should be introduced earlier than in recent years, to enable the infant to build up tolerance as soon as possible.