Evaluation of vomiting and regurgitation in the infant

Section of Allergy and Immunology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, USA.
Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology (Impact Factor: 2.75). 01/2012; 108(1):3-6. DOI: 10.1016/j.anai.2011.11.001
Source: PubMed
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    ABSTRACT: To provide information on certain formulas that are relevant to allergy practice, focusing on their protein source and allergenicity, and to provide recommendations for selecting an optimal formula, taking into consideration efficacy, safety, palatability, and cost. A literature search using the PubMed database for the following keywords: hypoallergenic formulas, infant formulas, hydrolysate formulas, elemental formulas, and amino acids formulas. Information was derived from pertinent original studies and selected reviews, including recent Cochrane Database Systematic Reviews, published in the English-language literature. For a formula to be considered hypoallergenic, it should be well tolerated by at least 90% of individuals who are allergic to the parent protein from which that formula has been derived. Extensively hydrolyzed formulas (EHFs), derived from bovine casein or whey, are tolerated by approximately 95% of cow's milk allergic individuals. Elemental formulas are prepared from synthesized free amino acids and are well tolerated practically by all individuals, including those who are allergic to EHFs. Partially hydrolyzed whey formula (PHWFs) cause allergy in one-third to half of milk allergic individuals and are not considered hypoallergenic. Both EHFs and PHWFs seem to be equally effective in reducing the risk of development of allergy in infants of atopic families. The EHFs and amino acids formulas, but not the partially hydrolyzed formulas, are optimal for milk allergic individuals. All 3 types of formulas are useful for prevention. The cost and palatability should be considered in deciding which formula to use.
    Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology 12/2008; 101(5):453-9; quiz 459-61, 481. DOI:10.1016/S1081-1206(10)60281-5 · 2.75 Impact Factor
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    ABSTRACT: The diagnosis of food allergy depends on thorough medical history-taking that may be supplemented with trials of dietary eliminations, skin testing, and specific IgE antibody measurement. However, the reliability of such procedures is often suboptimal. For most cases, oral challenge testing is needed to confirm the diagnosis of food allergy and to identify the causative food(s). Though blinded challenges are ideal, open challenges can be appropriate in some cases, particularly in young children. An optimal design of the procedure would depend on the age of the patient, the anticipated symptoms, and the provoking food quantity. The test is much safer than many surgical and medical procedures being routinely performed. This article presents a practical guideline that can reliably and safely encourage an increased use of this important test in the diagnosis of food allergy.
    Allergy and Asthma Proceedings 11/2007; 28(6):640-6. DOI:10.2500/aap.2007.28.3068 · 3.35 Impact Factor
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    ABSTRACT: To assess whether children with history of infantile colic may be at increased risk of subsequently developing asthma and/or atopy. We used data collected in a large, prospective study from an unselected population. Infantile colic and concurrent feeding method were determined from the 2-month well-infant visit form completed by the physician for 983 children who were enrolled at birth. Markers of atopy (total serum immunoglobulin E and allergy skin prick test), allergic rhinitis, asthma, wheezing, and peak flow variability were the main outcome measures studied at different ages between infancy and 11 years. Ninety (9.2%) children had infantile colic. Prevalence of colic was similar among children fed either breast milk or formula. There was no association between infantile colic and markers of atopy, asthma, allergic rhinitis, wheezing, or peak flow variability at any age. Our data cannot support the hypothesis that infantile colic provides increased risk for subsequent allergic disease or atopy.
    PEDIATRICS 11/2001; 108(4):878-82. DOI:10.1542/peds.108.4.878 · 5.30 Impact Factor