Studies in cow’s milk allergy: results from the Dutch EuroPrevall birth cohort

Cow’s milk allergy is a common disease in infancy. However, until recently accurate numbers were not available. To investigate how many infants suffered from cow’s milk allergy, the EuroPrevall study was designed. In this European, multicentre study, nine European hospitals followed over 12,000 children from birth up to 2.5 years of age. All children with symptoms suspected of cow’s milk allergy were further evaluated according to international guidelines, including a double blind placebo-controlled food challenge.
Five percent of the Dutch children participating in this study had challenge proven cow’s milk allergy. While being treated for cow’s milk allergy, half of the children were not symptom free when using the standard cow’s milk protein free formula (extensively hydrolysed formula), but were symptom free after using an amino acid formula. This was more than expected.
Furthermore, some hereditary components for cow’s milk allergy were identified. A hypermethylation was found with epigenetic investigations in children with cow’s milk allergy compared to healthy age-matched controls. Second, 2 small genetic changes (SNP’s) were found more often in children with cow’s milk allergy compared to their healthy age-matched controls. These 2 changes were previously reported in asthma and allergic rhinitis. This might favour the allergic march hypothesis.