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Pediatr Gastroenterol Hepatol Nutr. 2014 Jun;17(2):61-73. English. Review.
Vandenplas Y , Abuabat A , Al-Hammadi S , Aly GS , Miqdady MS , Shaaban SY , Torbey PH .
Department of Pediatrics, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
King Abdullah Bin Abdul Aziz University Hospital, Princess Nora Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia.
Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.
Department of Child Health and Nutrition, Institute of Postgraduate Childhood Studies, Ain Shams University, Cairo, Egypt.
Division of Pediatric Gastroenterology, Hepatology & Nutrition, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Department of Pediatrics, Hotel-Dieu de France, St. Joseph University, Beirut, Lebanon.

Presented are guidelines for the prevention, diagnosis, and treatment of cow's milk protein allergy (CMPA) which is the most common food allergy in infants. It manifests through a variety of symptoms that place a burden on both the infant and their caregivers. The guidelines were formulated by evaluation of existing evidence-based guidelines, literature evidence and expert clinical experience. The guidelines set out practical recommendations and include algorithms for the prevention and treatment of CMPA. For infants at risk of allergy, appropriate prevention diets are suggested. Breastfeeding is the best method for prevention; however, a partially hydrolyzed formula should be used in infants unable to be breastfed. In infants with suspected CMPA, guidelines are presented for the appropriate diagnostic workup and subsequent appropriate elimination diet for treatment. Exclusive breastfeeding and maternal dietary allergen avoidance are the best treatment. In infants not exclusively breastfed, an extensively hydrolyzed formula should be used with amino acid formula recommended if the symptoms are life-threatening or do not resolve after extensively hydrolyzed formula. Adherence to these guidelines should assist healthcare practitioners in optimizing their approach to the management of CMPA and decrease the burden on infants and their caregivers.

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