{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:36:26Z","timestamp":1793723786121,"version":"4.6.1"},"reference-count":75,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,8,1]],"date-time":"2012-08-01T00:00:00Z","timestamp":1343779200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This guideline provides recommendations for the diagnosis and management of suspected cow's\u2010milk protein allergy (CMPA) in Europe. It presents a practical approach with a diagnostic algorithm and is based on recently published evidence\u2010based guidelines on CMPA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Diagnosis:<\/jats:title>\n                    <jats:p>If CMPA is suspected by history and examination, then strict allergen avoidance is initiated. In certain circumstances (eg, a clear history of immediate symptoms, a life\u2010threatening reaction with a positive test for CMP\u2013specific IgE), the diagnosis can be made without a milk challenge. In all other circumstances, a controlled oral food challenge (open or blind) under medical supervision is required to confirm or exclude the diagnosis of CMPA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Treatment:<\/jats:title>\n                    <jats:p>In breast\u2010fed infants, the mother should start a strict CMP\u2010free diet. Non\u2013breast\u2010fed infants with confirmed CMPA should receive an extensively hydrolyzed protein\u2010based formula with proven efficacy in appropriate clinical trials; amino acids\u2013based formulae are reserved for certain situations. Soy protein formula, if tolerated, is an option beyond 6 months of age. Nutritional counseling and regular monitoring of growth are mandatory in all age groups requiring CMP exclusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reevaluation:<\/jats:title>\n                    <jats:p>Patients should be reevaluated every 6 to 12 months to assess whether they have developed tolerance to CMP. This is achieved in &gt;75% by 3 years of age and &gt;90% by 6 years of age. Inappropriate or overly long dietary eliminations should be avoided. Such restrictions may impair the quality of life of both child and family, induce improper growth, and incur unnecessary health care costs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/mpg.0b013e31825c9482","type":"journal-article","created":{"date-parts":[[2012,5,8]],"date-time":"2012-05-08T07:46:47Z","timestamp":1336463207000},"page":"221-229","source":"Crossref","is-referenced-by-count":637,"title":["Diagnostic Approach and Management of Cow's\u2010Milk Protein Allergy in Infants and Children"],"prefix":"10.1002","volume":"55","author":[{"given":"S.","family":"Koletzko","sequence":"first","affiliation":[{"name":"Dr von Haunersches Kinderspital Ludwig\u2010Maximilians\u2010University Munich"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Niggemann","sequence":"additional","affiliation":[{"name":"Pediatric Allergology and Pneumology German Red Cross Hospital Westend Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Arato","sequence":"additional","affiliation":[{"name":"First Department of Pediatrics Semmelweis University Budapest Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.A.","family":"Dias","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Hospital S. Jo\u00e3o Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Heuschkel","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology Addenbrooke's Hospital Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Husby","sequence":"additional","affiliation":[{"name":"Hans Christian Andersen Children's Hospital OUH Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.L.","family":"Mearin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Papadopoulou","sequence":"additional","affiliation":[{"name":"First Department of Pediatrics Athens Children's Hospital P. &amp; A. Kyriakou Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.M.","family":"Ruemmele","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Descartes Sorbonne Cit\u00e9 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Staiano","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Naples \u201cFederico II\u201d Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.G.","family":"Sch\u00e4ppi","sequence":"additional","affiliation":[{"name":"Unit of Pediatric Gastroenterology Department of Pediatrics University Hospitals of Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Vandenplas","sequence":"additional","affiliation":[{"name":"UZ Brussel Vrije Universiteit Brussel Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,8]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2010.10.008"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2010.11.044"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2007.05.026"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2002.121458"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-200410000-00015"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1398-9995.2001.056005393.x"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2010.10.033"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2010.10.011"},{"issue":"21","key":"e_1_2_13_10_1","first-page":"1","article-title":"World Allergy Organization (WAO) diagnosis and rationale for action against cow's milk allergy (DRACMA) guidelines","volume":"21","author":"Fiocchi A","year":"2010","journal-title":"Pediatr Allergy Immunol"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00112-009-2014-x"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2008.tb01534.x"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-009-0955-7"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1754.2009.01546.x"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2002.121935"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3038.2010.00991.x"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2009.02171.x"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.1990.tb00944.x"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3038.13.s.15.7.x"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1988.tb10727.x"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2005.00705.x"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACI.0b013e32813aee4a"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-1069"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.108.4.1047"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199810153391602"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/10245330600775105"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199208063270603"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2004.09.033"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1997.tb14803.x"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.1997.tb02427.x"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2007.08.023"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2001.114708"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.2005.02150.x"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.2005.2324.x"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1526-0542(03)00026-5"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2001.120192"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2005.08.033"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2222.1998.00383.x"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3181b97bed"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2005.00806.x"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2008.01705.x"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2004.024513"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2002.126299"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(97)70104-5"},{"key":"e_1_2_13_45_1","volume-title":"Nutrition During Pregnancy and Lactation: An Implementation Guide","author":"Institute of Medicine.","year":"1992"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(99)70368-9"},{"key":"e_1_2_13_47_1","first-page":"CD000133","article-title":"Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child","volume":"3","author":"Kramer MS","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_13_48_1","first-page":"CD005203","article-title":"Dietary exclusions for established atopic eczema","volume":"1","author":"Bath\u2010Hextall F","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_13_49_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.81.1.80"},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACI.0b013e32832b3f33"},{"key":"e_1_2_13_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3038.2007.00653.x"},{"key":"e_1_2_13_52_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e318054b0c3"},{"key":"e_1_2_13_53_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2004.00466.x"},{"key":"e_1_2_13_54_1","doi-asserted-by":"publisher","DOI":"10.1159\/000247298"},{"key":"e_1_2_13_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2008.10.010"},{"key":"e_1_2_13_56_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.all.0000225164.06016.5d"},{"key":"e_1_2_13_57_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3038.2008.00785.x"},{"key":"e_1_2_13_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2008.06.002"},{"key":"e_1_2_13_59_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2007.01501.x"},{"key":"e_1_2_13_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2010.12.1098"},{"key":"e_1_2_13_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2008.05.043"},{"key":"e_1_2_13_62_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114511004831"},{"key":"e_1_2_13_63_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-3022"},{"key":"e_1_2_13_64_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.106.2.346"},{"key":"e_1_2_13_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(95)70111-7"},{"key":"e_1_2_13_66_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3038.2007.00566.x"},{"key":"e_1_2_13_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(99)70249-0"},{"key":"e_1_2_13_68_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mpg.0000189358.38427.cd"},{"key":"e_1_2_13_69_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-0564"},{"key":"e_1_2_13_70_1","unstructured":"Scientific Committee on Food.Report on the Revision of Essential Requirements of Infant Formulae and Follow\u2010on Formulae. SCF\/CS\/NUT\/IF\/65;2003."},{"key":"e_1_2_13_71_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/68.6.1453S"},{"key":"e_1_2_13_72_1","first-page":"158","volume-title":"Food Allergy in Childhood. Causes and Consequences","author":"Koletzko B","year":"2007"},{"key":"e_1_2_13_73_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3181fb9e80"},{"key":"e_1_2_13_74_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mpg.0000304464.60788.bd"},{"key":"e_1_2_13_75_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e31819f1e05"},{"key":"e_1_2_13_76_1","doi-asserted-by":"publisher","DOI":"10.1079\/BJN20051503"}],"container-title":["Journal of Pediatric Gastroenterology and Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1097\/MPG.0b013e31825c9482","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T08:25:42Z","timestamp":1705566342000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1097\/MPG.0b013e31825c9482"}},"subtitle":["ESPGHAN GI Committee Practical Guidelines"],"short-title":[],"issued":{"date-parts":[[2012,8]]},"references-count":75,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2012,8]]}},"alternative-id":["10.1097\/MPG.0b013e31825c9482"],"URL":"https:\/\/doi.org\/10.1097\/mpg.0b013e31825c9482","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.721710551.793503711","asserted-by":"object"}]},"ISSN":["0277-2116","1536-4801"],"issn-type":[{"value":"0277-2116","type":"print"},{"value":"1536-4801","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,8]]}}}