{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:48:49Z","timestamp":1792630129965,"version":"4.5.0"},"reference-count":92,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T00:00:00Z","timestamp":1611187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Cow\u2019s milk allergy (CMA) and gastro-esophageal reflux disease (GERD) may manifest with similar symptoms in infants making the diagnosis challenging. While immediate reaction to cow\u2019s milk protein indicate CMA, regurgitation, vomiting, crying, fussiness, poor appetite, sleep disturbances have been reported in both CMA and GERD and in other conditions such as functional gastrointestinal disorders, eosinophilic esophagitis, anatomic abnormalities, metabolic and neurological diseases. Gastrointestinal manifestations of CMA are often non-IgE mediated and clinical response to cow\u2019s milk free diet is not a proof of immune system involvement. Neither for non-IgE CMA nor for GERD there is a specific symptom or diagnostic test. Oral food challenge, esophageal pH impedance and endoscopy are recommended investigations for a correct clinical classification but they are not always feasible in all infants. As a consequence of the diagnostic difficulty, both over- and under- diagnosis of CMA or GERD may occur. Quite frequently acid inhibitors are empirically started. The aim of this review is to critically update the current knowledge of both conditions during infancy. A practical stepwise approach is proposed to help health care providers to manage infants presenting with persistent regurgitation, vomiting, crying or distress and to solve the clinical dilemma between GERD or CMA.<\/jats:p>","DOI":"10.3390\/nu13020297","type":"journal-article","created":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T02:36:05Z","timestamp":1611196565000},"page":"297","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Cow\u2019s Milk Allergy or Gastroesophageal Reflux Disease\u2014Can We Solve the Dilemma in Infants?"],"prefix":"10.3390","volume":"13","author":[{"given":"Silvia","family":"Salvatore","sequence":"first","affiliation":[{"name":"Department of Medicine and Surgery, Pediatric Unit, \u201cF. Del Ponte\u201d Hospital, University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Agosti","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Pediatric Unit, \u201cF. Del Ponte\u201d Hospital, University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0590-6664","authenticated-orcid":false,"given":"Maria Elisabetta","family":"Baldassarre","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Human Oncology-Neonatology and NICU Section, \u201cAldo Moro\u201d University of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enza","family":"D\u2019Auria","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Vittore Buzzi Children\u2019s Hospital, University of Milan, 20154 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2043-5530","authenticated-orcid":false,"given":"Licia","family":"Pensabene","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Pediatric Unit, University \u201cMagna Graecia\u201d of Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luana","family":"Nosetti","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Pediatric Unit, \u201cF. Del Ponte\u201d Hospital, University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1862-8651","authenticated-orcid":false,"given":"Yvan","family":"Vandenplas","sequence":"additional","affiliation":[{"name":"Kidz Health Castle, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 1090 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1542\/peds.110.5.972","article-title":"Gastroesophageal reflux and cow milk allergy: Is there a link?","volume":"110","author":"Salvatore","year":"2002","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1111\/all.12423","article-title":"EAACI Food Allergy and Anaphylaxis Guidelines Group Prevalence of common food allergies in Europe: A systematic review and meta-analysis","volume":"69","author":"Nwaru","year":"2014","journal-title":"Allergy"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1097\/MPG.0000000000000949","article-title":"Prevalence and Health Outcomes of Functional Gastrointestinal Symptoms in Infants From Birth to 12 Months of Age","volume":"61","author":"Vandenplas","year":"2015","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1111\/apa.13270","article-title":"Functional gastro-intestinal disorder algorithms focus on early recognition, parental reassurance and nutritional strategies","volume":"105","author":"Vandenplas","year":"2015","journal-title":"Acta Paediatr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1007\/BF00441767","article-title":"Cow\u2019s milk protein allergy and gastro-oesophageal reflux","volume":"144","author":"Forget","year":"1985","journal-title":"Eur. J. Pediatr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1111\/j.1440-1754.1994.tb00653.x","article-title":"Is cow\u2019s milk protein intolerance a cause of gastro-oesophageal reflux in infancy?","volume":"30","author":"McLain","year":"1994","journal-title":"J. Paediatr. Child. Health"},{"key":"ref_7","first-page":"1215","article-title":"Gastroesophageal reflux associated with cow\u2019s milk allergy in infants, which diagnostic examinations are useful?","volume":"91","author":"Cavataio","year":"1996","journal-title":"Am. J. Gastroenterol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1136\/adc.75.1.51","article-title":"Clinical and pH-metric characteristics of gastro-oesophageal reflux secondary to cows\u2019 milk protein allergy","volume":"75","author":"Cavataio","year":"1996","journal-title":"Arch. Dis. Child."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1016\/S0091-6749(96)80160-6","article-title":"Gastroesophageal reflux and cow\u2019s milk allergy in infants, a prospective study","volume":"97","author":"Iacono","year":"1996","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1136\/adc.77.2.183a","article-title":"Gastro-oesophageal reflux and cows\u2019 milk protein allergy","volume":"77","author":"Milocco","year":"1997","journal-title":"Arch. Dis. Child."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1136\/adc.73.5.439","article-title":"Differentiation of cows\u2019 milk intolerance and gastro-oesophageal reflux","volume":"73","author":"Staiano","year":"1995","journal-title":"Arch. Dis. Child."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/S0301-0546(02)79085-X","article-title":"An extensively hydrolysed cow\u2019s milk formula im-proves clinical symptoms of gastroesophageal reflux and reduces the gastric emptying time in infants","volume":"30","author":"Garzi","year":"2002","journal-title":"Allergol. Immunopathol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"298","DOI":"10.5009\/gnl.2011.5.3.298","article-title":"Cow\u2019s milk allergy among children with gastroesopha-geal reflux disease","volume":"5","author":"Farahmand","year":"2011","journal-title":"Gut Liver."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1067\/mpd.2000.104774","article-title":"Role of food protein intolerance in infants with persistent distress attributed to reflux esophagitis","volume":"136","author":"Hill","year":"2000","journal-title":"J. Pediatr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1097\/01.all.0000225164.06016.5d","article-title":"Gastroesophageal reflux disease, colic and constipation in infants with food allergy","volume":"6","author":"Heine","year":"2006","journal-title":"Curr. Opin. Allergy Clin. Immunol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1111\/j.1440-1754.2006.00812.x","article-title":"Clinical predictors of pathological gastro-oesophageal reflux in infants with persistent distress","volume":"42","author":"Heine","year":"2006","journal-title":"J. Paediatr. Child. Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1002\/j.1536-4801.2004.tb00871.x","article-title":"Severe Gastroesophageal Reflux Disease and Cow Milk Hypersensitivity in Infants and Children: Disease Association and Evaluation of a New Challenge Procedure","volume":"39","author":"Nielsen","year":"2004","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1136\/jcp.2004.024513","article-title":"Eosinophilia in the upper gastrointestinal tract is not a characteristic fea-ture in cow\u2019s milk sensitive gastro-oesophageal reflux disease Measurement by two methodologies","volume":"59","author":"Nielsen","year":"2006","journal-title":"J. Clin. Pathol."},{"key":"ref_19","first-page":"199","article-title":"24-hour esophageal pH monitoring in children with pathological acid gastroesophageal reflux: Primary and secondary to food allergy. Part, I. Intraesophageal pH values in distal channel; preliminary study and control studies--after 1, 2, 4 and 9 years of clinical observation as well as dietary and pharmacological treatment","volume":"52","author":"Semeniuk","year":"2007","journal-title":"Adv. Med. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Semeniuk, J., Kaczmarski, M., and U\u015bcinowicz, M. (2008). Manometric study of lower esophageal sphincter in children with primary acid gastroesophageal reflux and acid gastroesophageal reflux secondary to food allergy. Adv. Med. Sci., 53.","DOI":"10.2478\/v10039-008-0034-8"},{"key":"ref_21","first-page":"59","article-title":"Vomiting and gastric motility in infants with cow\u2019s milk allergy","volume":"32","author":"Ravelli","year":"2001","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.jpeds.2012.03.002","article-title":"Cow\u2019s Milk Challenge Increases Weakly Acidic Reflux in Children with Cow\u2019s Milk Allergy and Gastroesophageal Reflux Disease","volume":"161","author":"Borrelli","year":"2012","journal-title":"J. Pediatr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.jped.2013.05.009","article-title":"Gastroesophageal reflux disease, exaggerations, evidence and clinical practice","volume":"90","author":"Ferreira","year":"2014","journal-title":"J. Pediatr."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e243","DOI":"10.1111\/apa.12615","article-title":"Extensive protein hydrolysate formula effectively reduces regurgitation in infants with positive and negative challenge tests for cow\u2019s milk allergy","volume":"103","author":"Vandenplas","year":"2014","journal-title":"Acta Paediatr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.3390\/nu7032015","article-title":"The Controversial Role of Food Allergy in Infantile Colic: Evidence and Clinical Management","volume":"7","author":"Nocerino","year":"2015","journal-title":"Nutrients"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1111\/ped.12779","article-title":"Food allergy in children with refractory gastroesophageal reflux disease","volume":"58","author":"Yukselen","year":"2015","journal-title":"Pediatr. Int."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Pensabene, L., Salvatore, S., D\u2019Auria, E., Parisi, F., Concolino, D., Borrelli, O., Thapar, N., Staiano, A., Vandenplas, Y., and Saps, M. (2018). Cow\u2019s Milk Protein Allergy in Infancy: A Risk Factor for Functional Gastrointestinal Disorders in Children?. Nutrients, 10.","DOI":"10.3390\/nu10111716"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"D\u2019Auria, E., Salvatore, S., Pozzi, E., Mantegazza, C., Sartorio, M.U.A., Pensabene, L., Baldassarre, M.E., Agosti, M., Vandenplas, Y., and Zuccotti, G.V. (2019). Cow\u2019s Milk Allergy: Immunomodulation by Dietary Intervention. Nutrients, 11.","DOI":"10.3390\/nu11061399"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1097\/MPG.0000000000002600","article-title":"Characterization of Upper Gastrointestinal Motility in Infants with Persistent Distress and Non-IgE-mediated Cow\u2019s Milk Protein Allergy","volume":"70","author":"Omari","year":"2020","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/MPG.0b013e31825c9482","article-title":"Diagnostic approach and management of cow\u2019s-milk protein allergy in infants and children, ESPGHAN gastrointestinal committee practical guidelines","volume":"55","author":"Koletzko","year":"2012","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1111\/all.12429","article-title":"EAACI Food Allergy and Anaphylaxis Guidelines: Diagnosis and management of food allergy","volume":"69","author":"Muraro","year":"2014","journal-title":"Allergy"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1111\/cea.12302","article-title":"BSACI guideline for the diagnosis and management of cow\u2019s milk allergy","volume":"44","author":"Luyt","year":"2014","journal-title":"Clin. Exp. Allergy"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s40413-016-0125-0","article-title":"Cow\u2019s milk allergy: Towards an update of DRACMA guidelines","volume":"9","author":"Fiocchi","year":"2016","journal-title":"World Allergy Organ. J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1097\/MPG.0000000000001889","article-title":"Pediatric Gastroesophageal Reflux Clinical Practice Guidelines, Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN)","volume":"66","author":"Rosen","year":"2018","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1522","DOI":"10.1016\/j.dld.2019.07.016","article-title":"Esophageal pH-impedance monitoring in children: Position paper on indications, methodology and interpretation by the SIGENP working group","volume":"51","author":"Quitadamo","year":"2019","journal-title":"Dig. Liver Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.jaci.2017.11.003","article-title":"Food allergy, A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management","volume":"141","author":"Sicherer","year":"2018","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1097\/MPG.0b013e318186008e","article-title":"Mast Cell\u2013Nerve Interactions in Children with Functional Dyspepsia","volume":"47","author":"Borrelli","year":"2008","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/MPG.0b013e3182a154ff","article-title":"Infant crying, colic, and gastrointestinal discomfort in early childhood, a review of the evidence and most plausible mechanisms","volume":"57","author":"Shamir","year":"2013","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1111\/apa.14378","article-title":"Review shows that parental reassurance and nutritional advice help to optimise the management of functional gastrointestinal disorders in infants","volume":"107","author":"Salvatore","year":"2018","journal-title":"Acta Paediatr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.jaci.2017.06.017","article-title":"The \u201cdangers\u201d of chronic proton pump inhibitor use","volume":"141","author":"Yadlapati","year":"2018","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1111\/apa.15213","article-title":"Proton pump inhibitors, microbiota and micronutrients","volume":"109","author":"Levy","year":"2020","journal-title":"Acta Paediatr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1053\/j.gastro.2016.02.016","article-title":"Childhood Functional Gastrointestinal Disorders: Neonate\/Toddler","volume":"150","author":"Benninga","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.jpeds.2017.02.020","article-title":"Systematic review and meta-analysis, fussing and crying durations and prevalence of colic in infants","volume":"185","author":"Wolke","year":"2017","journal-title":"J. Pediatr."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1111\/apa.14348","article-title":"Multiple functional gastrointestinal disorders are frequent in formula-fed infants and decrease their quality of life","volume":"107","author":"Bellaiche","year":"2018","journal-title":"Acta Paediatr."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.jpeds.2019.04.061","article-title":"Neonatal Antibiotics and Prematurity Are Associated with an Increased Risk of Functional Gastrointestinal Disorders in the First Year of Life","volume":"212","author":"Salvatore","year":"2019","journal-title":"J. Pediatr."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"366","DOI":"10.5223\/pghn.2020.23.4.366","article-title":"Birth Weight and the Development of Functional Gastrointestinal Disorders in Infants","volume":"23","author":"Baldassarre","year":"2020","journal-title":"Pediatr. Gastroenterol. Hepatol. Nutr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13052-016-0272-5","article-title":"Pharmacological interventions on early functional gastrointestinal disorders","volume":"42","author":"Salvatore","year":"2016","journal-title":"Ital. J. Pediatr."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1001\/archpedi.1997.02170430035007","article-title":"Prevalence of symptoms of gastroesophageal reflux in infancy","volume":"151","author":"Nelson","year":"1997","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1111\/j.1651-2227.2009.01306.x","article-title":"Natural evolution of regurgitation in healthy infants","volume":"98","author":"Hegar","year":"2009","journal-title":"Acta Paediatr."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Vandenplas, Y. (2017). Epidemiology. Gastroesophageal Reflux in Children, Springer.","DOI":"10.1007\/978-3-319-60678-1"},{"key":"ref_51","first-page":"210","article-title":"Gastroesophageal reflux disease in infants, how much is predictable with questionnaires, pH-metry, endoscopy and histology?","volume":"40","author":"Salvatore","year":"2005","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1016\/j.jpeds.2008.09.054","article-title":"Multicenter, double-blind, randomized, placebo-controlled trial assessing the efficacy and safety of proton pump inhibitor lansoprazole in infants with symptoms of gastroesophageal reflux disease","volume":"154","author":"Orenstein","year":"2009","journal-title":"J. Pediatr."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/j.jpeds.2010.07.029","article-title":"Esophageal Impedance in Children: Symptom-Based Results","volume":"157","author":"Salvatore","year":"2010","journal-title":"J. Pediatr."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1542\/peds.88.4.834","article-title":"Gastroesophageal reflux, as measured by 24-hour pH monitoring, in 509 healthy infants screened for risk of sudden infant death syndrome","volume":"88","author":"Vandenplas","year":"1991","journal-title":"Pediatrics"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/MPG.0b013e31815eeabe","article-title":"Prevalence of Endoscopic Findings of Erosive Esophagitis in Children: A Population-based Study","volume":"47","author":"Gilger","year":"2008","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1097\/MPG.0b013e3182478f83","article-title":"Gastrointestinal endoscopy and mucosal biopsy in the first year of life, indications and outcome","volume":"55","author":"Volonaki","year":"2012","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1007\/s40272-018-0314-0","article-title":"The Effect of Alginate in Gastroesophageal Reflux in Infants","volume":"20","author":"Salvatore","year":"2018","journal-title":"Pediatr. Drugs"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1097\/MPG.0000000000002841","article-title":"Distress in Infants and Young Children, Don\u2019t Blame Acid Reflux","volume":"71","author":"Salvatore","year":"2020","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1111\/all.12630","article-title":"Incidence and natural history of challenge-proven cow\u2019s milk allergy in European children\u2014EuroPrevall birth cohort","volume":"70","author":"Schoemaker","year":"2015","journal-title":"Allergy"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/0-306-46830-1_10","article-title":"Breast-Feeding and the Development of Cows\u2019 Milk Protein Allergy","volume":"478","author":"Saarinen","year":"2000","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1111\/all.13947","article-title":"Diagnosis and management of Non-IgE gastrointestinal allergies in breastfed infants-An EAACI Position Paper","volume":"75","author":"Meyer","year":"2020","journal-title":"Allergy"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/s12016-018-8701-4","article-title":"Impact of Gastroesophageal Reflux Disease on Mucosal Immunity and Atopic Disorders","volume":"57","author":"Hait","year":"2019","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1016\/j.jaci.2016.12.966","article-title":"International consensus guidelines for the diagnosis and management of food protein-induced enterocolitis syndrome, executive summary-Workgroup Report of the Adverse Reactions to Foods Committee, American Academy of Allergy, Asthma & Immunology","volume":"139","author":"Chehade","year":"2017","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Labrosse, R., Graham, F., and Caubert, J.C. (2020). Non-IgE-mediated gastrointestinal food allergies in children, an update. Nutrients, 12.","DOI":"10.3390\/nu12072086"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"107","DOI":"10.5223\/pghn.2019.22.2.107","article-title":"Diagnosis and Management of Gastroesophageal Reflux Disease in Infants and Children, from Guidelines to Clinical Practice","volume":"22","author":"Hauser","year":"2019","journal-title":"Pediatr. Gastroenterol. Hepatol. Nutr."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.nut.2017.10.010","article-title":"Thickened formula, what to know","volume":"49","author":"Salvatore","year":"2018","journal-title":"Nutrition"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Baldassarre, M.E., Di Mauro, A., Pignatelli, M.C., Fanelli, M., Salvatore, S., Di Nardo, G., Chiaro, A., Pensabene, L., and Laforgia, N. (2019). Magnesium Alginate in Gastro-Esophageal Reflux: A Randomized Multicenter Cross-Over Study in Infants. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17010083"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Vandenplas, Y. (2017). Prevention and Management of Cow\u2019s Milk Allergy in Non-Exclusively Breastfed Infants. Nutrients, 9.","DOI":"10.3390\/nu9070731"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Verduci, E., D\u2019Elios, S., Cerrato, L., Comberiati, P., Calvani, M., Palazzo, S., Martelli, A., Landi, M., Trikamjee, T., and Peroni, D. (2019). Cow\u2019s Milk Substitutes for Children: Nutritional Aspects of Milk from Different Mammalian Species, Special Formula and Plant-Based Beverages. Nutrients, 11.","DOI":"10.3390\/nu11081739"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1159\/000442699","article-title":"Hydrolyzed Proteins in Allergy","volume":"86","author":"Salvatore","year":"2016","journal-title":"Nestle Nutr. Inst. Workshop Ser."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1111\/apa.12902","article-title":"A workshop report on the development of the Cow\u2019s Milk-related Symptom Score awareness tool for young children","volume":"104","author":"Vandenplas","year":"2015","journal-title":"Acta Paediatr."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"22","DOI":"10.5223\/pghn.2017.20.1.22","article-title":"Pooled Analysis of the Cow\u2019s Milk-related-Symptom-Score (CoMiSSTM) as a Predictor for Cow\u2019s Milk Related Symptoms","volume":"20","author":"Vandenplas","year":"2017","journal-title":"Pediatr. Gastroenterol. Hepatol. Nutr."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Salvatore, S., Bertoni, E., Bogni, F., Bonaita, V., Armano, C., Moretti, A., Ba\u00f9, M., Luini, C., D\u2019Auria, E., and Marinoni, M. (2019). Testing the Cow\u2019s Milk-Related Symptom Score (CoMiSSTM) for the Response to a Cow\u2019s Milk-Free Diet in Infants, A Prospective Study. Nutrients., 11.","DOI":"10.3390\/nu11102402"},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Vandenplas, Y., Salvatore, S., Ribes-Koninckx, C., Carvajal, E., Szajewska, H., and Huysentruyt, K. (2018). The Cow Milk Symptom Score (CoMiSSTM) in presumed healthy infants. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0200603"},{"key":"ref_75","first-page":"309","article-title":"Colic in infants","volume":"2010","author":"Lucassen","year":"2010","journal-title":"BMJ Clin. Evid."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1007\/s10995-011-0842-5","article-title":"Dietary management of infantile colic, a systematic review","volume":"16","author":"Iacovou","year":"2012","journal-title":"Matern. Child Health J."},{"key":"ref_77","first-page":"CD011029","article-title":"Dietary modification for infantile colic","volume":"10","author":"Gordon","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1542\/peds.81.6.756","article-title":"Parental counseling compared with elimination of cow\u2019s milk or soy milk protein for the treatment of infant colic syndrome, a randomized trial","volume":"81","author":"Taubman","year":"1988","journal-title":"Pediatrics"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1038\/sj.ejcn.1602457","article-title":"Reduction of crying episodes owing to infantile colic: A randomized controlled study on the efficacy of a new infant formula","volume":"60","author":"Savino","year":"2006","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1007\/s11894-010-0140-1","article-title":"Symptoms and reflux in infants, Infant Gastroesophageal Reflux Questionnaire Revised (I-GERQ-R)\u2014Utility for symptom tracking and diagnosis","volume":"12","author":"Orenstein","year":"2010","journal-title":"Curr. Gastroenterol. Rep."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/j.jpeds.2014.11.030","article-title":"No Effect of Proton Pump Inhibitors on Crying and Irritability in Infants: Systematic Review of Randomized Controlled Trials","volume":"166","author":"Konarska","year":"2015","journal-title":"J. Pediatr."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.cgh.2015.07.041","article-title":"Efficacy of Proton Pump Inhibitor Drugs for Inducing Clinical and Histologic Remis-sion in Patients With Symptomatic Esophageal Eosinophilia, A Systematic Review and Meta-Analysis","volume":"14","author":"Lucendo","year":"2016","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_83","unstructured":"National Institute for Health and Care Excellence (NICE) (2015, April 30). Gastro-Oesophageal Reflux Disease, Recognition, Diagnosis and Management in Children and Young People. (Clinical Guideline 193). Available online: http,\/\/www.nice.org.uk\/guidance\/NG1."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1957","DOI":"10.1007\/s00431-020-03855-6","article-title":"Prescription of acid inhibitors in infants: An addiction hard to break","volume":"179","author":"Levy","year":"2020","journal-title":"Eur. J. Pediatr."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1016\/j.dld.2020.05.001","article-title":"Laryngeal signs and pH-multichannel intraluminal impedance in infants and children, The missing ring, LPR and MII-pH in children","volume":"52","author":"Mantegazza","year":"2020","journal-title":"Dig. Liver Dis."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1016\/0016-5085(95)90637-1","article-title":"Eosinophilic esophagitis attributed to gastroesophageal reflux: Improvement with an amino acid-based formula","volume":"109","author":"Kelly","year":"1995","journal-title":"Gastroenterology"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1097\/MPG.0b013e3182a80be1","article-title":"Management Guidelines of Eosinophilic Esophagitis in Childhood","volume":"58","author":"Papadopoulou","year":"2014","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1016\/j.anai.2016.08.003","article-title":"Diets for diagnosis and management of food allergy, The role of the dietitian in eosinophilic esophagitis in adults and children","volume":"117","author":"Venter","year":"2016","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1002\/iid3.273","article-title":"The use of amino acid-based nutritional feeds is effective in the dietary management of pediatric eosinophilic oesophagitis","volume":"7","author":"Atwal","year":"2019","journal-title":"Immunity Inflamm. Dis."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.jaci.2017.05.018","article-title":"Prenatal, intrapartum, and postnatal factors are associated with pediatric eosinophilic esophagitis","volume":"141","author":"Jensen","year":"2018","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"263","DOI":"10.3389\/fped.2020.00263","article-title":"Early Life Risk Factors in Pediatric EoE: Could We Prevent This Modern Disease?","volume":"8","author":"Votto","year":"2020","journal-title":"Front. Pediatr."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1007\/s11938-014-0041-8","article-title":"Translating New Developments in Eosinophilic Esophagitis Pathogenesis into Clinical Practice","volume":"13","author":"Cheng","year":"2015","journal-title":"Curr Treat Options Gastroenterol."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/2\/297\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:13:20Z","timestamp":1760159600000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/2\/297"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,21]]},"references-count":92,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2]]}},"alternative-id":["nu13020297"],"URL":"https:\/\/doi.org\/10.3390\/nu13020297","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,21]]}}}