Feeding infants with cow’s milk allergies can be a difficult task, according to Taylor Arnold, a registered dietitian nutritionist who had to deal with a similar situation with her second child. As with Arnold’s child, infants with cow’s milk protein allergies (CMPA) often scream while they eat and may face challenges in gaining weight. While it is reported that CMPAs could be on the rise much like other food allergies in children, it is unclear the extent of the increase and what is driving it. Experts suggest that the rise in CMPAs could be due to either the improvement in diagnosing the condition or overdiagnosing it. Others have posited a possible influence from the global formula industry, valued at $55 billion in a 2022 report from the World Health Organization and UNICEF. Despite the prevalence of CMPAs, no systematic studies have ever been carried out on affected children. A lack of clarity often leaves both medical practitioners and parents with questions regarding how to diagnose and manage affected children. The guidelines for diagnosing CMPAs are vague, leading to confusion among doctors and patients as to what constitutes CMPA and its symptoms. Milk-allergy formula prescriptions have shown an increase of up to 2.8-fold in England from 2007 to 2018. Researchers at the University of Rochester noticed similar trends in the US: hypoallergenic-formula sales rose from 4.9 percent of total formula sales in 2017 to 7.6 percent in 2019. Some experts argue that the views of the formula industry may have led to the marking up of cases of CMPA diagnosis. They note that these companies often promote their products by creating the impression that babies’ crying, regurgitation of milk, or minor rashes could be signs of CMPA. Despite their criticism, the guidelines on CMPAs are backed by both the UK’s National Institute for Health and Care Excellence and the US’s National Institute of Allergy and Infectious Diseases. To address concerns, the Infant Nutrition Council of America, an association of some of the largest US infant formula manufacturers, has updated its guidelines. Pediatrician Nigel Rollins views the increase in diagnoses as driven by formula industry marketing to parents, which underpins the notion that fussiness or colic may be signs of CMPA. Pediatric allergist and immunologist Amy Burris believes that numerous factors could be contributing to the problem of overdiagnosis of CMPA. The lack of clarity on diagnosing CMPAs leaves both medical professionals and parents uncertain about managing the condition.
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