When Does The Milk Allergy Go Away? Patterns Of Resolution Of Non-IgE Milk Protein Induced Colitis.
Saturday, March 3, 2018
South Hall A2 (Convention Center)
Andrew Pidutti, Stephanie L. Vakaljan, BSc., Jason A. Ohayon, MD FRCPC
RATIONALE: Cow’s milk protein induced proctocolitis (CMPIP) is a non-IgE mediated condition occurring in infancy that is self-limited. Advice on milk reintroduction is variable amongst Allergists, Pediatricians and Gastroenterologists. Characterization of CMPIP resolution is needed for counselling future patients and their families on milk reintroduction.

METHODS: A retrospective chart review was carried out in a community Allergy clinic responsible for consulting an over 1 million population catchment area in Southwest Ontario Canada. Families diagnosed with a CMPIP child were contacted by email and follow up phone survey to collect data on the status of their CMPIP, along with reintroduction methods and attempts.

RESULTS: Data was collected over a period of 3 years from 2014 and 2017. A total of 27 infants were diagnosed, 15/27 were female (56%). Average age at onset was 3.3 months. Twenty-two of 27 (81%) parents reintroduced milk at time of survey. Average age of reintroduction was 15.1 months (6-48 months) with an average interval of time from diagnosis to reintroduction being 13.6 mo (4-41mo). Sixteen of 22 (73%) succeeded in reintroduction on first attempt. Three of 6 (50%) succeed on later reintroduction within variable intervals (1-6-37 mo.) Three of 22 remained off of milk at time of survey. There was no association between methods of reintroduction (gradual or direct, heated or fresh milk) and success.

CONCLUSIONS: CMPIP is self-limited with average interval of 7 months from diagnosis to resolution. Attempts to reintroduce sooner than 8 months from diagnosis resulted in CMPIP flare. Methods of milk reintroduction did not influence success.