Cawood, lead study author Abby L. Cawood, PhD, RN, MICR, chief scientific officer at Nutricia Ltd in Trowbridge, and colleagues: “This large cohort study provides new evidence for the significant health economic burden of cow’s milk allergy in children.” write in Clinical and mobile sensitivity.
“Dealing with a cow’s milk allergy entails excluding cow’s milk protein from the diet. While breast milk remains an ideal food source for infants with cow’s milk allergy, babies who are not exclusively breastfed need a hypoallergenic formula,” adds Caud, who is also Visiting research fellow at the University of Southampton, and its co-authors.
Mild cow allergy, an immune response to one or more proteins in cow’s milk, is one of the most common childhood food allergies, affecting 2%-5% of infants in Europe. The authors explain that management includes avoiding cow’s milk protein and treating gastrointestinal, skin, respiratory, and other related allergic conditions.
In their matched, retrospective cohort study, Caude and colleagues turned to the Health Improvement Network (THIN), a Cegedim Rx-owned database of 2.9 million active anonymous patient records. They extracted data from nearly 7,000 case records covering 5 years (2015-2020).
They screened prescriptions and healthcare professional contacts based on diagnostic reading codes and prescriptions for antiallergic formulations and compared healthcare costs for children with cow’s milk allergy with those without.
They compared 3,499 children 1 year of age or younger who had a confirmed or suspected cow’s milk allergy with the same number of children without a cow’s milk allergy. About half of the participants were male, and the average observation period was 4.2 years.
Children with cow’s milk allergy need more expensive health care
The researchers found:
The drugs were prescribed to a much larger number of children with cow’s milk allergy (CMA), at a higher rate than those without CMA. In particular, prescriptions for anti-flux drugs increased nearly 500%.
Children with CMA require more contact with health care and at a higher rate than those without CMA.
The CMA has been linked to an additional potential healthcare cost of £1381.53 per person per year. Assuming a prevalence of 2.5% of the estimated CMA prevalence range of 2%-5% and extrapolating to the UK infant population, the CMA may have added more than £25.7 million in annual healthcare costs nationwide.
Coffey, MD, assistant professor of pediatrics at the University of Pittsburgh Penn State College of Medicine said Medscape Medical News by e-mail.
“This study shows that regardless of the reason for avoiding cow’s milk, these infants require more uses of health care services (clinic visits, nutritional assessments, prescriptions) than [do] Covey, who was not involved in the study, added that their peers, and it’s certainly a commitment of a lot of time and money to their families to ensure they can thrive and thrive.
Jodi A. Shroba, MSN, APRN, CPNP, coordinator of the Food Allergy Program in Children’s Mercy Kansas City, Missouri, didn’t find these numbers surprising.
“Children with food allergies typically have other atopic comorbidities that require more visits to primary care physicians and specialists and more prescriptions,” Shropa, who was also not involved in the study, said by email.
She noted, “The interesting statement is that British guidelines recommend the involvement of a dietitian for children with cow’s milk allergy.” “In the United States, having a dietitian would be a great addition to care, because avoiding cow’s milk can cause nutritional deficiencies and stunted growth. But these resources are not available in all healthcare practices.
“The rise in antibiotic use and the nearly 500% increase in anti-reflux prescriptions by children with cow’s milk allergy requires further research,” she added.
Nutricia Ltd funded the study. Caud and one co-author work for Nutricia Ltd, and all other co-authors were employees of or had other financial relationships with Nutricia. One of the co-authors was hired by Cegedim Rx, which for this research was funded by Nutricia. Shrupa and Covey reported no conflict of interest with the study.
Clin Allergy Translator. Posted online August 26, 2022. full text