Pediatr Gastroenterol Hepatol Nutr.
2022 May;25(3):263-275. 10.5223/pghn.2022.25.3.263.
International Cross-Sectional Survey among Healthcare Professionals on the Management of Cow’s Milk Protein Allergy and Lactose Intolerance in Infants and Children
- Madrazo JA
1 - Alrefaee F2
- Chakrabarty A3
- Leon JCd4
- Geng L5
- Gong S6
- Heine RG7
- Järvi A7
- Ngamphaiboon J8
- Ong C9
- Rogacion JM10
- Affiliations
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- 1Department of Pediatrics, Universidad Nacional Autónoma de México, México City, México
- 2Pediatric Department, Al Adan Hospital, Ministry of Health, Kuwait City, Kuwait
- 3Department of Paediatrics, West Middlesex University Hospital, Isleworth, United Kingdom
- 4Department of Pediatrics, Cardinal Santos Medical Center, Manila, Philippines
- 5Department of Gastroenterology, Guangzhou Women’s and Children’s Medical Center, Guangzhou, China
- 6Department of Pediatrics, Guangzhou Women’s and Children’s Medical Center, Guangzhou, China
- 7Nestlé Health Science, Vevey, Switzerland
- 8Department of Pediatrics, Chualalongkorn University, Bangkok, Thailand
- 9Department of Paediatric Gastroenterology, KK Women’s and Children’s Hospital, Singapore
- 10Department of Pediatrics, University of the Philippines, Philippine General Hospital, Manila, Philippines
- KMID: 2529936
- DOI: http://doi.org/10.5223/pghn.2022.25.3.263
Abstract
- Purpose
The present international survey among healthcare providers aimed to collect data on theoretical knowledge and clinical practices in the diagnosis and management of cow’s milk protein allergy (CMPA) and lactose intolerance (LI) in infants.
Methods
A global survey was conducted in several countries with diverse health care settings. The survey consisted of multiple-choice questions in 3 main domains: (1) understanding and clinical practices around CMPA and LI; (2) case scenarios; and (3) diseasespecific knowledge and potential educational needs.
Results
Responses were available from 1,663 participants. About 62% of respondents were general practitioners or general pediatricians, and the remainder were pediatric allergists/ gastroenterologists (18%) or other health practitioners (20%). The survey identified knowledge gaps regarding the types of CMPA (IgE-mediated vs. non-IgE-mediated) and the clinical overlap with LI. The survey suggested diverse clinical practices regarding the use of hypoallergenic formulas, as well as misconceptions about the prebiotic benefits of lactose in extensively hydrolyzed formulas in non-breastfed infants with CMPA. Responses to the two case scenarios highlighted varying levels of awareness of the relevant clinical practice guidelines. While respondents generally felt confident in managing infants with CMPA and LI, about 80% expressed an interest for further training in this area.
Conclusion
The current survey identified some knowledge gaps and regional differences in the management of infants with CMPA or LI. Local educational activities among general and pediatric healthcare providers may increase the awareness of clinical practice guidelines for the diagnosis and treatment of both conditions and help improve clinical outcomes.
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