PURPOSE OF THE STUDY.
This study sought to gain a more complete understanding of the current pediatric milk allergy distribution and diagnosis trends in the United States.
Data were collected on 38 480 children using a randomized cross-sectional survey of a representative sample of US households, which identified 657 children who were reported by parents to have a milk allergy.
Primary outcome measures were prevalence and severity of milk allergy defined as a convincing or confirmed allergy to any form of milk. Data were also collected on age of onset, development of tolerance, severity of reaction, and coexistence of other food allergies.
Eight percent (n = 3218 children) of the analytic sample had food allergies. Milk allergy was present in 19.9% and was second only to peanut allergy at 24.8%. The highest percentage of milk-allergic children (23.8%) fell within the 6- to 10-year age group, and the lowest percentage (15.0%) was in the 11- to 15-year age group; however, it was significantly more prevalent in children <2 years of age. Of the reported milk allergies, 55.5% occurred in white children, 19.8% in Hispanic children, 16.6% in African American children, and 4.7% in Asian children. First reaction occurred at a mean age of 2 years. Severe reactions occurred in 31.3% compared with 47.2% with other food allergies. Vomiting and diarrhea were the most common symptoms, closely followed by hives and eczema. The most common severe symptoms were wheezing and shortness of breath. The mean age at which tolerance was reported to have occurred was 4 years; odds ratio compared with other food allergies was 2.1. The most common comorbid food allergen was shellfish. Seventy-five percent of milk allergies were physician-diagnosed, but only 43.5% of those had diagnostic testing.
Milk allergy is highly prevalent among the US pediatric population, accounting for one-fifth of all food allergies. Nearly one-third of these children present with severe symptoms. Diagnostic testing is being performed in less than half of the children. There is a significant ethnic variation in milk allergy.
This study presents some interesting epidemiologic data on milk allergy in the United States. Confirmatory testing is not often performed, and many of these children may be incorrectly diagnosed, leading to unnecessary avoidance and dietary restrictions.
- Copyright © 2013 by the American Academy of Pediatrics