Evidence map›Paper›PMID 34712052›Full record

ReviewJournal of asthma and allergy2021

Current Guidelines and Future Strategies for the Management of Cow's Milk Allergy.

Yvan Vandenplas, Helen A Brough, Alessandro Fiocchi, Mohamad Miqdady, Zakiudin Munasir, Silvia Salvatore, Nikhil Thapar, Carina Venter, Mario C Vieira, Rosan Meyer

Open access · goldAbstract readReview
In one paragraph

Review in Journal of asthma and allergy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 1 pooled it
9.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

43 citing papers in PubMed, 1 synthesis or guideline pooled it, 88 citations in OpenAlex.

  1. Guideline
  2. Trial
  3. Article
  4. From the Field - Supporting Families as They Navigate Infant Food Allergies.Journal of human lactation : official journal of International Lactation Consultant Association · 2026
    Review
  5. Article
  6. Article
  7. Cow milk protein allergy mimics in infancy.World journal of clinical pediatrics · 2025
    Review
  8. Review
  9. Review
  10. Article
  11. Difference in Cow's Milk-Related Symptom Score (CoMiSSPediatric gastroenterology, hepatology & nutrition · 2025
    Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Diet and Management of Diarrhea.Indian journal of pediatrics · 2024
    Review
  18. Review
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 10 institutions in 8 countries.

Yvan VandenplasVrije Universiteit Brussel (VUB), UZ Brussel, KidZ Health Castle, Brussels, Belgium.ORCID 0000-0002-1862-8651
Helen A BroughDepartment Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
Alessandro FiocchiTranslational Research in Pediatric Specialities Area, Division of Allergy, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, Rome, Italy.
Mohamad MiqdadyDepartment of Pediatrics, Sheikh Khalifa Medical City, College of Medicine & Health Sciences, Khalifa University, Khalifa, United Arab Emirates.
Zakiudin MunasirDepartment of Child Health, Ciptomangunkusumo Hospital-Medical Faculty Universitas Indonesia, Jakarta, Indonesia.
Silvia SalvatorePediatric Department, Hospital "F. Del Ponte", University of Insubria, Varese, Italy.
Nikhil ThaparGastroenterology, Hepatology and Liver Transplant, Queensland Children's Hospital, Brisbane, Queensland, Australia.
Carina VenterUniversity of Colorado, Children's Hospital Colorado, Denver, CO, USA.
Mario C VieiraCenter for Pediatric Gastroenterology -Hospital Pequeno Príncipe, Curitiba, Brazil.ORCID 0000-0003-3405-2995
Rosan MeyerDepartment of Paediatrics, Imperial College, London, UK.
Bambino Gesù Children's Hospital · ITChildren's Health Queensland Hospital and Health Service · AUChildren's Hospital Colorado · USHospital Erasto Gaertner · BRKhalifa University of Science and Technology · AEKing's College London · GBUniversity of Indonesia · IDUniversity of Insubria · ITUniversity of Winchester · GBVrije Universiteit Brussel · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

abstractExclusive breast feeding is recommended in all guidelines as the first choice feeding. Cow milk allergy (CMA) can be diagnosed by a diagnostic elimination diet for 2 to 4 weeks with a hypo-allergenic formula, followed by a challenge test with intact cow milk protein. The most often used hypo-allergenic formula for the diagnostic elimination diet and the therapeutic diet is a CM based extensive hydrolysate. CM-based partial hydrolysates cannot be recommended in the management of CMA because of insufficient efficacy and possible reactions, but about half of the infants with CMA may tolerate a partial hydrolysate. The pros and cons of other dietary options are discussed in this paper. The use of an amino acid-based formula and/or rice based hydrolysate formula during the diagnostic elimination and therapeutic diet is debated. When available, there is sufficient evidence to consider rice hydrolysates as an adequate alternative to CM-based hydrolysates, since some infants will still react to the CM hydrolysate. The pros and cons of dietary options such as soy formula, buckwheat, almond, pea or other plant based dietary products are discussed. Although the majority of the plant-based beverages are nutritionally inadequate, some are nutritionally adapted for toddlers. However, accessibility and content vary by country and, thus far there is insufficient evidence on the efficacy and tolerance of these plant-based drinks (except for soy formula and rice hydrolysates) to provide an opinion on them.

conclusionA diagnostic elimination diet, followed by a challenge remains the diagnostic standard. The use of an awareness tool may result in a decrease of delayed diagnosis. Breastmilk remains the ideal source of nutrition and when not available a CM extensively hydrolyzed formula, rice hydrolysate or amino acid formula should be recommended. More evidence is needed regarding plant-based drinks.

Indexed as

amino acid formulachallenge testcow milk allergyhydrolysateplant-based drinkrice hydrolysatesoy formula

Identifiers

PMID34712052
PMCPMC8548055
OpenAlexW3206411602

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.