Cow`s milk protein allergy awareness and practice among Turkish pediatricians: A questionnaire-survey

Abstract

Region-specific recommendations for the prevention, diagnosis, and treatment of cow's milk protein allergy (CMPA) are not available in Turkey. This crosssectional questionnaire-survey was designed to evaluate CMPA awareness and practice among Turkish pediatricians. A total of 410 pediatricians were included based on their voluntary participation. Questionnaires elicited demographic data and pediatricians' awareness and practice of CMPA in infants and children. Atopic dermatitis (91.5%), diarrhea (88.0%) and significant blood in stool (85.9%) were the most common symptoms considered suggestive of CMPA. Continuation of breast feeding via elimination of CMP containing products from maternal diet was the most commonly selected (79.0%) therapeutic option in exclusively breast-fed infants diagnosed with CMPA. Amino acid-based formula was the most commonly selected formula in a non-exclusively breast-fed infant with CMPA, for infants presenting with anaphylaxis (58.8%), enterocolitis (40.7%) or multiple food allergies (52.0%), and also for at-risk infants (40.2%). Earliest time to re-challenge was identified to be 6 months by 52.0% of pediatricians. In conclusion, our findings revealed high awareness of CMPA among Turkish pediatricians in terms of clinical presentation and first priority diagnostic tests. However, CMPA practice among Turkish pediatricians needs to be improved in terms of avoidance of other mammalian milks, selection of therapeutic formulas among non-exclusively breast-fed infants and at-risk infants consistent with guideline-based indications and cost-effectivity.

Comparison between General Pediatricians and Other Sub-Specialty of Pediatrics Regarding Knowledge of CMPA

“…This study showed that, most of pediatricians were general pediatricians (78.1%). This agrees with Yüce et al (4) who made cross-sectional questionnairesurvey that was designed to evaluate CMPA awareness and practice among Turkish pediatricians. A total of 410 pediatricians were included based on their voluntary participation.…”

“…Yüce et al (4) found accordingly, majority of their pediatricians considered atopic dermatitis, diarrhea, blood in stool and colic to be suggestive of CMPA. Overall, colonoscopy was the most common diagnostic test considered by pediatricians (85.5%) to be not the first priority in evaluation of a welldeveloped infant presenting with flecks or streaks of blood in stool.…”

“…The sample size was calculated using open Epi according to the following awareness of physicians about allergy symptoms was 88% (4) , and total number of pediatric physicians in El-Sharkia Governorate was 592 so at CI 95% the sample was calculated to be 256 physicians with design effect = 2.…”

Waardenburg Syndrome and Proctocolitis Association in a Infant

“…Eliminasyon ile 72 saatte dışkıda kan kaybolur. Klinik olarak ilk birkaç yıl içinde besine tolerans gelişir (8,9).…”

Over restrictive elimination of foods in children with food allergy

“…10,11 Currently only few data exist that describe practices in the diagnosis and management of FA among pediatricians in Turkey. 12 Similar studies that evaluated the FA-related practices of primary care physicians (PCP) and/or pediatricians in the US, Finland, Kuwait, Australia and Croatia have consistently demonstrated significant deficits. [13][14][15][16][17] Given the developing need for the physicians to adapt themselves to recent changes in FA management, the wide range of different clinical presentations of IgE and non-IgE mediated FA, and the impacts of FA and diet restrictions on the patient's quality of life we prepared this survey to describe the FA knowledge and practices of general pediatricians, pediatric allergists and pediatric gastroenterologists.…”