PMID- 35268042
OWN - NLM
STAT- MEDLINE
DCOM- 20220314
LR  - 20220316
IS  - 2072-6643 (Electronic)
IS  - 2072-6643 (Linking)
VI  - 14
IP  - 5
DP  - 2022 Mar 3
TI  - A Survey to Identify the Current Management of Cow's Milk Disorders and the Role 
      of Goat Milk-Based Formulas in the Middle East and North Africa Region.
LID - 10.3390/nu14051067 [doi]
LID - 1067
AB  - BACKGROUND: Cow's milk allergy (CMA) and cow's milk intolerance (CMI) are the 
      major cow's milk disorders observed in infants and young children. This study 
      investigates, for the first time, physician knowledge regarding CMA and CMI 
      prevalence, diagnosis, and management in the Middle East and North Africa (MENA) 
      region. In addition, we explore the role of goat milk-based formula as an 
      alternative in infants suffering from CMI. METHOD: This cross-sectional survey 
      was conducted from December 2020 to February 2021. A convenience sample of 2500 
      MENA-based physicians received the questionnaire, developed by a working group of 
      pediatric experts. RESULTS: 1868 physicians completed the questionnaire, 
      including pediatric specialists (80.8%), training physicians (0.2%), 
      dermatologists (0.1%), family/general physicians (12.9%), neonatologists (3.6%), 
      neurosurgeons (0.2%), allergy nurse specialists (0.3%), pharmacists (2.1%), and 
      public health workers (0.1%). Differentiation between CMA and CMI was recognized 
      by the majority of respondents (80.7%), for which the majority of respondents 
      (35.4%) identified that the elimination and challenge test was the best test to 
      differentiate CMA from CMI, whereas 30.7% and 5.4% preferred the immunoglobulin E 
      (IgE) test and skin prick test, respectively. In addition, 28.5% of respondents 
      reported that there is no confirmatory test to differentiate CMA from CMI. The 
      majority of respondents (47.3%) reported that amino acid-based formula (AAF)/ 
      extensively hydrolyzed formula (EHF) is the cornerstone for the management of 
      CMA. However, most respondents (33.7%) reported that lactose avoidance was best 
      for the management of CMI. Overall, 65% of the respondents were aware of 
      nutritionally adapted goat's milk formula as an alternative to cow's milk 
      products and 37% would recommend its routine use in infants (</=2 years of age). 
      CONCLUSION: The results of this survey demonstrate that the majority of 
      physicians are aware of the underlying pathophysiology and management of CMA and 
      CMI. However, a significant proportion of physicians do not follow the clinical 
      guidelines concerning CMA/CMI diagnosis and management. Notably, this survey 
      identified that goat's milk formulas may offer a suitable alternative to AAF/EHF 
      in infants with CMI as they contain beta-casein protein which is easily digestible. 
      In addition, goat's milk formulas contain higher levels of oligosaccharides and 
      medium-chained fatty acids compared with standard cow's milk formulas, yet 
      further clinical trials are warranted to support the inclusion of goat's milk 
      formulas in clinical guidelines.
FAU - Bahbah, Wael A
AU  - Bahbah WA
AUID- ORCID: 0000-0001-6145-0572
AD  - Department of Pediatrics, Faculty of Medicine, Menoufia University, Shebin El-Kom 
      32511, Egypt.
FAU - ElHodhod, Mostafa
AU  - ElHodhod M
AUID- ORCID: 0000-0003-0966-5466
AD  - Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt.
AD  - Faculty of Medicine, October 6 University, Giza 12511, Egypt.
FAU - Salah, Mohamed
AU  - Salah M
AD  - Egyptian Academy of Pediatrics, Cairo 11311, Egypt.
FAU - AlRefaee, Fawaz
AU  - AlRefaee F
AUID- ORCID: 0000-0002-7980-1518
AD  - Department of Pediatrics, Al Adan Hospital, Ministry of Health, Kuwait City P.O. 
      Box 46969, Kuwait.
FAU - AlTuraiki, Muath
AU  - AlTuraiki M
AD  - Department of Pediatrics, King Salman Hospital, Riyadh 12769, Saudi Arabia.
FAU - Mousa, Samira
AU  - Mousa S
AUID- ORCID: 0000-0002-4001-4568
AD  - Medical Department, Faculty of Veterinary Medicine, Benha University, Benha 
      13518, Egypt.
FAU - Al Mehaidib, Ali
AU  - Al Mehaidib A
AD  - Department of Pediatrics, King Faisal Specialist Hospital & Research Center, 
      Riyadh 11211, Saudi Arabia.
FAU - Ayesh, Wafaa Helmi
AU  - Ayesh WH
AD  - Department of Clinical Nutrition, Dubai Health Authority, Dubai P.O. Box 4545, 
      United Arab Emirates.
FAU - El-Bazzar, Ahmed N
AU  - El-Bazzar AN
AUID- ORCID: 0000-0002-7857-7876
AD  - Department of Pediatrics, Ministry of Health Hospitals, Cairo 12613, Egypt.
FAU - El Haddad, Joseph
AU  - El Haddad J
AD  - Department of Pediatrics and Neonatology, Saint George University Hospital, 
      Beirut 1100, Lebanon.
FAU - El Khashab, Heba Y
AU  - El Khashab HY
AD  - Department of Pediatrics, Sulaiman Al Habib Medical Group, Riyadh 12214, Saudi 
      Arabia.
AD  - Department of Pediatrics, Ain Shams University, Cairo 11566, Egypt.
FAU - El Zawahry, Amr
AU  - El Zawahry A
AD  - Pediatrics Department, King's College Hospital London, Dubai P.O. Box 340901, 
      United Arab Emirates.
AD  - Department of Pediatrics, Sharjah University, Sharjah P.O. Box 27272, United Arab 
      Emirates.
FAU - Hasosah, Mohammed
AU  - Hasosah M
AUID- ORCID: 0000-0002-8434-2109
AD  - King Abdullah International Medical Research Center, Pediatric Gastroenterology 
      Department, National Guard Hospital, King Saud Bin Abdulaziz University for 
      Health Sciences, Jeddah 21482, Saudi Arabia.
FAU - Shaaban, Sanaa Youssef
AU  - Shaaban SY
AD  - Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo 11566, 
      Egypt.
FAU - Vandenplas, Yvan
AU  - Vandenplas Y
AUID- ORCID: 0000-0002-1862-8651
AD  - KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, 1090 Brussels, 
      Belgium.
LA  - eng
PT  - Journal Article
DEP - 20220303
PL  - Switzerland
TA  - Nutrients
JT  - Nutrients
JID - 101521595
SB  - IM
MH  - Africa, Northern
MH  - Animals
MH  - Cattle
MH  - Child
MH  - Child, Preschool
MH  - Cross-Sectional Studies
MH  - Female
MH  - *Goats
MH  - Humans
MH  - Middle East/epidemiology
MH  - *Milk
MH  - Surveys and Questionnaires
PMC - PMC8912394
OTO - NOTNLM
OT  - Middle East and North Africa
OT  - cow's milk allergy
OT  - cow's milk intolerance
OT  - goat milk-based formulas
EDAT- 2022/03/11 06:00
MHDA- 2022/03/15 06:00
PMCR- 2022/03/03
CRDT- 2022/03/10 15:27
PHST- 2021/12/12 00:00 [received]
PHST- 2022/01/18 00:00 [revised]
PHST- 2022/01/20 00:00 [accepted]
PHST- 2022/03/10 15:27 [entrez]
PHST- 2022/03/11 06:00 [pubmed]
PHST- 2022/03/15 06:00 [medline]
PHST- 2022/03/03 00:00 [pmc-release]
AID - nu14051067 [pii]
AID - nutrients-14-01067 [pii]
AID - 10.3390/nu14051067 [doi]
PST - epublish
SO  - Nutrients. 2022 Mar 3;14(5):1067. doi: 10.3390/nu14051067.