Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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International Cross-Sectional Survey among Healthcare Professionals on the Management of Cow's Milk Protein Allergy and Lactose Intolerance in Infants and Children

  • Madrazo, J Armando (Department of Pediatrics, Universidad Nacional Autonoma de Mexico) ;
  • Alrefaee, Fawaz (Pediatric Department, Al Adan Hospital, Ministry of Health) ;
  • Chakrabarty, Anjan (Department of Paediatrics, West Middlesex University Hospital) ;
  • de Leon, Julia C. (Department of Pediatrics, Cardinal Santos Medical Center) ;
  • Geng, Lanlan (Department of Gastroenterology, Guangzhou Women's and Children's Medical Center) ;
  • Gong, Sitang (Department of Pediatrics, Guangzhou Women's and Children's Medical Center) ;
  • Heine, Ralf G. (Nestle Health Science) ;
  • Jarvi, Anette (Nestle Health Science) ;
  • Ngamphaiboon, Jarungchit (Department of Pediatrics, Chualalongkorn University) ;
  • Ong, Christina (Department of Paediatric Gastroenterology, KK Women's and Children's Hospital) ;
  • Rogacion, Jossie M. (Department of Pediatrics, University of the Philippines, Philippine General Hospital)
  • Received : 2021.07.30
  • Accepted : 2022.03.07
  • Published : 2022.05.15
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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) disease-specific 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.

Keywords

Acknowledgement

The authors wish to thank all healthcare professionals who participated in the survey and thank the participating medical societies for distributing emails with the online survey. We also thank Dr. Prashant Bachina at Rainbow Children's Hospital, Hyderabad, India, for his expertise and coordination of the survey in India. The support of Dr. Ramesh Manocha, HealthEd Australia, in conducting the survey in Australia is gratefully acknowledged.

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