Cow’s milk protein allergy in infants: Clinical presentations and outcomes

Table 1 Clinical characteristics of the study population

Category	Number	Percentage (%)
Total study cohort number	38
Mean age at diagnosis (months, Q1-Q3)	3.0 (0.5–5)
Sex: Male	24	63.2
Symptoms at presentation:
Flatulence	35	92.1
Abdominal distension	33	86.8
Constipation	18	47.4
Recurrent vomiting	18	47.4
Diarrhea	17	44.7
Eczema (face and body)	17	44.7
Poor growth	16	42.1
Mucus in the stool	15	39.5
Eczema (face only)	15	39.5
Difficulty breathing and/or cough	14	36.8
Wheezes	14	36.8
Multiple food allergy	13	34.2
Edema or urticaria	11	28.9
Blood in the stool	8	21.1
Jaundice - indirect hyperbilirubinemia	6	15.8
Severe crying and/or irritability	6	15.8
Anemia	5	13.2
Increased liver enzyme levels (ALT and AST)	3	7.9
Allergy to medication(s)	2	5.3
Fever	2	5.3
Vomiting blood	1	2.6
Dehydration	1	2.6
Family history
Average number of children in the family (Q1-Q3)	2.3 (2-3)
Average child order in the family	2.1
Other cases of CMPA in the family	13	34.2
Brother	8
Sister	3
Cousin	1
Aunt	1
Asthma, eczema, or any type of allergy in the family	22	57.9
Mother’s work status
Housewife	21	55.3
Employed	17	44.7
Father’s work status
Employed	37	97.4
Unemployed	1	2.6
Mother’s education level
Bachelor’s	26	68.4
High school	9	23.7
PhD	1	2.6
Diploma	1	2.6
Elementary school	1	2.6
Place of CMPA diagnosis:
Private clinic	20	52.6
MoH hospital/MoH health center	10	26.3
University of Jordan Hospital	4	10.5
Royal medical services hospital	3	7.9
Another country	1	2.6
CMPA diagnosis made by
Pediatric gastroenterologist	27	71.1
General pediatrician	11	28.9
Pregnancy:
Use of antibiotics during pregnancy–Yes	11	28.9
Use of antibiotics during pregnancy–No	27	71.1
Mode of delivery:
Cesarean section	23	60.5
Normal vaginal	15	39.5
Feeding:
Mixed (breast milk and formula)	23	60.5
Formula only	15	39.5
Duration of AA-based formula (months, Q1–Q3)	13.89 (9-17.5)
> 1 year	19	50
6 months to 1 year	14	36.8
< 6 months	5	13.2

ALT: Alanine transaminase; AST: Aspartate transaminase; AA-based formula: Amino acid-based formula; CMPA: Cow’s milk protein allergy; MoH: Ministry of Health.

Table 2 Cost of cow’s milk protein allergy treatment

Child age during treatment	Number of AAF cans dispensed during treatment	Treatment cost, JD ($)
< 6 months	1150	23000 (32200)
6 months to 1 year	2275	45500 (63700)
Total	3425	68500 (95900)

AAF: Amino acid-based formula.

Table 3 Barriers to breastfeeding

Reasons for not initiating/continuing breastfeeding	Number	Percentage (%)
Mother’s perception of inadequate milk supply	14	36.8
Personal choice: No specific reason	13	34.2
Work limitations	4	10.5
Baby-related causes: Latching difficulties and NICU admission	3	7.9
Maternal causes: Health issues and depression	2	5.3
Twin babies	2	5.3
Total	38	100

NICU: Neonatal intensive care unit.

Table 4 Fisher’s exact test results for the association between breastfeeding barriers and maternal characteristics

Variable	Odds ratio	95%CI	P value
Work status	7.2a	1.21–42.82	0.03
Educational level	0.19	0.01–2.70	0.22

^aP < 0.05, employed mothers vs unemployed mothers.