Hypoallergenicity of a thickened hydrolyzed formula in children with cow’s milk allergy

BACKGROUND Allergy to cow’s milk is the most frequent allergy occurring in infants and young children.The dietary management of these patients consists of the elimination of any cow’s milk proteins from the diet,and for formula-fed infants,the substitution of the usual infant formula with an adapted formula that is generally based on extensively hydrolyzed cow’s milk proteins.The American Academy of Pediatrics has established specific criteria to confirm the hypoallergenicity of a formula intended for these children.AIM To assess the hypoallergenicity of a new thickened extensively hydrolyzed casein-based formula (TeHCF) in children with cow’s milk allergy (CMA).METHODS Children diagnosed with CMA through a double-blind placebo-controlled food challenge (DBPCFC) were randomly administered increased doses of a placebo formula or the TeHCF [Allernova,new thickener including fibres (Novalac)] under double-blind conditions and medical surveillance on two separate days.Otherwise,both of these formulas and a cow’s milk-based formula were randomly introduced to children who were highly suspected of having CMA on three separate days.Immediate and late reactions occurring after the introduction of any of these formulas were thoroughly recorded by the physician at the hospital and reported by parents to the physician after hospital discharge,respectively.If the children tolerated the TeHCF during the DBPCFC,they were exclusively fed this formula during a 3-mo period where potential allergic symptoms,anthropometric parameters,as secondary outcomes,and adverse events were registered.The Cow’s Milk-related Symptoms Score (CoMiSSTM) was assessed and anthropometric parameters were compared to World Health Organization (WHO) reference data.RESULTS Of the 30 children included in the study,the CMA diagnosis of 29 (mean age: 8.03 ± 7.43 mo) patients was confirmed by a DBPCFC.The children all tolerated the TeHCF during both the challenge and the subsequent 3-mo feeding period,which they all completed.During the latter period,the CoMiSSTM remained at a very low level,never exceeding its baseline value (1.4 ± 2.0),growth parameters were within WHO reference standards and no adverse event related to the TeHCF was reported.Over the first week of this period,the proportion of patients with digestive discomfort significantly decreased from 20.7%(6/29) to 3.4%(1/29),P = 0.025.The proportion of satisfaction with the overall effect of the formula reported by the parents and investigator was high,as was the formula acceptability by the child.CONCLUSION The new TeHCF meets the hypoallergenicity criteria according to the American Academy of Pediatrics standards,confirming that the tested TeHCF is adapted to the dietary management of children with CMA.Moreover,growth was adequate in the included population.

Milk fat globule membrane supplementation protects againstβ-lactoglobul-ininduced food allergy in mice via upregulation of regulatory T cells and enhancement of intestinal barrier in a microbiota-derived short-chain fatty acids manner

Milk fat globule membrane(MFGM),which contains abundant glycoproteins and phospholipids,exerts beneficial effects on intestinal health and immunomodulation.The aim of this study was to evaluate the protective effects and possible underlying mechanisms of MFGM on cow’s milk allergy(CMA)in aβ-lactoglobulin(BLG)-induced allergic mice model.MFGM was supplemented to allergic mice induced by BLG at a dose of 400 mg/kg body weight.Results demonstrated that MFGM alleviated food allergy symptoms,decreased serum levels of lipopolysaccharide,pro-inflammatory cytokines,immunoglobulin(Ig)E,Ig G1,and Th2 cytokines including interleukin(IL)-4,while increased serum levels of Th1 cytokines including interferon-γand regulatory T cells(Tregs)cytokines including IL-10 and transforming growth factor-β.MFGM modulated gut microbiota and enhanced intestinal barrier of BLG-allergic mice,as evidenced by decreased relative abundance of Desulfobacterota,Rikenellaceae,Lachnospiraceae,and Desulfovibrionaceae,while increased relative abundance of Bacteroidetes,Lactobacillaceae and Muribaculaceae,and enhanced expressions of tight junction proteins including Occludin,Claudin-1 and zonula occludens-1.Furthermore,MFGM increased fecal short-chain fatty acids(SCFAs)levels,which elevated G protein-coupled receptor(GPR)43 and GPR109A expressions.The increased expressions of GPR43 and GPR109A induced CD103+dendritic cells accumulation and promoted Tregs differentiation in mesenteric lymph node to a certain extent.In summary,MFGM alleviated CMA in a BLG-induced allergic mice model through enhancing intestinal barrier and promoting Tregs differentiation,which may be correlated with SCFAs-mediated activation of GPRs.These findings suggest that MFGM may be useful as a promising functional ingredient against CMA.

Very early onset perinatal constipation:Can it be cow’s milk protein allergy?

Delayed passage of meconium or constipation during the perinatal period is traditionally regarded as a signal to initiate further work up to evaluate for serious diagnoses such as Hirschsprung’s disease(HD),meconium ileus due to Cystic Fibrosis,etc.The diagnosis of HD particularly warrants invasive testing to confirm the diagnosis,such as anorectal manometry or rectal suction biopsy.What if there was another etiology of perinatal constipation,that is far lesser known?Cow’s milk protein allergy(CMPA)is often diagnosed in infants within the first few weeks of life,however,there are studies that show that the CMPA allergen can be passed from mother to an infant in-utero,therefore allowing symptoms to show as early as day one of life.The presentation is more atypical,with perinatal constipation rather than with bloody stools,diarrhea,and vomiting.The diagnosis and management would be avoidance of cow's milk protein within the diet,with results and symptom improvement in patients immediately.Therefore,we discuss whether an alternative pathway to address perinatal constipation should be further discussed and implemented to potentially avoid invasive techniques in patients.This entails first ruling out CMPA with safe,noninvasive techniques with diet modification,and if unsuccessful,then moving forward with further diagnostic modalities.

Molecularly defined adult-type hypolactasia in school-aged children with a previous history of cow's milk allergy

AIM： To assess the role of lactase non-persistence/per- sistence in school-aged children and their milk-related symptoms. METHODS： The genotypes for the C/T-13910 variant associated with lactase non-persistence/ persistence were determined using PCR-minisequencing in a group of 172 children with a mean age of 8.6 years （SE = 0.02, 93 boys） participating in a follow-up study for cow＇s milk allergy. The parents were asked to assess their children＇s milk consumption and abdominal symptoms. RESULTS： The presence of allergy to cow＇s milk was not associated with the C/C-13910 genotype related with a decline of lactase enzyme activity during childhood （lactase non-persistence）. The frequency of the C/C-13910 genotype （16%） was similar to published figures for the prevalence of adult-type hypolactasia in Finland. The majority of the children （90%） in this series consumed milk but 26% of their families suspected that their children had milk-related symptoms. Forty-eight percent of the children with the C/C-13910 genotype did not drink milk at all or consumed a low lactose containing diet prior to the genotyping （P〈 0.004 when compared to the other genotypes）. CONCLUSION： Analysis of the C/T-13910 polymorphism is an easy and reliable method for excluding adult-type hypolactasia in children with milk-related symptoms. Genotyping for this variant can be used to advise diets for children with a previous history of cow＇s milk allergy.

Cow milkα_(s1)-casein induces allergic responses in a mouse model of atopy

α_(s1)-Casein is a potential allergen to induce hypersensitivity in cow milk.We had identifiedα_(s1)-casein and its epitopes in previous studies.The present study aimed to evaluate the allergic mechanism ofα_(s1)-casein in a BALB/c mouse model.The levels of specific IgE,mast cell proteinase,histamine and cytokines in sensitized mice were determined,and the clinical and pathological observation were evaluated.Results showed that the levels of specific IgE,mast cell proteinase,histamine,IL-4,IL-5,IL-10 increased significantly with a dose-dependent trend.The local alveolar septum collapsed or thickened,and lymphatic foci were produced in the spleen and thymus,and the inflammatory cells infiltrated in small intestinal mucosa mesenchyme.In conclusion,the levels of specific IgE,mast cell proteinase,histamine,IL-4,IL-5,IL-10 and some inflammatory factors could possibly serve as allergic biomarkers ofα_(s1)-casein,however,additional studies on signal transduction and gene expression are necessary in future.

Dietary polyphenols reduced the allergenicity ofβ-lactoglobulin via non-covalent interactions:a study on the structure-allergenicity relationship

Studies showed that complexation of polyphenols with milk allergens reduced their immunogenic potential.However,the relationship between structures of polyphenols and their hypoallergenic effects on milk allergens in association with physiological and conformational changes of the complexes remain unclear.In this study,polyphenols from eight botanical sources were extracted to prepare non-covalent complexes withβ-lactoglobulin(β-LG),a major allergen in milk.The dominant phenolic compounds bound toβ-LG with a diminished allergenicity were identified to investigate their respective role on the structural and allergenic properties ofβ-LG.Extracts from Vaccinium fruits and black soybeans were found to have great inhibitory effects on the IgE-and IgG-binding abilities ofβ-LG.Among the fourteen structure-related phenolic compounds,flavonoids and tannins with larger MWs and multi-hydroxyl substituents,notably rutin,EGCG,and ellagitannins were more potent to elicit changes on the conformational structures ofβ-LG to decrease the allergenicity of complexedβ-LG.Correlation analysis further demonstrated that a destabilized secondary structure and protein depolymerization caused by polyphenol-binding were closely related to the allergenicity property of formed complexes.This study provides insights into the understanding of structure-allergenicity relationship ofβ-LG-polyphenol interactions and would benefit the development of polyphenol-fortified matrices with hypoallergenic potential.

Cow’s milk-induced gastrointestinal disorders:From infancy to adulthood

Milk is related to many gastrointestinal disorders from the cradle to the grave due to the many milk ingredients that can trigger gastrointestinal discomfort and disorders.Cow’s milk protein allergy(CMPA)is the most common food allergy,especially in infancy and childhood,which may persist into adulthood.There are three main types of CMPA;immunoglobulin E(IgE)-mediated CMPA,non-IgEmediated CMPA,and mixed type.CMPA appears before the first birthday in almost all cases.Symptoms may start even during the neonatal period and can be severe enough to simulate neonatal sepsis.CMPA(often non-IgE mediated)can present with symptoms of gastroesophageal reflux,eosinophilic esophagitis,hemorrhagic gastritis,food protein-induced protein-losing enteropathy,and food protein-induced enterocolitis syndrome.Most CMPAs are benign and outgrown during childhood.CMPA is not as common in adults as in children,but when present,it is usually severe with a protracted course.Lactose intolerance is a prevalent condition characterized by the development of many symptoms related to the consumption of foods containing lactose.Lactose intolerance has four typical types:Developmental,congenital,primary,and secondary.Lactose intolerance and CMPA may be the underlying pathophysiologic mechanisms for many functional gastrointestinal disorders in children and adults.They are also common in inflammatory bowel diseases.Milk consumption may have preventive or promoter effects on cancer development.Milk may also become a source of microbial infection in humans,causing a wide array of diseases,and may help increase the prevalence of antimicrobial resistance.This editorial summarizes the common milk-related disorders and their symptoms from childhood to adulthood.

Bisphenol A in Fluid and Powdered Milk Samples and Associated Child Dietary Exposures

Bisphenol A (BPA) is a synthetic chemical found in a wide range of consumer products and consumables that humans are exposed to. The aim of this study was to determine BPA contamination levels in 51 milk samples sold in the Rio de Janeiro Metropolitan Region, Brazil. Bisphenol A was detected (≥limit of detection, LOD) in five of the analyzed samples (9.8%) and quantified (≥limit of quantification, LOQ) in two (3.8%). The estimated daily intake (EDI) for children aged up to 12 months ranged from 24.95 to 97.72 ng/kg body weight/day, lower than the established European Union tolerable daily intake value. Recent evidence, however, suggests that even low doses of endocrine disruptors such as BPA may pose potential health risks, even more so when exposure occurs at such an early life stage.

Assessment of a Precaution Index for Environmental Evaluation: An Example of Application to the Cow’s Milk Production

The paper presents a Precaution Index (P) developed to create an instrument to assess the potential risk related to the presence of pollution sources next to milk production farms. The methodology starts from the inventory and geo-referencing of all pollution sources in an area, with the help of the multi-criteria decision analysis. Results are represented in a map of P, which highlights which areas are most at risk and need monitoring, and which pollutants may be involved. This may help in the early identification of emerging hazards to food safety. P was calculated for the milk production in an Italian region. Results show that 97% of the area is in a condition of minimum precaution that would be needed in controlling the safety of dairy products.

Effects of Cow’s Milk on Reproduction in ICR Male Mice

Objective To study the effects of Cow＇s milk on the reproduction in male mice. Methods Twenty-four male mice were divided randomly into two groups： milk group （M） and control group （C）. Each mouse was given 10 mL milk per day from 4 to 16 weeks in the group M. At the age of 17 weeks, all the mice were sacrificed. Results Serum testosterone was decreased in the group M （P=0.037）. No significant difference was found in weight of testes, seminal vesicle or adrenal gland of mice between the groups C and M. However, the weight of seminal vesicle decreased when expressed in g/100 g body weight in the group M. Epididymal sperm concentration, motility, morphology, and sperm head number were not affected by milk. Conclusion Cow＇s milk has adverse effects on the reproductive system in ICR male mice. Further studies are needed to clarify the specific effects of milk on reproductive health.

Evaluation of the Physicochemical Parameters of Cow’s Fresh Milk in Shkodra

Milk is universally recognized as complete food, which contains essential components for human nutrition. Physicochemical analysis constitutes an important device that monitors its quality. The purpose of this study was to determine the physicochemical characteristics of fresh cow milk in samples taken in the region of Shkodra and Lezha and compare it to European quality standards. Results of the analyses were statistically processed by the Minitab 17 statistical program. Results showed that there is no significant difference (P > 0.05) in fat, protein, lactose and density value, while there is significant difference (P < 0.05) in pH, ash% without fat, freezing point and water value. The results show a stability of physicochemical parameters of milk, with variation according to the region where samples were gathered.

Milk protein IgG and IgA:The association with milk-induced gastrointestinal symptoms in adults

AIM:To study the association between serum levels of milk protein IgG and IgA antibodies and milk-related gastrointestinal symptoms in adults.METHODS:Milk protein IgG and IgA antibodies were determined in serum samples of 400 subjects from five outpatient clinics in Southern Finland.Subjects were randomly selected from a total of 1900 adults undergoing laboratory investigations in primary care.All 400 participants had completed a questionnaire on abdominal symptoms and dairy consumption while waiting for the laboratory visit.The questionnaire covered the nature and frequency of gastrointestinal problems,the provoking food items,family history and allergies.Twelve serum samples were disqualifi ed due to insuff icient amount of sera.The levels of specif ic milk protein IgG and IgA were measured by using the ELISA technique.The association of the milk protein-specific antibody level was studied in relation to the milk-related gastrointestinal symptoms and dairy consumption.RESULTS:Subjects drinking milk(n=265) had higher levels of milk protein IgG in their sera than non-milk drinkers(n=123,P<0.001).Subjects with gastrointestinal problems related to milk drinking(n=119) consumed less milk but had higher milk protein IgG levels than those with no milk-related gastrointestinal symptoms(n=198,P=0.02).Among the symptomatic subjects,those reporting dyspeptic symptoms had lower milk protein IgG levels than non-dyspeptics(P<0.05).However,dyspepsia was not associated with milk drinking(P=0.5).The association of high milk protein IgG levels with constipation was close to the level of statistical signif icance.Diarrhea had no association with milk protein IgG level(P=0.5).With regard to minor symptoms,flatulence and bloating(P=0.8),were not associated with milk protein IgG level.Milk protein IgA levels did not show any association with milk drinking or abdominal symptoms.The levels of milk protein IgA and IgG declined as the age of the subjects increased(P<0.004).CONCLUSION:Milk protein IgG but not milk IgA seems to be associated with self-reported milk-induced gastrointestinal symptoms.

Milk Consumption and Lactose Intolerance in Adults

Objective To investigate relations between milk consumption and lactose intolerance （LI） in adults and to explore the effect of milk consumption on lactase activity.Methods Total of 182 subjects aged 20‐70 years were recruited and interviewed by questionnaires,and their accumulative cow＇s milk intake （AMI） was calculated.LI was evaluated by hydrogen breath test （HBT）.Results A negative correlation was found between AMI and severity of observed LI symptom （r=-0.2884;P0.05）.Binary logistic regression analysis showed a negative correlation between LI and duration and frequency of milk consumption （OR,0.317 and 0.465,respectively;both P0.05） and a positive correlation between LI and amount of milk consumed per sitting （OR,6.337;P0.05）.Conclusion LI is related to various milk consumption behaviors.Most Chinese adults with LI may tolerate moderate milk consumption 160 mL.

孕期因素与婴儿牛奶蛋白过敏的关系

目的:初步探讨孕期因素与婴儿牛奶蛋白过敏的关系。方法:数据来自一项“中国儿童对牛奶蛋白过敏的遗传易感性研究”的子队列,包括2020年3月1日至12月31日在北京大学人民医院出生的婴儿,根据随访至1岁时有无牛奶蛋白过敏(cow’s milk protein allergy,CMPA),分为病例组(CMPA组)和对照组。回顾性收集婴儿及其母亲孕前和孕期的临床资料,分析孕期多因素与婴儿牛奶蛋白过敏的相关性。结果:共纳入278例婴儿,CMPA患儿52例,对照组226例;男性婴儿143例,女性婴儿135例,其中男性婴儿在CMPA组比例(69.2%)高于对照组(47.3%),差异有统计学意义(P=0.004);CMPA患儿和对照组在出生体质量、出生胎龄、低出生体重儿、早产、脐带绕颈、新生儿窒息分布上差异无统计学意义(P>0.05)。母亲孕期合并免疫性疾病、贫血者以及孕期存在抗生素暴露者在CMPA组比例均高于对照组,两组之间差异有统计学意义(P<0.05);其他妊娠期合并症,如子痫/子痫前期、慢性高血压/妊娠期高血压、糖尿病/妊娠期糖尿病、甲状腺疾病等在两组分布差异无统计学意义(P>0.05)。CMPA组与对照组孕期多项血常规指标总体分布差异无统计学意义(P>0.05)。多因素Logistic回归分析发现男性婴儿、母亲妊娠合并免疫性疾病、妊娠合并贫血以及孕期抗生素暴露是CMPA发生的独立危险因素。结论:男性婴儿、母亲妊娠合并免疫性疾病、妊娠合并贫血以及孕期抗生素暴露是CMPA发生的独立危险因素。

免疫斑点印迹法检测水解乳蛋白婴幼儿配方粉免疫反应

目的:建立一种快速且精准的方法,以确定水解乳蛋白婴幼儿配方粉的免疫反应性。方法:首先采用直接免疫斑点印迹法,利用牛奶过敏患儿血清初步评估待测样品的免疫反应性;然后通过间接竞争免疫斑点印迹法以市售普通牛奶粉为阳性对照,评估水解乳蛋白婴幼儿配方粉与血清免疫球蛋白E(IgE)的结合能力;最后采用间接和间接竞争酶联免疫检测法,以佐证免疫斑点印迹结果。结果:部分水解乳蛋白婴配粉仍可以结合IgE以诱发过敏反应,而深度水解乳蛋白婴配粉不具有免疫反应性。免疫斑点印迹和酶联免疫检测评价免疫反应性结果显著且一致。结论:免疫斑点印迹技术操作性强,周期短,成本低,结果可靠,为利用较难获取的婴幼儿过敏患儿血清初步评估乳蛋白产品致敏性提供了新思路。

牛乳过敏及其降敏技术研究进展

牛乳蛋白是常见的食物过敏原,牛乳过敏已成为全球范围内常见的公共卫生问题。探索乳蛋白致敏机制,开发绿色、高效降敏技术已成为食品领域的重要研究课题。本文总结了牛乳过敏原的抗原表位,介绍了牛乳过敏的机制与症状,讨论了不同加工技术(如热加工、高压、超声、糖基化、偶联多酚、酶处理、发酵以及转基因)对牛乳蛋白降敏作用及潜在机制,并对牛乳降敏技术的发展做出展望。

个体化营养干预在牛奶蛋白过敏患儿中的应用

目的探讨个体化营养干预对牛奶蛋白过敏(cow milk protein allergy,CMPA)患儿营养状况及生长发育的影响。方法选取2022年2月—2023年2月惠州市中心人民医院儿科收治的60例CMPA患儿作为研究对象。其中30例作为对照组给予游离氨基酸奶粉进行喂养,另外30例作为研究组给予个体化营养干预(包括游离氨基酸奶粉喂养、辅食回避、微量元素及维生素的合理补充)。干预6个月后,对比2组患儿生长发育指标(身高、体质量、头围)、营养指标(血红蛋白、白蛋白、转铁蛋白)、血清维生素D、钙、锌水平及干预疗效。结果干预后,研究组患儿的生长发育指标优于对照组,营养状况优于对照组,血清维生素D、钙、锌水平高于对照组(P<0.05)。研究组患儿的总有效率为100%,高于对照组的83.33%,差异有统计学意义(P<0.05)。结论对CMPA患儿给予个体化营养干预可以有效促进患儿生长发育,提升患儿营养状况,临床效果显著。

氨基酸配方替代喂养对重度牛奶蛋白过敏婴儿肠道菌群特征的影响

目的探讨氨基酸配方(AAF)替代喂养对重度牛奶蛋白过敏(CMPA)婴儿肠道菌群特征的影响。方法纳入23例确诊为重度CMPA且人工喂养的≤3月龄婴儿,采用同一品牌AAF进行喂养干预。干预前及干预3个月后,收集所有婴儿的粪便样本,通过16S rRNA高通量测序及生物信息学分析评估肠道菌群的特征变化。结果干预前后,重度CMPA婴儿肠道菌群Chao1指数、Shannon指数、observed species指数、Simpson指数差异具有统计学意义(P<0.05),Beta多样性具有差异,且组间差异大于组内差异。门水平的相对丰度分析及LEfSe分析结果均显示,AAF干预后重度CMPA婴儿肠道中厚壁菌门、拟杆菌门显著富集。属水平的相对丰度分析结果显示,AAF干预后重度CMPA婴儿肠道中拟杆菌属、粪杆菌属、双歧杆菌属的相对丰度较干预前明显升高,弓形菌属、克雷伯菌属、梭菌属的相对丰度较干预前降低,LEfSe分析结果显示拟杆菌属、粪杆菌属、弓形菌属、克雷伯菌属为在丰度上有显著差异的标志物种。在种水平上相对丰度排名前10的菌群中,产气荚膜梭菌、产酸拟杆菌、丁酸梭菌、格氏乳杆菌、罗伊氏乳杆菌的相对丰度显著升高。结论AAF替代喂养可使得重度CMPA患儿肠道菌群多样性增加,拟杆菌、厚壁菌等的丰度增加。

醒脾养儿颗粒与孟鲁司特钠联合治疗小儿牛奶蛋白过敏的效果分析

目的分析醒脾养儿颗粒与孟鲁司特钠联合治疗小儿牛奶蛋白过敏的效果。方法94例牛奶蛋白过敏患儿,使用随机数字表法分为对照组与研究组,每组47例。对照组采用孟鲁司特钠咀嚼片治疗,研究组在对照组的基础上应用醒脾养儿颗粒治疗。比较两组患儿的临床疗效以及炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、免疫因子(CD8^(+)、CD4^(+))水平。结果在总有效率比较中,研究组95.74%高于对照组的80.85%(P<0.05)。治疗后,研究组IL-6、TNF-α水平分别为(7.65±2.03)、(6.28±1.50)pg/ml,较对照组的(15.20±3.05)、(13.23±2.45)pg/ml低(P<0.05)。治疗后,研^(+)^(+)究组CD4水平(48.68±5.50)%较对照组的(44.50±4.86)%高,CD8水平(25.05±2.02)%较对照组的(28.64±3.05)%低(P<0.05)。结论醒脾养儿颗粒与孟鲁司特钠联合治疗小儿牛奶蛋白过敏效果确切,可以有效抑制患儿的炎症反应,提高其免疫功能,适于临床应用。

婴儿牛奶蛋白过敏的危险因素:一项多中心前瞻性巢式病例对照研究

目的探讨婴儿牛奶蛋白过敏(cow'smilkproteinallergy,CMPA)发生的危险因素。方法该研究为多中心前瞻性巢式病例对照研究。选取北京市7家医学中心0~12月龄婴儿为研究对象。共纳入CMPA婴儿200例,未发生CMPA的婴儿(对照组)799例。采用单因素和多因素logistic回归分析探讨CMPA发生的危险因素。结果单因素logistic回归分析显示,早产儿、低出生体重儿、第一胎、第一产、春季出生、夏季出生、混合/人工喂养、父母患过敏性疾病与婴儿CMPA患病风险增加有关(P<0.05)。多因素logistic回归分析显示,第一产(OR=1.89,95%CI:1.14~3.13)、春季出生(OR=3.42,95%CI:1.70~6.58)、夏季出生(OR=2.29,95%CI:1.22~4.27)、混合/人工喂养(OR=1.57,95%CI:1.10~2.26)、父亲或母亲有过敏史(OR=2.13,95%CI:1.51~3.02)、双亲有过敏史(OR=3.15,95%CI:1.78~5.56)是婴儿CMPA发生的危险因素(P<0.05)。结论第一产出生、春季出生、夏季出生、混合/人工喂养或有过敏家族史的婴儿CMPA的患病风险增加。