Paeds: General

Question 1

Cow’s milk protein allergy management?

Answer 1

Management if formula-fed

• Extensive hydrolysed formula (eHF) milk is the first-line replacement formula for infants with mild-moderate symptoms
• Amino acid-based formula (AAF) in infants with severe CMPA or if no response to eHF
• Around 10% of infants are also intolerant to soya milk

Management if breastfed

• Continue breastfeeding
• Eliminate cow’s milk protein from maternal diet. Consider prescribing calcium supplements for breastfeeding mothers whose babies have, or are suspected to have, CMPI, to prevent deficiency whilst they exclude dairy from their diet
• Use eHF milk when breastfeeding stops, until 12 months of age and at least for 6 months

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CMPI usually resolves. Can be IgE mediated or non-IgE mediated.

Diagnosed by

• Skin prick/patch testing
• Total IgE and specific IgE (RAST) for cow’s milk protein

Question 2

What are the major risk factors for Sudden infant death syndrome?

Answer 2

prone sleeping

parental smoking

bed sharing

hyperthermia and head covering

prematurity

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Male is a risk factor