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Monitoring the impact of cow's milk allergy on children and their families with the FLIP questionnaire - a six-month follow-up study

Journal article
Authors Andrea Mikkelsen
Kirsten Mehlig
M. P. Borres
Lena Oxelmark
Cecilia Björkelund
Lauren Lissner
Published in Pediatric Allergy and Immunology
Volume 26
Issue 5
Pages 409-415
ISSN 0905-6157
Publication year 2015
Published at Institute of Medicine, School of Public Health and Community Medicine
Institute of Medicine, Department of Public Health and Community Medicine, Public Health Epidemiology Unit
Institute of Health and Care Sciences
Pages 409-415
Language en
Keywords children and family, cow's milk allergy, cow's milk hypersensitivity, food allergy, food hypersensitivity, NEGATIVE FOOD CHALLENGES, ELIMINATION DIET, GUIDELINES, DIAGNOSIS, VALIDITY, ALLERGY/INTOLERANCE, MANAGEMENT, CHILDHOOD, ADHERENCE, SCHOOL, Allergy, Immunology, Pediatrics
Subject categories Immunology in the medical area, Pediatrics


BackgroundMany children with cow's milk allergy (CMA) develop tolerance, but, challenges in daily life may remain. Using the Food hypersensitivity famiLy ImPact questionnaire (FLIP), we sought to monitor changes in the impact of CMA over time. MethodsFamilies of children with CMA, who participated in the validation of the FLIP, were re-approached 6months later for follow-up. Change in reported difficulties was assessed by paired sample t-test and mixed models, stratifying by outgrown vs. persistent CMA. ResultsImpact on families with children who had outgrown CMA (n=20) decreased in the FLIP's total score (p=0.0001) and in two subscales; Health and Emotions (p=0.0001) and Everyday Life (p=0.0001). In contrast, no significant improvements were registered in nutritional concerns. Impact on the group with persistent CMA (n=57) was unchanged at follow-up except for more impact on Everyday Life (p=0.001). In the final analysis comparing longitudinal changes in the groups, the strongest differences were observed for the subscales Health & Emotions and Everyday Life; for the Nutrition subscale, the between-group changes also differed, but to lesser extent. ConclusionsWe have documented the varying impact of CMA on parents and children over time. Families who were still affected continued to experience impact in daily life. Despite development of tolerance, families who were no longer affected revealed continuing nutritional concerns. Follow-ups should be offered even after outgrown CMA to encourage progression to unrestricted diet, to prevent eating disorders and to promote healthy growth.

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