COW’S MILK PROTEIN ALLERGY AND REFLUX: HOW TO UNDERSTAND WHAT IS TROUBLING THE INFANT
DOI:
https://doi.org/10.32689/2786-7161-2026-2-5Keywords:
young children, gastroesophageal reflux, cow’s milk protein allergyAbstract
Background. In the first months of life, a considerable proportion of young infants display symptoms such as increased irritability, excessive crying, and regurgitation, which often become a source of concern and emotional exhaustion for parents. In such cases, clinicians face the question of whether these manifestations are due to physiological or pathological gastroesophageal reflux, or whether they may be related to cow’s milk protein allergy. Despite the similarity of clinical presentations, both diseases have different pathophysiological mechanisms and require a differentiated approach to diagnosis and treatment. The aim of this review is to analyze current scientific data on these conditions in young children, as well as to update the knowledge of primary care physicians in order to improve their diagnosis and management. Materials and methods. An in-depth review of the current scientific literature on gastroesophageal reflux and cow’s milk protein allergy in young children was conducted, along with an analysis of the current clinical guidelines of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition on the diagnosis and management of gastroesophageal reflux disease in children. Results. The main pathophysiological mechanisms and clinical features of gastroesophageal reflux and cow’s milk protein allergy in young children were analyzed. Both conditions were found to be common during the first year of life and may present with similar symptoms, including regurgitation, vomiting, excessive crying, irritability, decreased appetite, and sleep disturbances, which complicates their differential diagnosis. The absence of specific and accessible diagnostic tests can lead to both overdiagnosis and underestimation of these conditions. Based on an analysis of current guidelines, a practical stepwise approach to symptom assessment and management of infants with gastroesophageal reflux and cow’s milk protein allergy is proposed, providing a rationale for determining further treatment strategy. Conclusion. A practical stepwise algorithm is proposed to assist healthcare professionals in managing infants with persistent regurgitation, vomiting, crying, and discomfort.
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