There is evidence that babies with cow's milk protein sensitivity may 
not in fact show other symptoms of allergy.  This study (one of two I 
referenced in a post yesterday) found that most infants with CMP 
sensitivity and GER didn't have any other symptoms.  This is 
consistent with my personal experience as well.

Iacono G, Carroccio A, Cavataio F, Montalto G, Kazmierska I, Lorello 
D, Soresi M, Notarbartolo A. Gastroesophageal reflux and cow's milk 
allergy in infants: a prospective study.  J Allergy Clin Immunol. 
1996 Mar;97(3):822-7. 
	<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8613639&dopt=Abstract>

"METHODS: We studied 204 consecutive patients (median age, 6.3 
months) who had been diagnosed as having gastroesophageal reflux on 
the basis of 24-hour continuous pH monitoring and histologic 
examination of the esophageal mucosa. RESULTS: Clinical history 
suggested diagnosis of cow's milk allergy in 19 infants, and 93 
others had positive test results (serum IgE anti-lactoglobulin, prick 
tests, circulating or fecal or nasal mucus eosinophils) **but did not 
have symptoms indicating cow's milk allergy.**  (emphasis added)  The 
cow's milk-free diet and two successive blind challenges confirmed 
the diagnosis of cow's milk allergy in 85 of the 204 patients with 
gastroesophageal reflux. The clinical presentations of the infants 
with gastroesophageal reflux alone were different, in view of the 
greater frequency of diarrhea (p less than 0.0001) and atopic 
dermatitis (p less than 0.0002). In all, gastroesophageal reflux was 
associated with, and probably caused by cow's milk allergy, in 85 of 
204 cases (41.8%)."

Margaret
Longmont, CO


>Dear Jennifer,
>
>Most of the times, babies that have bad GER due to allergies will have
>some other clues about their atopic tendencies, most common one being
>eczema. There might be clues in the family history too. If neither mom nor
>dad have any hx of allergic rhinitis/eczema/asthma  and big brother
>doesn't have Sx of these, I'd put food allergies at the bottom of the
>list. A combination of Zantac and Reglan or Prilosec might be useful to
>reduce the Sx of esophagitis for this baby.
>
>Vaishali Kute, MD FAAP

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