> I seem to remember that there was mention of a possible connection
> between cow's milk allergy and reflux...... Does anyone have a
> reference on this issue, as I couldn't find it in the archives.

There were three CMP/reflux studies published in 1996, plus one on
tobacco smoke exposure.

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, Mar 1996
97(3):822-7
"gastroesophageal reflux was associated with, and probably caused by cow's
milk allergy, in 85 of 204 cases (41.8%)".

Cavataio F; Iacono G; Montalto G; Soresi M; Tumminello M;
Carroccio A.  Clinical and pH-metric characteristics of gastro-oesophageal
reflux secondary to cows' milk protein allergy. Arch Dis Child, 1996
75(1):51-6.
"14 out of 47 (30%) of infants with gastro-oesophageal reflux
had CPMA. These infants had similar symptoms to those with primary
gastro-oesophageal reflux. . . . A characteristic oesophageal pH pattern
is useful in distinguishing infants with gastro-oesophageal reflux
associated with CMPA"

Cavataio F; Iacono G; Montalto G; Soresi M; Tumminello M; Campagna P;
Notarbartolo A; Carroccio A.  Gastroesophageal reflux associated with
cow's milk allergy in infants: which diagnostic examinations are useful?
Am J Gastroenterol, 1996 91(6):1215-20
"Thirty of 72 patients with GER were also suffering from CMPA.  No
differences were observed as regards to age, sex, symptoms and clinical or
family history between patients with GER only and those with GER + CMPA."

Not forgetting tobacco smoke as a possible factor in GER:

Alaswad B;  Toubas PL;  Grunow JE.  Environmental tobacco smoke exposure
and gastroesophageal reflux in infants with apparent life-threatening
events.  J Okla State Med Assoc  1996 7(89):233-7
"There was a strong correlation between pH study parameters and
environmental tobacco smoke (ETS) exposure ......  and in this
group there was a linear relation between the number of cigarettes smoked
per day and reflux index, as well as reflux > 5 min/hr. Nursing
mothers were less likely to be smokers (18.2% vs. 34.0%)."

Ros Escott BAppSc IBCLC
Tasmania, Australia
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