WOFAPS 2025 8th World Congress of Pediatric Surgery

Elizabeth Brits

Paediatric Surgery, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa

Background: Cows' milk protein allergy (CMPA), a common infant food allergy, is often linked to refractory gastroesophageal reflux disease (GERD) in the paediatric population. Overlapping symptoms complicate diagnosis and delay treatment success. With CMPA implicated in up to half of the refractory GERD cases, this study aimed to address gaps, refine practices, and improve outcomes.

Objective: To analyse existing literature on the role of CMPA in refractory GERD in infants, identify knowledge gaps, and outline clinical and research recommendations. This scoping review identified relevant articles on the role of CMPA in refractory GERD in paediatrics.

Methods: A systematic search across databases with keywords was conducted.

Results: The review analysed 20 studies on the role of CMPA in refractory GERD in infants. CMPA contributed to up to 50% of cases, often resolving with cow's milk protein (CMP) elimination diets or hypoallergenic formulas as first-line treatments, reducing medication use. Diagnostic challenges, especially in non-immunoglobulin E (non-IgE) cases, stemmed from overlapping symptoms and limited diagnostic tools. Gaps were identified in long-term safety, diagnostic tools, and the impact of understanding CMPA-GERD, demanding future research.

Conclusion: Elimination diets and hypoallergenic formulas provide effective management of CMPA-associated GERD. Better diagnostics and standardised protocols are needed to improve outcomes, particularly for non-IgE cases.