Correlation between cow’s milk protein allergy and otitis media: a systematic review

Highlights

• The correlation between cow’s milk protein allergy and otitis media has been investigated in recent decades.

• Allergic inflammation in the nasal mucosa is associated with Eustachian tube dysfunction, contributing to otitis media.

• Previous studies about cow’s milk protein allergy and otitis media have limitations, leading to controversial results.

• There is no reliable evidence that cow’s milk protein allergy is related to acute otitis media or otitis media with effusion.

Abstract

Objectives

To review the evidence pertaining to the association between cow’s milk protein allergy and recurrent acute otitis media and otitis media with effusion.

Methods

The CENTRAL, Web of Science, EMBASE, MEDLINE, LILACS databases, and gray literature were searched.

Results

Four studies were included, identifying the prevalence rates: 0.2% of delayed speech due to chronic otitis media with effusion in 382 children with cow’s milk protein allergy, 10.7% of cow’s milk protein allergy in 242 children who underwent ENT procedures, 40% of cow’s milk protein allergy in 25 children with recurrent otitis media with effusion and higher tendency to otitis media in children with cow’s milk protein allergy of 186 children (1.5 + 0.6 vs. 0.4 + 0.1; p< 0.1).

Conclusion

Considering the characteristics and methodological variations of the identified studies, it is not possible to state that there is reliable evidence of an association between cow’s milk protein allergy and otitis media.

Keywords
Milk hypersensitivity; Milk proteins; Otitis media; Otitis media with effusion