Cow’s Milk-related
Symptom Score
(CoMiSS™)
Cow’s Milk Related Symptom Score (CoMiSS™) is an awareness tool for healthcare professionals. You can use it to evaluate the full range of symptoms typically related to cow's milk.
Cow’s Milk-related Symptom Score (CoMiSS™)
Cow’s Milk Related Symptom Score (CoMiSS™) is an awareness tool for healthcare professionals. You can use it to evaluate the full range of symptoms typically related to cow's milk.
What is CoMiSS™?
First developed by a group of leading international experts in 2014, CoMiSS™ is a simple, fast and easy-to-use tool for infants 12 months.
The intention of CoMiSS is to:
- Increase awareness of the most common symptoms seen in infants with CMPA, helping to speed up the diagnostic process.
- Support HCPs to quantify and evaluate symptoms in infants with suspected CMPA.
- Please note CoMiSS™ is not a diagnostic tool.
Please note that CoMiSS™ is not intended for use in infants with severe, life-threatening symptoms clearly indicating CMPA, including anaphylaxis, which requires an urgent referral to an HCP.
CoMiSS™ User Guide
Download the user guide that explains clearly each scoring section of CoMiSS™
Download
CoMiSS™ presented at ESPGHAN
Explained by CoMiSS™ experts
The CoMiSS™ user guide
Explained by expert Dr Kateřina Bajerová
Why is CMPA
Sometimes Difficult
to Diagnose?
Cow's Milk Protein Allergy (CMPA) is an adverse immune reaction to cow's milk and affects up to 3% of infants globally making it one of the most common food allergies in early life.1,2
Early identification of CMPA can be life-changing for infants and families, but diagnosis can be challenging for Healthcare Professionals (HCPs).
CHALLENGES DIAGNOSING CMPA
CONSEQUENCES OF DELAYED DIAGNOSIS
Symptoms can overlap with other common infant health conditions, such as colic and regurgitation2
Increase costs and higher healthcare usage4,5
Non-IgE-mediated CMA cases are often harder to diagnose and supportive tests are not available2,3
Inappropriate dietary changes4
It can take several visits to the doctor and months before an official diagnosis is made
Impact on infants growth and development6
Many primary care HCPs are not always very familiar with the common symptoms of CMA and the CMA guidelines for diagnosis and management3
Lower quality of life6,7
Supported by
Clinical Studies
Since 2015 there have been over 30 clinical studies conducted and published using CoMiSS™. Based on this new clinical evidence and their years of experience, the group of international experts updated CoMiSS™ and it was launched at the ESPGHAN congress in 2022.
Supported by 30
clinical studies and
counting.
What were the key updates to CoMiSS™?2
- The overall cut off score indicating the presence of CMPA has been reduced from ≥ 12 to ≥ 10.
- The Bristol Stool Scale has been replaced by the Brussels Infant and Toddlers Stool Scale (BITSS), to better reflect the stool consistency of non-toilet trained infants.
- Clearer guidance has been provided for healthcare professionals to indicate for which infants the tool is not appropriate, and situations that may require immediate referral (such as anaphylaxis, failure to thrive, and sick infants with hematochezia [blood in stool]).
CoMiSS™ at ESPGHAN 2022
Chairs Introduction
Meet the experts discussing CoMiSS™ at ESPGHAN.
Why Is the Diagnosis of CMPA So Challenging
Learn about how CMPA can be mis-diagnosed and how this can impact the young infant.
CoMiSS™ Lessons Learnt
Evidence presented from at least 25 clinical studies that have used CoMiSS™.
CoMiSS™: the 2022 Updates
Hear the latest updates to CoMiSS™ based on extensive evidence
Questions and Answers
Hear the audience Q&A that followed the discussion.
Nestlé owns the copyright to CoMiSS™ and that each of the 3 versions on the website falls under this copyright
