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This version was machine-translated from German and has not been medically reviewed. The authoritative version is the German version.

CoMiSS: indication of cow’s milk-related symptoms in infants

Cow's Milk-related Symptom Score, version 2022: crying, regurgitation, stool, skin, airways, 0–33 points; from 10 points an indication, not a diagnosis (healthy infants up to 6 months)

Crying (according to parents, without identifiable cause, for at least 1 week(s))
Spitting up (regurgitation, for at least 1 week)
Stool by the Brussels Infant and Toddler Stool Scale (BITSS, for at least 1 week)
Atopic eczema on head, neck and trunk (for at least 1 week)
Atopic eczema on arms, hands, legs and feet (for at least 1 week)
Acute hives (urticaria) and/or swelling (angioedema)
Respiratory symptoms (for at least 1 week)

Calculation aid for healthcare professionals: the calculator reproduces what the sources cited assign to the inputs. Clinical assessment and every treatment decision remain with the treating physician. Inputs and results are not stored.

Frequently asked questions

CoMiSS: indication of cow’s milk-related symptoms in infants: What does this calculator compute?

The CoMiSS (Cow's Milk-related Symptom Score, Vandenplas 2022) counts symptoms that could be caused by cow’s milk: crying (0–6), regurgitation (0–6), stool according to the Brussels stool scale (0, 4 or 6), eczema (0–6), urticaria or swelling (0 or 6) and airways (0–3). Total 0–33. From 10 points the symptoms may be cow’s milk-related. With reservations: only an indicator tool for otherwise healthy infants up to 6 months, not a diagnosis. The threshold is a consensus; the work was funded by Nestlé Health Science.

CoMiSS: indication of cow’s milk-related symptoms in infants: Which sources is this calculator based on?

Vandenplas Y, Bajerova K, Dupont C, Eigenmann P, Kuitunen M, Meyer R, Ribes-Koninckx C, Salvatore S, Shamir R, Szajewska H: The Cow's Milk Related Symptom Score: The 2022 Update (Nutrients 14:2682) (2022)