CoMiSS® Cow’s Milk-related Symptom Score

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 caused by CMPA in very young infants.

What is CoMiSS®?

First developed by a group of leading international experts in 2015, CoMiSS® is a simple, fast and easy-to-use tool that helps you understand and evaluate different CMPA symptoms.

It has been designed to:

Increase awareness of the most common symptoms of CMPA, helping to speed up diagnosis
Help you evaluate and quantify the evolution of symptoms during a therapeutic intervention
Give you a better grasp of symptoms in pre-verbal infants from 0-12 months

Please note that CoMiSS® is not intended to interfere with severe and life-threatening symptoms clearly indicating CMA, including anaphylaxis, which requires urgent referral.

GET STARTED WITH CoMiSS®

Start using the interactive version of CoMiSS® now.

Start scoring

SmilesBack mobile application to track CMPA symptoms.

CoMiSS® User Guide

This comprehensive CoMiSS® User Guide walks you through each of the different scoring sections, including how to explain it to patients.

Download the guide

Learn more about the
updated CoMiSS®

CoMiSS presented at ESPGHAN

Follow the CoMiSS® discussion presented at ESPGHAN 2022.

The latest CoMiSS Scoring Updates

See how CoMiSS® has evolved to provide greater accuracy.

Supported by
clinical studies

Group of experts have revised and
updated CoMiSS®

Since 2015 there have been 25 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® in 2022 and launched at ESPGHAN 2022.

Supported by 25
clinical studies and
counting.

What are the key updates to CoMiSS®?

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The Bristol Stool Scale has been replaced by the Brussels Infant and Toddlers Stool Scale, to better reflect the stool consistency of non-toilet trained infants.
Clearer guidance has been provided for healthcare professionals to indicate which infants the tool is not appropriate for, and situations that may require immediate referral (such as anaphylaxis, failure to thrive, and sick infants with hematochezia).