Cows' Milk Protein Allergy: Are Guidelines Being Effectively Communicated?.pdf

Dr Rosan Meyer, Paediatric Allergy Dietitian and Lecturer at Imperial College London, highlights the prevalence and management challenges of cows' milk protein allergy (CMPA) in children. Despite multiple guidelines published globally over the last decade, concerns remain regarding diagnosis and management, especially for non-IgE-mediated CMPA.

Key Points:

- Prevalence: CMPA is the most common food allergy in infants and young children, with a prevalence of around 1% Europe-wide, but up to 3% in UK birth cohorts.
- Types of CMPA: It can be IgE-mediated (symptoms within 2 hours) or non-IgE mediated (symptoms up to a couple of days after ingestion), affecting gastrointestinal and skin tracts differently.
- Guidelines: 11 guidelines have been published globally, with three from the UK (MAP, BSACI, NICE). They provide similar guidance on diagnosis and management, including maternal elimination diets during breastfeeding and hypoallergenic formulas for non-breastfed children.
- Diagnosis Challenges: Non-IgE-mediated CMPA lacks a valid diagnostic test, relying instead on dietary elimination and symptom improvement.
- Recent Study: A study by Lozinsky et al (2016) questioned the effectiveness of current guidelines in improving diagnosis and management of CMPA, suggesting room for improvement in their implementation.