Cows Milk Protein Allergy

​under review – August 2022

Guidelines for the diagnosis and management of suspected cow’s milk protein allergy (CMPA) in primary care

Introduction

• These guidelines are for the diagnosis and management of suspected cow’s milk protein allergy
• The prevalence of cow’s milk allergy is up to 7.5% of infants during the first year of life
• Cow’s milk allergy commonly presents in infancy, with most affected children presenting  with symptoms by 6 months of age
• Cow’s milk allergy  can be classified into IgE mediated reactions immediate onset reactions and non- IgE mediated delayed onset
• Cow’s milk allergy will resolve in the majority of children during early child hood

4 steps to implement the guidelines

1. Take an allergy focused history
2. Decide whether history is suggestive of IgE mediated or non-IgE mediated allergy
3. Advise elimination diet and appropriate formula choice and onward referral if required.
4. In suspected mild to moderate non-IgE mediated allergy, primary care health professional to advise 4 week trial of complete milk and dairy exclusion then home reintroduction of milk, over 7 days, to confirm or refute diagnosis and onward referral if required. 

CMPA Table 1.pdf, CMPA Algorithm 1.pdf, CMPA Appendix 1_How to follow a cow’s milk free diet.pdf

CMPA Table 2.pdf, CMPA Algorithm 2.pdf , CMPA Appendix 2_Reintroduction of cow’s milk.pdf

CMPA Table 3.pdf, CMPA Appendix 3_Allergy focused clinical history.pdf