Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jul 8;3(1):23.
doi: 10.1186/2045-7022-3-23.

Diagnosis and management of non-IgE-mediated cow's milk allergy in infancy - a UK primary care practical guide

Carina Venter  1 , Trevor Brown, Neil Shah, Joanne Walsh, Adam T Fox
Affiliations

Diagnosis and management of non-IgE-mediated cow's milk allergy in infancy - a UK primary care practical guide

Carina Venter et al. Clin Transl Allergy. .

Abstract

The UK NICE guideline on the Diagnosis and Assessment of Food Allergy in Children and Young People was published in 2011, highlighting the important role of primary care physicians, dietitians, nurses and other community based health care professionals in the diagnosis and assessment of IgE and non-IgE-mediated food allergies in children. The guideline suggests that those with suspected IgE-mediated disease and those suspected to suffer from severe non-IgE-mediated disease are referred on to secondary or tertiary level care. What is evident from this guideline is that the responsibility for the diagnostic food challenge, ongoing management and determining of tolerance to cow's milk in children with less severe non-IgE-mediated food allergies is ultimately that of the primary care/community based health care staff, but this discussion fell outside of the current NICE guideline. Some clinical members of the guideline development group (CV, JW, ATF, TB) therefore felt that there was a particular need to extend this into a more practical guideline for cow's milk allergy. This subset of the guideline development group with the additional expertise of a paediatric gastroenterologist (NS) therefore aimed to produce a UK Primary Care Guideline for the initial clinical recognition of all forms of cow's milk allergy and the ongoing management of those with non-severe non-IgE-mediated cow's milk allergy in the form of algorithms. These algorithms will be discussed in this review paper, drawing on guidance primarily from the UK NICE guideline, but also from the DRACMA guidelines, ESPGHAN guidelines, Australian guidelines and the US NIAID guidelines.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Strengths and main clinical emphases of the NICE guideline.
Figure 2
Figure 2
Different presentations of cow’s milk allergy in infancy.
Figure 3
Figure 3
Diagnosis and management of mild to moderate non-IgE CMA in UK primary care.
Figure 4
Figure 4
Formulas available for the treatment of CMA in the UK.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. World Health Organisation. Global surveillance, prevention, and control of chronic respiratory diseases: a comprehensive approach. 2007. http://www.who.int/gard/publications/GARD%20Book%202007.pdf.
    1. Fiocchi A, Brozek J, Schunemann H, Bahna SL, von BA, Beyer K. et al.World Allergy organization (WAO) diagnosis and rationale for action against Cow's milk allergy (DRACMA) guidelines. World Allergy Organ J. 2010;3(4):57–161. doi: 10.1097/WOX.0b013e3181defeb9. - DOI - PMC - PubMed
    1. Venter C, Pereira B, Voigt K, Grundy J, Clayton CB, Higgins B. et al.Prevalence and cumulative incidence of food hypersensitivity in the first 3 years of life. Allergy. 2008;63(3):354–359. - PubMed
    1. Rona RJ, Keil T, Summers C, Gislason D, Zuidmeer L, Sodergren E. et al.The prevalence of food allergy: a meta-analysis. J Allergy Clin Immunol. 2007;120(3):638–646. doi: 10.1016/j.jaci.2007.05.026. - DOI - PubMed
    1. Sladkevicius E, Nagy E, Lack G, Guest JF. Resource implications and budget impact of managing cow milk allergy in the UK. J Med Econ. 2010;13(1):119–128. doi: 10.3111/13696990903543242. - DOI - PubMed