A practical approach for UK primary care on the management of cow's milk allergy in infants.

IntrodUCtIon CMA is the commonest food allergy among children in the UK. Data from 2008 indicated 2.3% of 1–3 year-olds in the UK suffer from CMA.1 In 2011, National Institute for Health and Care Excellence (NICE) published Clinical Guideline (CG)116 on the Diagnosis and Assessment of Food Allergy in Children and Young People in Primary Care and Community Settings.2 It has become increasingly evident that for effective implementation, there needs to be further practical advice, which was outside of the scope of the current NICE guideline, on establishing the initial diagnosis and the further management of infants with CMA. A health economic analysis published in 2010 concluded that CMA imposes a, ‘substantial burden on the NHS’.3 The ‘cost’ of this burden can be kept at a minimum by improving the care provided in the community. As clinicians involved in the development of the NICE guideline, we have therefore aimed to provide a practical tool for the management of CMA in primary care. The algorithm we have produced is intended as an adjunct to the published NICE guideline2 and is intended for local adaptation. Algorithms have been published previously 4 but not aimed at UK primary care. The algorithms and further supporting information have been published and are freely available online.5