Detection and management of milk allergy: Delphi consensus study

Area of Science:

• Pediatrics
• Allergy and Immunology
• Gastroenterology

Background:

• Significant overdiagnosis of milk allergy in young children leads to unnecessary specialized formula use.
• This guidance was developed by experts without commercial ties to the formula industry.
• Aims to reduce milk allergy overdiagnosis and support caregivers of children with suspected milk allergy.

Purpose of the Study:

• To provide updated guidance on the diagnosis and management of suspected milk allergy in infants and young children.
• To reduce overdiagnosis and inappropriate use of specialized infant formulas.
• To support healthcare professionals and caregivers in accurately identifying and managing milk allergy.

Main Methods:

• A Delphi study involving two rounds of anonymous consensus building and an open meeting.
• Seventeen multidisciplinary experts from various global regions participated.
• Feedback was incorporated from authors of previous guidelines and parents.

Main Results:

• 38 essential recommendations were agreed upon through consensus.
• Stricter, more reproducible criteria for diagnosing milk allergy were established.
• Maternal dietary restriction is generally not necessary; diagnosis for exclusively breastfed infants with chronic symptoms is rare.

Conclusions:

• New recommendations advise narrower criteria for milk allergy diagnosis compared to previous guidelines.
• Emphasizes greater support for breastfeeding and reduced reliance on specialized infant formula.
• Aims to improve diagnostic accuracy and reduce unnecessary interventions for suspected milk allergy.