Discrepancies in the Diagnosis, Treatment and Prevention of Cow Milk Allergy Among Paediatricians

Different scientific societies published guidelines and recommendations on the diagnosis, treatment and prevention of cow's milk allergy (CMA). We aimed to compare the guidelines of the European Society of Gastroenterology, Hepatology and Nutrition (ESPGHAN) with the practices of Flemish paediatricians.

During 2023, 73 statements of the ESPGHAN CMA-position paper were submitted to 50 Flemish general paediatricians, who voted on these statements with the same methodology. If more than 25% of the paediatricians disagreed with the statements approved by ESPGHAN, the statements were considered 'rejected'.

The applicability of guidelines might be limited since Flemish paediatricians rejected 25/73 (34%) of the statements endorsed in the ESPGHAN manuscript.

The opinions of general paediatricians and ESPGHAN authors regarding the diagnosis, management and prevention of CMA differ substantially. Further research should investigate if this is due to lack of knowledge and comprehension of the available information, due to lack of applicability or application of the recommendations.