Are you spending too much on Cow’s Milk Allergy?

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You’ll find references and further reading below.

1. UK Guidance recommends that if a child is exclusively breastfed or mixed feeding to actively support continued breastfeeding, but if that is not an option then a trial of Extensively Hydrolysed Formula should be the first line option.

Breast milk is best for babies and breastfeeding should continue for as long as possible. (MIMS 2020). Specialist formula must be used under medical supervision.

  • NICE Clinical Knowledge Summary. 2019. Cow’s Milk Allergy in Children. NICE. October 2020. Available from:

  • Fox, A., et al. An update to the Milk Allergy in Primary Care guideline. Clin Transl Allergy. 2019;9(40):1-7.

  • Luyt, D., et al. Executive summary of BSACI guideline for the diagnosis and management of cow's milk allergy. British Society for Allergy & Clinical Immunology (BSACI). Clinl & Experimental Allergy. 2014;44:642–672

  • 2. Local Guidelines

    Greater Manchester Joint Commissioning Team. Prescribing infant formula for cow’s milk protein allergy in primary care. Version 3. April 2020. Available from:

    Midlands and Lancashire CSU. Prescribing Guidelines for Specialist Infant Formula Feeds. December 2017. Available from:

    3. Demonstrated safety and efficacy vs an amino acid

    Niggemann, B. et al. Safety and efficacy of a new extensively hydrolyzed formula for infants with cows milk protein allergy. Pediatr Allergy Immunol. 2008;194(4):348.

    4. Plant and microbial derived enzyme

    Nowak-Węgrzyn A, et al. Hypoallergenicity of a whey-based, extensively hydrolyzed infant formula prepared with nonporcine enzymes. Allergy 2019; 74: 1582-4.

    5. MIMS (accessed September 2021)

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