Abstract Body

Food allergy remains common in children. However, the diagnosis and management of food allergy can vary between clinical practice settings. To promote the best clinical practices, worldwide, scientific organizations or groups of experts provide guidelines. Even if such documents are typically based on systematic reviews, the guidelines often differ. This presentation will discuss the most recent documents, including: 1) the 2021 guideline from the Global Allergy and Asthma European Network (GA²LEN), focusing on food allergy in general, and 2) two 2022/2023 documents focusing on cow’s milk allergy (CMA), which remains the most common food allergy in infants and young children, i.e., the World Allergy Organization DRACMA (Diagnosis and Rationale for Action against Cow’s Milk Allergy) guidelines and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines. Key similarities and differences will be discussed.

Dietary management of CMA requires choosing the best suitable cow’s milk substitute for use in infancy and beyond. This presentation will discuss how and when to choose a suitable substitute, which is dependent on many factors. These factors include the infant’s symptomatic presentation, age, and nutritional needs, the latter which may include a hypoallergenic formula, maternal elimination diet if the infant is symptomatic during exclusive breastfeeding, or plant-based formulas. The question as to what to do when recommendations from medical societies are not in agreement will be addressed. The gaps in the current evidence will be presented and discussed with recommendations for future research and/or clinical trials to address these gaps.