[One guideline for diagnosing cow milk allergy; for primary, secondary and tertiary care in the Netherlands]. / 1 richtlijn voor diagnostiek van koemelkallergie; voor de eerste, tweede en derde lijn in Nederland.

ABSTRACT

The aims of the new Dutch guideline 'Diagnosing Cow Milk Allergy in Children in the Netherlands' are to provide an evidence-based instrument for the reliable and safe diagnosis of cow milk allergy and to improve the collaboration between health care professionals at well-baby clinics, general practices and hospitals. The double-blind, placebo-controlled cow-milk provocation test is the only test available for establishing an allergy to cows' milk. The double-blind provocation test in children at a low risk of severe reactions may be performed at the better-equipped well-baby clinics and at all general practices, thereby shifting care from secondary to primary care. The use of extensively hydrolysed formulas based on whey protein as well as on casein can be advised for a cow-milk-free diet. The general practitioner and well-baby physician should collaborate in designating responsibilities during the diagnostic phase of cow milk allergy in primary care.