Step 1 -Commence CMP free diet

 

adapted from regional guideline

Presenting symptoms:

  1. Gut

  2. Skin

  3. Respiratory

Feeding history:

  1. Formula fed

  2. Exclusively breast fed

  3. Mixed feeding

  4. Weaned

Could this be CMA?

  1. Previous  Dx and response to treatment

  2. Atopic eczema - moderate to severe

  3. Faltering growth?

  4. FH of atopy in a 1st degree relative

Anaphylaxis
Severe presentation
“Acute” presentation
“Delayed” presentation

Emergency admission

Urgent referral

Early referral

Primary care management

Start CMP free diet for 2-6 wk

Exclusively breast fed

Formula fed

Mixed feeding

  1. Start eHF for 2-4 wk

  2. Refer dietician

  1. Strict exclusion of CMP for 2-4 wk

  2. Refer dietician

  3. Start maternal calcium and Vit D3

  1. Strict exclusion of CMP for 2-4 wk

  2. Top up with eHF

  3. Refer dietician

  4. Start maternal calcium and Vit D3