Step 2 - Confirming the diagnosis

 
Start CMP free diet for 2-6 wk

FORMULA-FED or MIXED FEEDING

EXCLUSIVELY BREAST-FED

Start eHF for 2-6 wk
Not Improved
Improved
Improved
Not Improved

Re-introduce cow’s milk formula between 2-4 weeks from starting elimination diet

Symptoms return
Symptoms don’t return
Early referral to paediatrician with interest in allergy

CMA still suspected

Re-start eHF for 2-6 wk
Symptoms improve
CMA confirmed

Re-introduce cow’s milk protein between 2-4 weeks from starting elimination diet

Symptoms return
Symptoms don’t return
Exclude CMP for 2-6 wk
Symptoms improve
CMA confirmed

CMA still suspected

Consider other maternal foods e.g. egg

Early referral to paediatrician with interest in allergy

Not

CMA

Not

CMA

adapted from regional guideline

Symptoms don’t settle
Trial of AA formula
Trial of AA formula