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Cow’s milk allergy guidelines are not evidence based and are beset by conflicts of interest, researchers warn

Guidelines that advise doctors to manage common infant symptoms as cow’s milk allergy are not evidence based and might be promoting overdiagnosis, a study has found.

Researchers from Imperial College London said that the advice was especially inappropriate for breastfed infants who are not directly consuming cow’s milk and risked undermining confidence in breastfeeding.1

The evidence review, published in JAMA Paediatrics , also concluded that cow’s milk allergy guidelines were rife with conflicts of interest. Three of the guidelines it analysed were directly supported by formula manufacturers or marketing consultants, and eight in 10 guideline authors reported a conflict of interest with formula manufacturers.

The findings follow an investigation published in The BMJ in 2018,2 which revealed that allergy to cow’s milk protein might be acting as a Trojan horse …