The aim of the service is to ensure children with likely food allergy and conditions of atopy, receive the correct diagnosis and appropriate management plans as early as possible. The service comprises of consultant paediatric allergy specialists, GPs with a special interest in allergy, paediatric allergy nurse specialists, a specialist allergy pharmacist and dietician, delivering a multi-disciplinary clinic.

The MDT will liaise with local GPs, health visitors and school nurses, providing support, education and training sessions with allergy updates. The team will also support schools/nurseries in managing allergies within their setting. The service aims to prevent multiple unnecessary visits to other services and overprescribing of hypoallergenic formula.

Eligibility Criteria

Inclusions

Referrals are accepted for all children aged 0-15 years with any of the following criteria:

• allergic reaction to any food
• suspected allergic reaction to oral medication
• poorly controlled or recalcitrant multi-systemic conditions of aopy
• persistent symptoms of delayed allergy such as:
  • eczema
  • reflux
  • entero/proctocolitis
  • faltering growth
  • not responding to primary care management, e.g. iMAP
• children <2 years of age with moderate/severe eczema if not responding to matched potency topical steroids initiated within primary care settings per NICE guidance – see eczema treatment algorithm below.
• suspected Food Protein Induced Enterocolitis Syndrome (FPIES)
• chronic or recurrent urtucaria +/- angioedema lasting ≥6x weeks without a clear trigger.

Please note: Prior to referral, all suspected cow's milk protein-allergy patients should be started on a cow milk exclusion diet or prescribed an appropriate extensively hydrolysed or amino-acid formula according to the iMAP guidance for primary care. See Resources below: The Milk Allergy in Primary Care (MAP) Guideline 2019.

Exclusions

• children with suspected delayed cow's milk protein allergy should be managed in primary care in the first instance – See Resources below: The Milk Allergy in Primary Care (MAP) Guideline 2019
• children ≥2 years of age with no other allergic symptoms, only presenting with eczema, should be treated with topical steroid ointment strength matching the degree of inflammation and referred to a paediatric dermatology department
• children with acute urticaria lasting <6 weeks without a clear trigger should be provided with a food diary and PRN Cetirizine.

How to Refer