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Paediatric Allergy Policy Series
The Paediatric Allergy Policy Series explores how the National Health System (NHS) can deliver earlier identification and consistent, family-centred management of paediatric allergies across the NHS.
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This series will bring together senior clinicians, commissioners, dietitians, pharmacists, and patient advocates to identify practical improvements that standardise pathways, reduce unwarranted variation, and improve outcomes for infants and families.
Focus: Prevention and Health System Impact
Cow’s Milk Protein Allergy (CMPA) is a significant health issue in the United Kingdom, affecting young children's health and development. In the UK, CMPA affects 2 to 3 out of every 100 infants (Anaphylaxis UK, 2022), making it the most common childhood food allergy (West Suffolk NHS Foundation Trust, 2022). These allergic reactions manifest through various allergic reactions ranging from digestive disturbances and dermatological symptoms, including severe colic, constipation, diarrhoea, eczema and vomiting, to more severe, life-threatening responses (County Durham and Darlington NHS Foundation Trust, n.d.; Lovis, 2019; Allergy UK, 2025). Additionally, CMPA has increasingly been recognised as a gateway condition linked to future allergic manifestations such as food and airborne allergies, asthma, eczema, and rhinoconjunctivitis (House of Lords Science and Technology Committee, 2007; Venter et al., 2013). Early and appropriate care are essential to treating this allergy, with approximately 90% of non-IgE-mediated CMPA in infants resolving within 3 years (House of Lords Science and Technology Committee, 2007; Venter et al., 2013; Lovis, 2019). However, the underuse of Milk Allergy in Primary Care (iMAP) guidelines in primary care settings leads to a lack of effective management. This results in prolonged symptoms, misinformed decisions, and emotional distress for parents. If CMPA is not managed effectively, children may suffer long-lasting adverse effects, which can extend to their families and the broader healthcare system. Ultimately, this situation creates a greater burden, including increased healthcare visits, income loss due to time away from work, and higher costs to the healthcare system.
Featured Speakers
This roundtable will examine how prevention and early action can reduce time to diagnosis, avoid unnecessary prescribing, and improve growth and well-being outcomes for children presenting with CMPA. The discussion will focus on the health system impact of consistent, evidence-based pathways, including how integrated neighbourhood teams can support earlier recognition of both IgE and non-IgE presentations, effective safety-netting, and timely access to dietetic care.
Niten Makwana
Consultant Paediatrician, Sandwell and West Birmingham Hospitals​
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Professor Nick Makwana is a highly respected Consultant Paediatrician and paediatric allergy specialist based in Birmingham, United Kingdom, with over 25 years of clinical and academic experience. He is internationally recognised for his work at the intersection of paediatric gastroenterology, food allergy, immunology, and infectious disease, with a particular focus on improving care for children with complex allergy and gastrointestinal conditions.
Rui Martins
Health Economist, Global Market Access Solutions
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Rui is a health economist with nine years of experience in economic modelling, systematic reviews, data analytics, and research design. He has published peer-reviewed models across several disease areas, including mental health, allergology, autoimmune disorders, infectious, and neurological conditions. He completed an MSc in Public Health and Health Economics at the London School of Hygiene & Tropical Medicine before joining the National Institute for Health and Care Excellence (NICE). At NICE, he developed economic models to inform recommendations for clinical and social care guidelines and gained expertise in interventional procedures and medical devices, producing several systematic reviews to support national guidance.
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Rui is currently pursuing a PhD in health economics at the University of Groningen in the Netherlands. His research interests focus on the impact of ageing and ill health on individual productivity and wealth.
Prof. Carina Venter
Assistant Professor of Paediatrics, Children's Hospital Colorado
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Carina Venter is a Professor of Paediatrics, Section of Allergy/Immunology at the Children's Hospital Colorado and the University of Colorado Denver School of Medicine, where she is conducting research in allergy prevention and working with children with food allergies. Dr. Venter obtained her B.Sc. Dietetics from the University of the Free State, South Africa and he PhD in Allergy and Immunology from the University of Southampton, United Kingdom. She is a registered dietitian in the United Kingdom and the United States. She has had publications in international journals, book chapters, and edited a book for the Health Professional's Guide to Nutrition Management of Food Allergies. She is a member of the FPIES guideline group. Dr. Venter is currently the chair of the EAACI work group on Immunomodulation and nutrition. Dr. Venter has received awards from American, British, European, South African and Canadian allergy and nutrition societies and academies for her contributions to the field of allergic diseases.
Natalie Yerlett
Lead Dietitian at Great Ormond Street Hospital ​
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Natalie is a highly specialist paediatric registered dietitian with 20 years' experience at the highest clinical level and has a passion and dedication for helping infants, children and adolescents with gastrointestinal and dermatological disorders. Natalie is Head of Dietetics at one of the world's leading children's hospitals in London and leads by example, inspiring the next generation of dietitians. Natalie has a passion for research, regularly publishing, presenting and trying to find the answers to unanswered questions! Natalie is also proud to be a qualified supplementary prescriber