Diagnosis and Management of Non-IgE gastrointestinal Allergies in Breastfed Infants - an EAACI Position Paper

Rosan Meyer, Adriana Chebar Lozinsky, David M Fleischer, Mario C Vieira, George Du Toit, Yvan Vandenplas, Christophe Dupont, Rebecca Knibb, Piınar Uysal, Ozlem Cavkaytar, Anna Nowak-Wegrzyn, Neil Shah, Carina Venter

Research output: Contribution to journalArticlepeer-review


It is well-established that food proteins, such as egg, soya, cow's milk and wheat, are detectable in breastmilk for many hours or days after ingestion. Exposure to these proteins is important to the process of developing tolerance but can also sometimes elicit IgE-mediated and non-IgE-mediated allergic symptoms in breastfed infants. Non-IgE-mediated allergy, outside of food protein-induced allergic proctocolitis and eosinophilic oesophagitis, is not well understood, leading to variations in the diagnosis and management thereof. A primary objective of the European Academy for Allergy and Clinical Immunology is to support breastfeeding in all infants, including those with food allergies. A Task Force was established, to explore the clinical spectrum of non-IgE-mediated allergies, and part of its objectives was to establish diagnosis and management of non-IgE-mediated allergies in breastfed infants. Eight questions were formulated using the Patient, Intervention, Comparison, Outcome (PICO) system and Scottish Intercollegiate Guideline Network (SIGN) criteria for data inclusion, and consensus was achieved on practice points through the Delphi method. This publication aims to provide a comprehensive overview on this topic with practice points for healthcare professionals.

Original languageEnglish
Pages (from-to)14-32
Number of pages19
Issue number1
Early online date14 Jun 2019
Publication statusPublished - 1 Jan 2020

Bibliographical note

This is the peer reviewed version of the following article: Meyer, R. , Chebar Lozinsky, A. , Fleischer, D. M., Vieira, M. C., Du Toit, G. , Vandenplas, Y. , Dupont, C. , Knibb, R. , Uysal, P. , Cavkaytar, O. , Nowak‐Wegrzyn, A. , Shah, N. and Venter, C. (2019), Diagnosis and Management of Non‐IgE gastrointestinal Allergies in Breastfed Infants – an EAACI Position Paper. Allergy. Accepted Author Manuscript, which has been published in final form at https://doi.org/10.1111/all.13947.  This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.


  • breastfed children
  • diagnosis of non–IgE-mediated allergy
  • food allergy
  • maternal elimination
  • non–IgE-mediated allergy


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