Evaluating weaning guidance provided to a sample of caregivers of infants diagnosed with cow’s milk allergy

Cow’s Milk Allergy (CMA) is one of the most common food allergies in infancy worldwide, affecting up to 3% of infants in Europe (1) . The complementary feeding period - particularly the timely and varied introduction of both allergenic and non-allergenic foods, has been suggested to play a key role in allergy prevention and gut microbiome development (2,3) . Guidance on the introduction of allergenic foods has historically been inconsistent, and parents of infants with CMA may receive conflicting or unclear advice (4) . Such inconsistencies can heighten parental anxiety, reduce dietary diversity and potentially compromise both nutritional status and long-term allergy outcomes in affected children (3) . This study aimed to address the gap in the literature by investigating the advice received by a sample of caregivers with infants diagnosed with CMA in Ireland, on weaning their infant on to solid foods. A cross-sectional online survey with a 21-item questionnaire was distributed via an Irish parenting platform, Everymum .ie, targeting parents of infants (aged 4–30months) with a current or previous diagnosis of CMA. Descriptive statistics were carried out using SPSS v29. Within the 124 valid responses, the majority of caregivers reported holding a third-level education qualification (90%, n=112). The mean age of the infants was 14 months (sd=6.48) with just over half in the 6-12month age range (53%, n=65). General practitioners (34%, n=42) and paediatricians (35%, n=43) were the main healthcare professionals to diagnose CMA in these infants. While 76%, (n=93) of caregivers received advice on when to start the introduction of solid foods, only 40%, (n=49), were given specific advice on introducing typically allergenic foods. Over two thirds of caregivers (69%, n=85) felt they needed more information in relation to weaning their infant onto solid foods and most (84%, n=104) reported that they felt more anxious about the weaning journey due to their infant having CMA, with 76%, (n=95), describing the experience as ‘Difficult’ or ‘Very Difficult’. This study highlights a potential gap in the provision of comprehensive, practical weaning guidance for parents managing CMA, with many seeking additional information and reporting high levels of anxiety. There is a need for consistent, evidence-based resources and healthcare professional training to better support families at this critical stage to help reduce parental stress, promote dietary diversity, and contribute to optimal nutritional and allergy outcomes in infancy.