The aim of the Paediatric Clinical Immunology and Allergy Service at North Middlesex University Hospital is to ensure children with likely food allergy and conditions of Atopy, receive the correct diagnosis and appropriate management plan as early as possible. The service is overseen by a consultant paediatric allergy specialists, GPs with a special interest in allergy, paediatric allergy nurse specialists, a specialist allergy pharmacist and dietician support delivering a multi-disciplinary clinic.

This is more than just another clinic; the allergy MDT will liaise with local GPs, health visitors and school nurses, providing support and education and training sessions about allergy updates. The team will also support schools/nurseries in managing allergies within their setting.

Please use this service to prevent:

• multiple visits to GPs
• multiple visits to health visitors
• referrals to a variety of secondary care services
• frequent ED/urgent care attendance
• 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 Atopy
• 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 allergy conditions only presenting with eczema, should be treated as per the eczema algorithm link above and referred to the 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

Locations

Children's Outpatient Department