Counsel a family on a cow's-milk protein allergy diagnosis and formula choice — OSCE

Candidate instructions

You are the paediatric registrar in the outpatient clinic. The parents of a four-month-old boy have ten minutes with you. The baby has had blood and mucus in the stools and a flare of eczema for two weeks; he is growing well and is well in himself. The parents have read online that he has a 'dairy allergy' and have brought a goat's-milk and an 'A2' formula, asking which to switch to. They are frightened he will stop breathing if he has any milk, and that he will be allergic for life. Explain the likely diagnosis, why a planned elimination and rechallenge is the right next step, why neither goat's-milk nor A2 is the answer, what formula is appropriate, and how he will likely outgrow this. Use plain language, check understanding, and agree a clear plan. ^[1]