Knowledge, clinical practices, and perceived self-efficacy regarding cow's milk protein allergy among family physicians and pediatricians: a cross-sectional survey study.

Cow's milk protein allergy (CMPA) is among the most common food allergies in infancy and early childhood. Its nonspecific clinical presentation increases the risk of both overdiagnosis and delayed diagnosis. This study aimed to evaluate the knowledge levels, clinical approaches, and perceived competence of family physicians, pediatricians, and pediatric subspecialists regarding CMPA. This online, cross-sectional, questionnaire-based study used convenience sampling and included actively practicing family physicians, pediatricians, and pediatric subspecialists other than pediatric allergy and immunology. The structured questionnaire comprised four sections: demographic data, knowledge level, clinical practice, and perceived competence. Knowledge was assessed with 14 guideline-based multiple-choice questions, each scored 1 point (total 0-14). Mann-Whitney U and Kruskal-Wallis tests were used for between-group comparisons. A total of 177 physicians participated (mean age 36.3 ± 8.71 years; 71.2% women), including 66 family physicians, 83 pediatricians, and 28 subspecialists. The mean knowledge score was 7.10 ± 2.99/14. No item exceeded an 80% correct-answer rate; the lowest rates involved IgE-mediated symptoms, non-IgE-mediated symptoms, and awareness of the milk ladder. Knowledge scores were significantly associated with specialty, prior CMPA training, allergy/immunology rotation, guideline adherence, and perceived competence. Family physicians scored lower than pediatricians and subspecialists.

conclusionMarked knowledge gaps exist in CMPA diagnosis and management, particularly in practical areas such as symptom recognition, clinical phenotyping, and the milk ladder. Short, case-based educational programs based on current guidelines may help address these gaps among physicians in family medicine and pediatric practice. WHAT IS KNOWN: • Cow's milk protein allergy (CMPA) is common in childhood and can be challenging to diagnose. • Knowledge gaps exist among physicians regarding CMPA diagnosis and management. WHAT IS NEW: • Significant knowledge gaps were identified, particularly in symptom recognition and the milk ladder, with family physicians demonstrating lower knowledge scores. • Prior CMPA training, allergy/immunology rotation, and perceived self-efficacy were associated with higher knowledge scores.