Kids Food Allergies
Beware of Childhood Food Allergies—and Treat Them Accordingly
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According to the results of a study published in Pediatrics,[1] accidental food exposures frequently cause allergic reactions in preschool-aged children, and severe reactions are rarely treated appropriately.
The study included more than 500 children ages 3 to 15 months at high risk of food allergies who are already enrolled in an observational study on the natural course of milk/egg allergy and are being observed for the development of peanut allergy. As part of the study, parents received advice on how to avoid allergen-containing foods plus written emergency plans with prescriptions for epinephrine injections.
Because the most efficient way to manage a food allergy is to avoid foods that contain that food or ingredient, the U.S. Food and Drug Administration (FDA) requires food manufacturers to list the eight most common ingredients that trigger food allergies including
- Milk
- Eggs
- Peanuts
- Tree nuts (such as almonds, cashews, walnuts)
- Fish (such as bass, cod, flounder)
- Shellfish (such as crab, lobster, shrimp)
- Soy
- Wheat
During a median follow-up of three years, 72% of the children suffered at least one allergic reaction; 52% of parents or caretakers (grandparents, sitters, siblings, and teachers) reported that a child had more than one reaction. Almost 75% of the reactions were triggered by milk (42%), eggs (21%), or peanuts (8%). Almost 90% of reactions were caused by accidental exposures attributed to unintentional ingestion, label-reading errors, and cross-contact. Nonaccidental exposures of milk, egg, and peanuts—defined as foods offered by parents or caretakers to children on purpose, likely to determine their allergenicity—accounted for 11% of all reactions. Almost all severe reactions were attributed to ingestion rather than other via skin or inhalation.
Although 10% of reactions were deemed severe, only a third of them were treated with epinephrine. The reasons for the hesitation in using epinephrine included not recognizing a reaction (48%), epinephrine unavailable (23%), too afraid (12%), waiting for more symptoms (6%), and unsure if needed (3%).
The researchers call for better education of caregivers on “persistent vigilance, accurate label reading, prevention of cross-contamination, avoidance of purposeful exposures, and appropriate treatment of allergic reactions.” An excellent source of educational materials can be found at COFar, the Consortium of Food Allergy Research.
A 2011 study published in Pediatrics, found that 8% of children younger than 18 years had a food allergy, which translates to roughly 5.9 million children—or 1 in every 13 children.[2] This figure is double the 3.9% prevalence rate previously reported by the U.S. Centers for Disease Control and Prevention in 2009.[3]
Jill Shuman, MS, ELS
Published June 26, 2012
References
- Fleischer DM, Perry TT, Atkins D, et al. Allergic reactions to foods in preschool-aged children in a prospective observational food allergy study [published online ahead of print June 25, 2012]. Pediatrics. doi: 10.1542/peds.2011-1762. 2
- Gupta RS, Springston EE, Warrier MR, et al. The prevalence, severity, and distribution of childhood food allergy in the United States. Pediatrics. 2011;128(1):e9-e17.
- Branum AM, Lukacs SL. Food allergy among children in the United States. Pediatrics. 2009;124(6):1549-1555.
i enjoy your CME it is always full new advancement in medicine.
I observe that citrus fruit juices and chocolates are the most often food associated with rhinitis which sometimes lead to post-nasal drip pharyngitis and sinusitis.