Food Allergy Action Month

May is ‘Food Allergy Action’ month and the week of May 8-14 is Food Allergy Awareness Week. Of note, I have been asked to present at the 51st Riley Pediatric Conference, May 10th at the first plenary session on the hot topic of food allergy prevention.

A few weeks ago I was asked to write a piece about an aspect of food allergy. I chose a topic that is somewhat unique to what we do in our clinic- Food Challenges. I was very steadfast in the message I wanted to say. In an effort to make a long story short, the editor and I did not share the same perspectives. I withdrew the article- regretting the giving up the opportunity to post what we do with a larger audience, but I had to remain firm on the content. What follows is the article;

Important stops to consider during your journey through the world of food allergy; the role of the food challenge.

The first step has been taken, your child has had a reaction to a food. You have reached out for direction and the guidance given may have included allergy testing or a referral to an expert in food allergy. Your suspicions have been verified by an allergy test, but there are unexpectedly more items found during the evaluation. Additional tests were performed and now you have a concerning list of allergenic foods to avoid. This list may contain foods that were eaten frequently without any reactions or foods that your child has never ingested. The obvious advice you are given is full and strict avoidance. The journey becomes more precarious. You and your child are afraid of the dismal prospects for a life without fear of a reaction. The quality of life suffers and the child’s nutrition may suffer. There is also the concern about the cost that surrounds special diets, schools, and medical supplies for reactions.

There are a few questions that you need to ask;
1. Is there a chance that this food allergy will go away?
2. Is there a chance that some of these test results are falsely positive?

Is there a way to verify an allergy test result?

The answer to that is an emphatic YES! Food allergy challenges can provide the correct direction-eat or avoid.
The food allergy challenge is also an allergy test and it is the gold standard test for food allergy.
When the history is obvious and the skin test supports the suspicion, a blood test called specific IgE may help sort out the risk of a reaction. If the risk is low, then a food challenge is a consideration.
We offer food challenges in a controlled clinical environment where we have the “e’s’;
1. Experience
2. Expertise
3. Equipment
The idea behind the food challenge is the gradual introduction of the allergenic food. There are about 10 exposures, each step is twice the amount until a full serving has been given. The procedure takes about 4 hours.
When you arrive we take care of registration, vital signs, and an examination. We review the history and have you sign a consent. We take time to answer any questions. We explain the procedure to the child as to what to expect and we make it very clear that at any time there is a concern, we stop and evaluate. The decision to continue is made together with the team, the parent, and the child.
Yes, we have had reactions that have caused us to stop. We have had concerns that led to a long waiting periods prior to stopping or continuing. We have had to place barrier creams on the face to keep the child from having a rash from wearing the food. We have had long talks with the children who are scared because they have been told of dire consequences due to the food. Some of the children are so well educated about avoidance that it makes the food challenge very hard to do.
What is our food allergy experience? We have done food challenges for egg, milk, wheat, peanut, soy, fish, shellfish, sesame seed, corn, watermelon, and tree nuts. Our track record is a pass in 80%.
The food challenge has serves many purposes; it paves the way for good nutrition. It helps with quality of life issues, it ends the need for injectable epinephrine, and importantly, it helps resolve the fear of a food allergy.

FEL 5/1/2016

May 1, 2016 · fleickly · No Comments
Tags: , , ,  · Posted in: Allergies, Allergy in Children, Allergy Testing, Food Allergies, Food Challenges

Leave a Reply

You must be logged in to post a comment.