A recent study offers secure recommendations for healthcare providers and parents coaching kids to conquer food allergies. Specialists compare this process to “preparing for a marathon.”

Allergies to food among children can be utterly daunting—every school lunch or birthday celebration might pose a significant health hazard. This constant worry greatly affects both the kids and their parents, disrupting daily social activities as well as plans for outings and festivities within the family.

Scientists have developed the first comprehensive set of guidelines aimed at assisting families in gradually increasing their child’s resistance to prevalent food allergens.

The treatment known as oral immunotherapy entails administering tiny quantities of an allergen, such as peanuts, to kids and slowly escalating the dosage over time to enhance their resistance.

Up until this point, healthcare providers have lacked substantial evidence-based advice to offer parents who are giving their children oral immunotherapy. The recently introduced guidelines aim to assist practitioners in establishing consistent protocols when collaborating with patients and families, thereby aiding kids in conquering food allergies.

This groundbreaking study stands out in our field as it represents an unprecedented endeavor that hasn’t been formalized until now. There’s a critical necessity for guidelines on managing oral immunotherapy,” stated Douglas Mack, a pediatric specialist from McMaster University based in Canada and principal investigator of the research.

What is the prevalence of food allergies?

Approximately 4% of children and 1% of adults globally have received a diagnosis for this condition.
food allergy
However, the incidence is more common in Western nations, with 8% of young children and 4% of adults suffering from food allergies.

A child’s meal might be toxic for another—peanut allergies are widespread in the United Kingdom, the United States, and Australia, whereas they remain rare in Asia, where
wheat
Egg and milk allergies are the ones that occur most frequently.

Over the past twenty years, the incidence of food allergies has increased, and researchers believe this trend may be linked to heightened standards of hygiene and sanitization. It’s hypothesized that with reduced exposure to microbes, children’s immune systems might misidentify benign substances such as peanuts or milk as threats. Additional contributing elements could involve insufficient levels of vitamin D and the age at which infants first encounter potential allergenic foods.

Many health authorities across different nations have stated that infants ought to gradually encounter possible allergens as a way to stop allergies from developing. It is recommended for families who have a history of food allergies to proceed under the supervision of a pediatrician when doing so.

Oral immunotherapy boasts a lengthy and effective track record in aiding children with pre-existing food allergies. Its origins trace back to 1908 when it was initially employed to desensitize a 13-year-old boy allergic to eggs. Commencing at a daily dosage equivalent to 1/10,000th of an egg, within half a year, this individual could consume eggs without issue.

“There’s a therapy we know works, with broad consensus among healthcare providers across various fields. Numerous studies are ongoing to further enhance these treatments, focusing on improving safety, decreasing their invasiveness, and increasing accessibility,” explained Julia Upton, a clinical immunologist at the Hospital for Sick Children in Toronto, Canada.

Oral immunotherapy assists children in overcoming food allergies.

Oral immunotherapy programs may necessitate caregivers to take on roles similar to those of novice healthcare providers, closely monitoring for excessive allergen exposure which could be risky. It’s typical for kids to encounter side effects such as stomach discomfort or nausea.

Families should educate themselves regarding food allergies, anaphylaxis, immunotherapy, proper dosing of foods, signs to watch for, appropriate times to administer treatment, and instances requiring communication with healthcare providers, as advised by Upton to LIFEHACK.

As stated by the researchers, up to one-third of patients received no preparatory measures prior to beginning their treatment.

“If families aren’t ready for oral immunotherapy, they might either falter or make it risky. It’s crucial that these households administer the treatment daily without fail. This underscores the significance of these guidelines,” stated Mack from McMaster University.

Developing food tolerance is akin to running a marathon.

These guidelines are intended for healthcare professionals instead of directly for parents or caregivers; therefore, it’s crucial for parents to collaborate with physicians so their children can conquer food allergies in a safe and effective manner.

However, the research also provides valuable insights for those who care for others and for parents.

“It indicates significant consensus regarding essential safety guidelines and anticipated results. For instance, asthma or reactive airways should be properly managed before and throughout immunotherapy, and various safety measures and dosage instructions must be adhered to,” explained Upton.

Upton views the therapy as similar to exercise training for a marathon—children require daily allergy practice, and their tolerance would decrease if they ceased oral immunotherapy completely.

“Many individuals with a food allergy find that the improvement from immunotherapy depends on continuous exposure. Consequently, this frequently necessitates substantial counseling, making it quite beneficial for families when there is broad agreement on this point,” explained Upton.

Edited by: Martin Kuebler

Sources:

D, Mack et al., 2024. Procedural Preparation and Consent for Oral Immunotherapy (OIT): An International Delphi Consensus on Patient Readiness.

DOI: 10.1016/j.jaci.2024.02.019

Initiate P, Chinthrajah RS, Nadeau KC. Utilizing oral immunotherapy as a treatment approach for food allergies. Human Vaccines & Immunotherapeutics. 2014. https://doi.org/10.4161/hv.29233

Elghoudi A, Narchi H. The Current Status and Future Directions of Food Allergy in Children. World J Clin Pediatr. 2022; DOI: 10.5409/wjcp.v11.i3.253

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