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Children with Food Allergies: Parents Need To Do More

By Neil Wagner

Parents need to do a better job of protecting young children from their food allergies. That's the conclusion of a study that tracked 512 infants with known or suspected food allergies through three years of their life.

Some of the study’s most striking findings:

  • Over 70% of the children had at least one allergic reaction during the course of the study.
  • Over half (52.5%) had more than one reaction.
  • About one in nine reactions (11.4%) were severe and should have been treated with epinephrine. Yet epinephrine was actually given only 30% of the time.
  • About one in nine reactions (11.2%) were caused by intentional feeding of milk, egg or peanut, foods which parents had specifically been advised not to feed their children.
  • A little over half of the reactions (50.6%) were caused by food provided by someone other than a parent.

Clearly, parents need to do more. These children are far too young to do it by themselves.

The study tracked 512 children aged 3 to 15 months who were either known to have an allergy to eggs, milk or both or were suspected of having one (had been diagnosed with atopic dermatitis and had a positive skin prick test for egg or milk).

Parents of these allergic children were all advised not to feed their children the suspect food or peanut, unless the children were known to be tolerant to peanut, since young children with milk or egg allergies have a higher than average risk of peanut allergy. Parents were also given a prescription for injectable epinephrine, with written plans for its use. Children were followed up for an average of three years.

Over the three years, there were 1171 reported allergic reactions in 367 (72%) of the children. That's over one reaction a year for these children. Nearly 90% of all allergic reactions were due to accidental exposure, with simple forgetfulness (65%) as the most common cause, including failure to check ingredients and unsupervised children taking the food by themselves. Label misreading (15.8%) and cross-contamination (15%) were responsible for most of the other accidental exposures.

More worrisome is that about 11% of all reactions to milk, egg or peanut were non-accidental--caused by parents or others knowingly feeding these suspect foods to their children.

Also troubling is that only about 30% of severe reactions were treated with epinephrine. About half of these were because parents did not recognize how severe the reaction was; about a quarter were because epinephrine was unavailable and 12% were because the parents were afraid to give epinephrine. This despite the fact that parents were advised to carry an epi-pen at all times and to make sure that caregivers also have one. Epinephrine can save the life of a child who is undergoing anaphylaxis, a severe allergic reaction where death can occur in minutes.

The fact that just over half of the reactions occurred when someone other than a parent was taking care of a child shows that parents also need to do a better job of explaining their child's food allergy to other caregivers and preparing them to deal with any reaction that may occur.

In all, there's plenty of room for improvement. A child's food allergies never take the day off. Neither can their parents.

A wealth of information on living with a child's food allergy can be found at the Consortium of Food Allergy Research website, And anyone interested in more details of the study's findings can read the article, which appears in the journal Pediatrics.

August 18, 2012



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