Impact of primary food allergies on the introduction of other foods amongst Canadian children and their siblings

Mary Mchenry,Wade Watson

doi:10.1186/1710-1492-10-26

Abstract

BackgroundFood-allergic children frequently avoid other highly allergenic foods. The NIAID 2010 guidelines state that individuals with an IgE-mediated food allergy should avoid their specific allergens and physicians should help patients to decide whether certain cross-reactive foods also should be avoided. Patients at risk for developing food allergy do not need to limit exposure to foods that may be cross-reactive with the major food allergens. The purpose of this study was to determine if parents of food-allergic children are given advice regarding introduction of allergenic foods; if these foods are avoided or delayed; if there is anxiety when introducing new foods; and if introducing other allergenic foods leads to any allergic reaction. The study also determined if there was a similar pattern seen amongst younger siblings.MethodsAn online survey was administered between December 2011 and March 2012 via Anaphylaxis Canada’s website, available to Canadian parents and caregivers who are registered members of the organization and who have a child with a food allergy.Results644 parents completed the online survey. 51% of families were given advice regarding the introduction of other allergenic foods. 72% were told to avoid certain foods, and 41% to delay certain foods. 58% of parents did avoid or delay other highly allergenic foods, mainly due to a fear of allergic reaction. 69% of children did not have an allergic reaction when these foods were subsequently introduced. 68% of parents felt moderate or high levels of anxiety when introducing other foods. A similar pattern was seen amongst the younger siblings.ConclusionsCanadian parents and caregivers of children with food allergies receive varied advice from health care professionals regarding the introduction of new allergenic foods, and feel moderate to high levels of anxiety. A similar pattern may be seen amongst younger siblings. While the majority of children in our study did not have an allergic reaction to a new food, a significant proportion of children did react. A more consistent approach to the advice given by health care professionals may decrease parental anxiety. Further research to support the 2010 NIAID guidelines may be necessary to clarify recommendations.

Highlights

Food-allergic children frequently avoid other highly allergenic foods
We found no published studies in the literature that have determined whether Canadian parents receive advice about introduction of new foods amongst food allergic children and their siblings, and if and why parents choose to limit their children’s diet beyond the foods to which they are allergic
Our study identified that while some parents and caregivers may decide to avoid or delay introducing certain foods to their child with a first food allergy, a similar pattern is seen with the introduction of food to younger siblings

Summary

Introduction

Food-allergic children frequently avoid other highly allergenic foods. The NIAID 2010 guidelines state that individuals with an IgE-mediated food allergy should avoid their specific allergens and physicians should help patients to decide whether certain cross-reactive foods should be avoided. Recent studies have shown that the prevalence of a general childhood food allergy is increasing [1]. One study found that more than 70% of food allergic children were allergic to or were avoiding multiple foods, despite negative tests or lack of prior reactions [4]. Among patients avoiding foods because of history of reaction, positive skin test and/or positive serum specific IgE, 78% were avoiding multiple foods (on average about 3 food allergens per person). When including all foods avoided (for any reason including no evidence of allergy), the prevalence of multiple food allergies and avoidance increased to 86% (average of about 4 food allergens per person). Children may be avoiding foods despite a lack of evidence of food allergy (negative tests or lack of prior reaction)

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