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AAP: Education critical to distinguish pediatric food allergies from other conditions
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Based on findings from the National Academies of Sciences, Engineering, and Medicine that outlined critical issues related to pediatric food allergies, the AAP has emphasized additional allergy education for pediatricians to improve the diagnosis of these patients and reduce risk of anaphylaxis.
“Adverse reactions to foods may be caused by metabolic, pharmacologic or toxic factors that must be distinguished from allergy,” Scott H. Sicherer, MD, from the division of pediatric allergy and immunology, the department of pediatrics and the Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai, and colleagues wrote. “In the United States, it is common for parents to avoid a food on the basis of the perception of food allergy when in fact most of the time diagnostic testing will reveal that there is none and the food could be added back to the diet.”
To highlight parts of the National Academy of Sciences, Engineering and Medicine report on food allergy that are of concern to pediatricians and members of the AAP, and to stress implementation of the recommendations made, the researchers explored the prevalence of such allergies, how diagnoses are made and the condition’s prognosis, the risk of food allergy and prevention, emergency management in schools and child care settings and research needs.
According to a former review, more than 1% to 2% and less than 10% of the U.S. population experience food allergies; however, 8% of children have a food allergy based on parental reports. Prevalence is difficult to determine because of variations among studies, but the researchers determined that the most serious reactions occur from cow’s milk, hen’s egg, peanuts, tree nuts and seafood. The report urges that more studies be conducted to determine prevalence through use of modalities like the National Health and Nutrition Examination Survey.
Recommendations had been made that physicians implement evidence-based and standardized practice for diagnosis of food allergy and that they should be trained and experienced in selection and interpretation of allergy tests. This is due to the incorrectness of self-diagnosis, where 12% of children report food allergies. In a study, only 3% of said children tested positive for allergies.
Additionally, misdiagnosis and underdiagnoses are also of concern. The researchers suggest that medical history may be aid in identifying those who have food allergy. They also remind physicians that sensitization is not diagnostic criteria, and panels should not be ordered for food allergy without explanation.
The researchers suggest six major actions be implemented from the report:
- Collecting better information about prevalence to identify the scope of the problem, with priority given to food allergy in context of other diseases and risk factors;
- Improving the quality of diagnosis and providing evidence-based health care;
- Improving evidence-based prevention strategies, because data are lacking on a variety of potential interventional strategies;
- Improving education and training of all stakeholders for recognizing and managing as well as preventing allergic reactions;
- Developing policies and related practices to help prevent and treat sever reactions.
- Prioritizing research to address key questions about diagnostics, mechanisms, risk determinants and management. — by Katherine Bortz
Disclosure: Please see the study for a full list of relevant financial disclosures.
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