Ask the Allergist: Food Allergy Management and Treatment
In honor of Food Allergy Action Month, we're excited to kick off our Ask the Allergist series, focused on providing food allergy education to families. At Ready, Set, Food!, we’re committed to all aspects of food allergy education, so families can make informed decisions about their children’s nutrition.
Currently, there is no cure for food allergy.
The cornerstone of treatment for an IgE-mediated food allergy is strict avoidance and nutritional counseling. (Exception: some people with milk or egg allergies can tolerate baked versions of these foods.) A high level of education is needed for multiple people involved in order to maintain safety, including:
- Label-reading (Learn more here)
- Hidden ingredients
- Early signs of anaphylaxis and when to use epinephrine is very important
Treating Severe Allergic Reactions: Epinephrine
Epinephrine is the only medication that can stop anaphylaxis and is life-saving.
- 3 different doses: 0.1mg, 0.15mg, and 0.3mg based on the person’s weight
- Immediate evaluation in the ER for monitoring after use
- Biphasic reactions: can occur 4 to 24 hours after the initial reaction in 10 to 15% of people and therefore two epi auto-injectors are required at all times
- Antihistamines (Benadryl, Zyrtec, Xyzal, Allegra, Claritin), steroids (Prednisone) and inhalers (Albuterol) are not used for first-line treatment in anaphylaxis
- They are additional medications that can improve symptoms, but they will not stop anaphylaxis from progressing
- Action Plan: every patient/family should have a personalized action plan. (FARE offers resources for these here.)
- In addition, creating a 504 plan for school-aged children with food allergies can be very helpful
Immunotherapy: Food Desensitization Treatments
While there is a lot of new research and exciting possibilities for food desensitization treatments, all of the below treatments can cause side effects and severe allergic reactions. Additionally, it is currently unknown if these treatments can successfully achieve tolerance which is the ability to permanently tolerate ingesting the food. They may only allow the food allergic person to be protected from accidental ingestion of the allergic food temporarily while they are receiving the treatment. There is still no true “cure” for food allergies.
There is still no true “cure” for food allergies.
However, current research focused on food desensitization includes:
Oral Immunotherapy (OIT): Small doses of the allergenic food are given to the patient and the amounts are slowly increased over time until a target dose is reached
Sublingual Immunotherapy (SLIT): Similar to OIT however, uses drops of liquid that contain the food allergen are given under the tongue. SLIT may not work as well as OIT but is associated with fewer side effects.
Epicutaneous Immunotherapy (EPIT): A patch that contains the food allergen is applied to the skin and releases tiny amounts of the food allergen into the skin.
A Recent Breakthrough in Early Allergen Introduction
Thankfully, recent landmark studies (LEAP, EAT, PETIT) have shown the importance of Early Allergen Introduction. In addition, new medical guidelines from the American Academy of Pediatrics, the National Institutes of Health (NIH), and the American Academy of Allergy, Asthma, and Immunology (AAAAI) have been published supporting early and sustained allergen introduction.
Along with a team of leading allergy experts and parents, I helped develop Ready, Set, Food!, a gentle, guided system based on these medical guidelines. After over a year of research and development, we're proud to offer Ready, Set, Food! to families like yours, making it as easy and safe as possible to introduce babies to peanut, egg, and milk in the amounts used in the landmark clinical studies.
About the author: Our Chief Allergist, Katie Marks-Cogan, M.D., is board certified in Allergy/Immunology and Internal Medicine, and treats both pediatric and adult patients. Originally from Cleveland, Ohio, she received her M.D. with honors from the University of Maryland School of Medicine. She then completed her residency in Internal Medicine at Northwestern and fellowship in Allergy/Immunology at the prestigious University of Pennsylvania and Children's Hospital of Pennsylvania (CHOP). After finishing training, she moved to Southern California and currently works in private practice. She is a member of the scientific advisory board for Ready, Set, Food! She currently resides in Los Angeles with her husband, 4-year-old son, and 1-year-old daughter where she enjoys hiking, building LEGO castles with her kids, and cooking with her family.
All health-related content on this website is for informational purposes only and does not create a doctor-patient relationship. Always seek the advice of your own pediatrician in connection with any questions regarding your baby’s health.
These statements have not been evaluated by the Food and Drug Administration. Products are not intended to diagnose, treat, cure or prevent any disease. If your infant has severe eczema, check with your infant’s healthcare provider before feeding foods containing ground peanuts.