In subjects with known food reactions, avoiding food ingestions is quite difficult (Pediatrics 2012; 130: e26-e32).
This study enrolled 512 children at ages 3-15 months and followed them for a median of 35.5 months. Patients had to have positive skin prick test to milk or egg in addition to either a history consistent with an IgE-mediated food reaction to milk or egg or a history of moderate-to-severe atopic dermatitis.
- High rate of reactions: 1171 reactions reported in 367 (72%) of subjects.
- Most reactions were attributed to lack of vigilance, like not checking ingredients
- Parents most frequently were the providers at time of incident (36%); however, about half of all allergic reactions were attributed to other providers (eg. grandparents, teachers)
- Of severe reactions (n=134, 11%), only 30% were treated with epinephrine. Almost all severe reactions were due to ingestions (95%) rather than skin or inhalation exposures.
Bottom line: More work is needed to prevent these reactions and to improve the treatment when they occur.