Childhood food allergies - New guidelines for milk allergies

New guidelines were issued for the treatment of children who are allergic to cow’s milk. The goal is to ensure that these children are diagnosed and managed as well as possible without increasing the risk of them developing secondary allergies. According to the press release , “Guidelines for the Diagnosis and Management of Cows’ Milk Protein Allergy recommend only extensively hydrolysed (eHF) and amino acid-based formulas (AAF), and the Taskforce’s recommendations warn against the risks of soy and other mammalian milks, such as sheep and goat, in CMA management.”

The release goes on to say that other mammalian milks can increase the risk of more allergies and “milk substitutes based on grains, legumes or nuts, such as rice, oat, pea or almond milk, are to be avoided in infants and young children due to their poor nutritional profile.”

Childhood allergies are frightening. To find out that your child can have a fatal reaction to eating or drinking something, like peanuts, can have a devastating effect and can severely impact family life. If a child is severely allergic, the whole family has to live around that allergy, something that siblings may have difficulty with from time to time.

I did a search on childhood allergies and increasing prevalence, and came across this interesting article that was published in September 2006: Are the Dangers of Childhood Food Allergies Exaggerated?. The article is based on an analysis and comment published in the BMJ article of the same name (BMJ 2006;333;494-496). You can read the full print article here.

One author, Allan Colver makes the following points (copied directly from the article):
- The incidence of severe food allergy reactions in children is small and not increasing
- The risk of death is very small
- Many effective and simple measures are available to reduce risk
- Many children grow out of food allergy, and clinical reactivity should be reassessed periodically
- It is unclear what proportion of children with food allergy should be prescribed an adrenaline autoinjector
- Autoinjectors generate anxiety in children and carers, and they should be prescribed only when a diagnosis of food allergy has been confidently established, usually by oral challenge

The other author, Jonathan Hourihane, makes his points (copied directly from the article:
- Food allergy is common—2% of adults and up to 6% of preschool children are affected
- Deaths are rare but other reactions are almost inevitable over time
- No tests are available to predict clinical severity
- Management consists of empowering patients and providing rescue drugs
- Delay in use of these drugs is associated with a worse outcome in severe reactions
- These drugs are rarely needed by patients who attend recognised allergy clinics but cannot be
withheld because of the medical uncertainty surrounding allergy

For people interested in childhood allergy, it’s an interesting read.


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