Key Study Findings and Management Implications for Infants/Young Children With Proven or Likely Egg or Milk Allergy
| Observation | Clinical Implication for Anticipatory Guidance/Education |
|---|---|
| The annualized rate or reactions for all foods was 0.81 (95% CI: 0.76–0.85). | The high rate of reactions suggests the need for increased education to avoid reactions. |
| Most (64.9%) accidental allergic reactions to milk, egg, or peanut were attributed to lack of vigilance (failure to check ingredients, forgetfulness, child taking the food, etc). | Emphasize need for supervision, checking ingredients for each meal/snack. |
| Additional common errors in accidental milk, egg, or peanut allergic reactions include misreading labels (15.8%), cross-contact in meal preparation (15.1%). | Educate about label-reading, avoiding allergens in meal preparation/restaurant meals. |
| Half (50.6%) of all allergic reactions were attributed to food not provided by parents, including relatives and teachers. | Education should be given to all caretakers, not just parents. |
| Purposeful trial of avoided milk, egg, or peanut accounted for 11.2% of allergic reactions to these foods. | Family should discuss allergen re-introduction before attempting on their own. |
| Overall, only 29.9% of reactions with severe symptoms were treated with epinephrine. | Emphasize the symptoms that warrant treatment with epinephrine. |
| Almost all severe reactions (94.8%) were attributed to ingestion rather than other routes of exposure (skin, inhalation). | Emphasis should be placed on avoidance of oral exposure (including transfer from hand to mouth in young children). |