Food Allergy (FA) prevalence is very high across the developed world with the highest prevalence in infants and young children. Prevalence in Irish children is 4.45%.
FA, especially nut, seed and fish allergy is usually a lifelong condition associated with impaired quality of life for those affected and their families. This is due to the restrictions imposed to prevent severe accidental reactions and the burden of having to remain emergency prepared.
High levels of FA also bring with it substantial healthcare costs for hospital visits, ED attendances, Food Challenges, medication costs etc.
There is no straightforward FA cure. Oral Immunotherapy (OIT) is a labour-intensive process for both families and health care professionals. Its risks include anaphylaxis and the development of Eosinophilic Oesophagitis.
Allergy prevention strategies aim to direct the infant human immune system to develop tolerance to a food allergen before it can develop allergy antibody responses. This is most difficult to achieve in infants with moderated to severe eczema as their immune system can be exposed to food allergens, in early infancy, through their defective skin barrier. This exposure pathway promotes the development of an allergic response. In contrast, early oral exposure fosters tolerance.
All health care professionals involved in the care of expectant, and new mothers and infants have a role in promoting evidence based allergy prevention strategies.
The first 6 months of infancy
Introducing solid food
Screening for food allergy using sIgE and or skin prick testing before embarking on food allergy prevention is discouraged as it risks false positive results and delays introduction.