Food Allergy Myths busted by Dr Ash Kallukaran

In time for food allergy awareness week, here are 10 common food allergy myths that you should be informed about.

MYTH #1: Peanut allergy is the most common food allergy in young children

FACT: In Australia, egg allergy is the most common food allergy. The nine most common food allergens are cow's milk (dairy), egg, peanut, tree nuts, sesame, soy, fish, shellfish and wheat.

MYTH #2: Parents should wait until a child is 2 years of age before introduction of common food allergens

FACT: It is recommended that all babies be given common allergy-causing foods in an age-appropriate form (e.g. smooth puree) before 12 months of age. Once tolerated it is important to keep these foods in your child's diet on a regular basis. Delayed introduction has been shown to increase the chances of developing food allergies.

MYTH #3: Each allergic reaction is worse than the last

FACT: Multiple factors influence severity of any given allergic reaction including dose ingested, form ingested (e.g. roasted, baked, raw), exercise, concurrent illness and use of medications. Therefore, allergic reactions do not predictably get worse with each subsequent exposure.

MYTH #4: Even if you are allergic to a food, one small bite is okay

FACT: Even a small amount of the food allergen has the potential to cause a serious reaction. It's also important to be vigilant about cross-contact from one food to another.

MYTH #5: Children under 2 years of age cannot be tested for food allergies

FACT: There is no specific age limit for food allergy testing and a qualified Paediatric Allergy Specialist can assess and perform these tests. Generally, infants under 6 months of age are not commonly given allergy tests.

MYTH #6: The size of a skin prick test or level of food-specific IgE blood test can predict anaphylaxis

FACT: There is currently no test that can accurately predict if or at what dose of an allergen a child would develop anaphylaxis. A higher result correlates with an increased likelihood of an IgE-mediated allergic reaction and is not indicative of severity.

MYTH #7: Antihistamines or steroids when used early in an allergic reaction can prevent anaphylaxis

FACT: Neither antihistamines nor steroids prevent progression to or treat anaphylaxis. Their use may delay administration of adrenaline, which is the first-line treatment for anaphylaxis. Non-sedating antihistamines help with itchiness or hives; if concerned about anaphylaxis, adrenaline MUST be administered.

MYTH #8: Food allergies can be cured

FACT: Although some food allergies resolve with time, there are currently no scientifically proven cures. Oral immunotherapy products are not currently registered by the TGA for use in Australia. Avoidance of confirmed food allergens is recommended until proven treatments become available.

MYTH #9: Food intolerances and food allergies are the same

FACT: They are not the same. Food allergy involves an immune-mediated reaction that can be severe or life-threatening. Food intolerance does not involve the immune system, predominantly presents with gut symptoms, and is rarely life-threatening.

MYTH #10: Children with egg allergy should avoid influenza vaccine

FACT: As per ASCIA, there is no evidence that having egg allergy increases the risk of an allergic reaction to currently available influenza vaccines. People with egg allergy can receive influenza vaccine in a primary care facility where staff are trained to recognise and treat suspected anaphylaxis. Observe for 15 - 20 minutes after vaccination.

Hope you find these facts useful for your patients.

References

1. allergy.org.au
2. Nickolls C, Campbell DE. Food allergy mythbusters. J Paediatr Child Health. 2015.
3 - 5. See ASCIA and peer-reviewed allergy literature for additional sources.