Saturday, December 11, 2010

New Food Allergy Diagnostic Guidelines

A few days ago I first saw a news story about new diagnostic guidelines for food allergies. One thing I found surprising is the difficulty of locating the actual guidelines. Multiple news stories stated that the guidelines came from the American Academy of Pediatrics, when they were actually issued by the National Institute of Allergy and Infectious Diseases. The summary for clinician use is available now, and a summary for patient/parent use will be available soon.

The important highlights in my view are as follows:
Diagnosis of IgE mediated Food Allergies needs to be based on Food Elimination diets and Oral Food Challenges. Skin Prick Tests and Allergen Specific Serum IgE Tests can play a part in diagnosis but cannot be the sole piece of information. Intradermal Tests and Atopy Patch Tests are not recommended for use in food allergy diagnosis, even in conjunction with other tests. There are a number of other tests listed as not recommended, most of which I've never heard of, including something called Hair Analysis. Regarding non-IgE mediated allergies, the recommendation is to rely mainly on medical history.

Management of food allergies is recommended to consist of avoidance of the allergen. "There are no medications currently recommended by the EP
to prevent IgE-mediated food-induced allergic reactions from occurring in an
individual with existing FA." It's important to note that there is no strategy for management of food allergies other than complete avoidance.

Prevention of food allergies is addressed as well--and essentially there is no recommended strategy. Avoidance of common allergens is not recommended during pregnancy or breastfeeding, and it is also recommended that starting solid foods is not delayed in children at risk for food allergies.

I find this document fascinating. It is, of course, based in current data and research, and there are a few new pieces of information. I still think it was worthwhile for me to avoid allergens while I was nursing my 4th child (the one after Sophie!), even if these doctors aren't sure it makes a difference. It gave me the assurance that I did what I could to prevent her from having allergies. And anyway, she doesn't have any food allergies, so I suppose I could sat that it worked. ;)

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