Management of allergy in children and teenagers

Please click on the links below to read our articles. If you are interested in research findings, click here for links to research reports.

Food families relevant in allergy. A helpful post on the Allergy Insight blog listing plant and fish food families. If you are allergic to one member of a family there is a greater likelihood that you may react to any food in that family - although you also may not. However, if you are unable to trace the cause of a new reaction, looking at the food family of your main allergen/s may come up with a link. August 2020

The British Society for Allergy and Clinical Immunology (BSACI) runs a UK allergy service finder listing NHS allergy clinics across the UK. You can only access these clinics thorugh your GP who will refer you/your child if you allergy is deemed to be sufficently serious or complex. However, having the details of possible clinics to hand when you visit your GP could be helpful. The BSACI pages include maps of where the clinics are to be found and details of what services they offer: a child/adult/child and adult service, children's clinics being very much more numerous than adult ones. BSACI Allergy Service Finder. September 2022

Need for national standards, local networks and simulation training in paediatric allergy care. A comprehensive national assessment of paediatric allergy services found that there has been a fourfold increase in paediatric allergy clinics and an approximately sevenfold increase in new patient appointment numbers in the United Kingdom over the past 15 years. Most services are small, with significant regional variation in availability of specific services such as allergen immunotherapy. August 2022


Travelling with allergies. Articles, tips and advice on travelling with allergies.


For other helpful articles on the mangement of food allergies see below here.


Callum's Story

Callum has 13 major food allergies but his mum, Nathalie, is determined that he is still going to lead a 'normal' life. Follow his progress from a weeping-eczema covered baby to winning his first race at his first sports day!

How did it all begin? Callum is now four and and has just started school – with 13 severe food allergies – but how did all this start? Mum, Nathalie, explains that from the first few weeks, they knew that all was not right. October 2016

Starting school with 13 severe food allergies.... Callum is four and is about to start school. But Callum also has 13 severe food allergies. His mum, Nathalie, explains the steps they have taken to ensure that Callum can go safely to school and enjoy a full school life. August 2016

The reality of school.... Callum, with his 13 severe food allergies, make his last minute preparations.... September 2016

Callum's first two weeks at school. How did he get on? Nathalie tells all... October 2016

Callum's first term at school. Callum, with all of his 13 allergies, successfully made it through his first term at school – and performed in the nativity play! But how did Nathalie survive? How hard was it to trust the school to look after him and to deal with crises which did occur? January 2017

Callum's first – and super successful – sports day! July 2017


Helpful articles on the management of food allergies


Coping with feeding difficulties in children with allergies. Assistant Psychologist Lucy Spicer and Paediatric Dietitian Rebecca Brocklehurst, from the Children’s Allergy  Service, Evelina London Children’s Hospital, offer thier suggestions. October 2019

Fun and safe things to do at Easter. Nathalie has 14 suggestions! March 2018

Managing eczema in cold weather. Nathalie Newman gives us her top tips. February 2018

Helping children face up to food allergy. Action Against Allergy funds what has proved to be a hugely successful psychology service for allergic children and their families at the Children's Allergy Service at Guys and St Thomas' Hospital. Dr Polly James and Roisin Fitzsimmons explain how they can help both allergy sufferers and their families. January 2018

10 ways to 'p' off an allergy mum! Nathalie Newman, mum of multi allergic Callum, lists the 10 absolute 'don'ts' when talking to an allergy mum!! January 2018

Parents' and caregivers' experiences and behaviours when eating out with children with a food hypersensitivity. July 2017
The full text of this article is available to read and it touches on many issues, with regard to eating out with food allergies, which will be familiar to many families who try to negotiate this minefield. An interesting read and one which suggests that families of children with food allergies should be given education and strategies to help enable safe eating out experiences.

Children’s Allergy Psychology Service moves into charity run boutique hotel on Lambeth Palace Road! August 2017

Low Food Allergy Prevalence Despite Delayed Introduction of Allergenic Foods - Data from the GUSTO Cohort – Asian populations July 2017
Recent research has suggested that early introduction of allergenic foods may be important in reducing the risk of developing food allergies. However, this hypothesis has not been explored in detail in Asian populations. This study explored the issue in a cohort in Singapore where food allergy rates are naturally low. Most of the infants in this study were reported to be first introduced to highly allergenic foods (such as eggs and peanuts at a late age (greater than 10 months). However, rates of food allergy to these foods between 1-3 years of age was very low. Early introduction of allergenic foods may thus not be necessary in populations in which overall food allergy prevalence is low. The main conclusion of this study is that allergy-related infant feeding advice needs to take into account the individual variations in different populations.

Allergy-Free Kids. Can food allergy be prevented in children? Alex Gazzola considers the recent evidence, and reviews a new book, inspired by the LEAP and EAT studies, aimed at parents hoping to do just that. May 2017

How to have a successful allergy testing appointment. Nathalie and Callum have attended more allergy testing appointments than they have had hot breakfasts! Nathalie gives her tips on how best to get through them successfully.April 2017

Top tips for a happy & allergy safe Easter! Nathalie was determined that Callum and his sister Chloe's Easter was not going to be ruined by Callum's allergies. And this is how she did it. April 2017

Living with guilt as an allergy parent. Nathalie should know – she not only has a highly allergic son but other children, a husband and runs her own business! March 2017

That Valentine's day kiss.... Not so simple, or so romantic, if you have a food allergy.... Kate Lawrence looks at some of the research around allergic reactions that have been triggered by a kiss. February 2017

Creating freefrom lunch boxes. Jenny Tschiesche, nutritionist and founder of The Lunch Box Doctor, gives some tips on how to create safe, nutritionist and appealing school lunch boxes. February 2017

Nathalie, mum of four-year-old Callum who has 13 major allergies, gives us her top tips for a safe but fun Christmas. Novmeber 2016

Dr Polly James, Paediatric Clinical Psychologist for Children’s Allergy Service St Thomas’ Hospital since February talks about the service she is providing. August 2016

Action Against Allergy funds two innovative schemes to support children with allergies at Evelina Children’s Hospital at Guy’s and St Thomas’ NHS Foundation Trust. March 2016

Cross curricular educational resource for managing allergy in school. Allergy Adventures - four video workshops which provide a cross curricular educational resource for managing allergy in school. March 2016

Food allergy meets the teenage brain. Excellent article in Allergic Living on helping teenagers to mange their allergies safely. October 2015.

School Food Allergy and Anaphylaxis Management for the Pediatrician—educating the family to partner with their schools and encouraging the school to provide reasonable and effective accommodations, as per state or federal guidelines. October 2015

Managing severe allergy in school. Karen Leahy's seven-year-old son Jamie has a nut allergy. Jamie has learned all about his allergy but his school did not seem to know how to deal with it. So his mum sat down and wrote an allergen management policy that schools could follow for their severely allergic children. September 2015

Interview with David Stukus, MD, Assistant rofessor of ediatrics in Allergy and Immunology at Columbus, Ohio's Nationwide Children's Hospital onteh diagnosis of allergy in children. January 2015

Food Allergy Bullying: what you can do. From Allergic Living magazine. November 2014

Lengthy article in Stanford Medicine about the management of food allergy, especially in children, and the use of immunotherapy as a management tool. October 2014

More US states are passing legislation permitting or requiring schools to stock the medication epinephrine to use for any child having a severe allergic reaction. September 2014

Milwaukee Public School develop protocol for treating severe allergic reactions in school. September 2014

Managing Food Allergies In The School System. Interviews with parents of allergic children and their school carers in Wichita. September 2014

The Allergy-free Baby and Toddler Book by Charlotte Muquit and Dr Adam Fox. Excellent guide for parents. May 2014

How to get a 504 plan for your food-allergic child at school. 2013

New US voluntary guidelines for managing allergies in school could be helpful to parents of allergic children outside the US. November 2013

Flying with allergies. Helpful advice from Allergic Living on travelling by air with children with food allergies.

Food Allergies in Children – Dr Adam Fox, Consultant Paediatric Allergist at Guy’s and St Thomas’ Hospitals. Part of the annual Nutrition and Health Live event – November 2013

Alexa Baracacia's presentation at an industry conference on freefrom in catering gives a vivid picture of what it is like living with a multiply allergic small child. October 2013

Child food stylists are lifesavers for kids' parties as they cater to allergies. September 2013

Anaphylaxis Campaign conference – Managing allergies in children and young people – October 2013

Vacationing without your food allergic children. Basic tips to make this possibility a reality. January 2013

Guidelines for allergen management in schools from a school in Massachusetts – a useful template for schools that do not have their own. February 2013

How do you explain allergies to your small child? Helpful blog on What Allergy? with a lot of useful suggestions. February 2013

Helpful article in Fox News about the problems of dating if you have allergies. February 2013

Helpful video for parents and teachers of children with allergies. September 2012

'Back to School' with Allergies – prepare for detentions, homework – and essay writing! Mel Fenson (Pig in the Kitchen to those who follow her blog) tackles the double round of duties of the parent of an allergic child. September 2012

Children should be taught how to avoid common allergens in the classroom, so that they can stay focused on their studies rather than their allergies. August 2012

Summer camps in Arizona for children with anaphylactic food allergies. June 2012

One third of allergic children being bullied at school because of their allergies - AAAAI report. March 2012

www.AllergyHome.org: new site run by two allergists in the US to provide practical teaching tools to those who care for children with food allergies. February 2012

Fourteen-year-old Colorado school girl with life threatening milk allergies attends school via a robot! Daily Mail on Line. November 2011

A report in the Evening Tribune on the excellent protocols set up for the management of allergic children in schools in District 186 in Springfield, Illinois. August 2011

Return to school? Doris Rapp's classic 1997 book, Is this your child's world? Is your child allergic to schools? is still a source of excellent information and advice for those whose children struggle to conform or keep up at school. September 2011

Sending an allergic child out into the big, wide world – Eve Menezes Cunningham has some helpful advice. 2011

The parent I-C-E (in case of emergency) app for iPhone or iPod could benefit anyone with an allergy. March 2011

Good dental care especially important for children on special diet. July 2010

Coeliacs and college: tips for parents and prospective students. Useful advice from www.coeliaccentral.org

Colleges accommodate more students with food allergies - a long article in USA Today detailing the encouraging progress made in colleges across the USA who are making active efforts to accommodate allergic students. February 2010

Sending an allergic child to their first school – Advice from paediatric allergy nurse specialist, Rebecca Elder. August 2009

Improving allergy safety at school: John Scott compares the provision for allergic children in this country with what is on offer elswhere. 2007

Managing Severe Allergies in Schools: Training for school nurses and staff helps to demystify and promote safe management of severe allergic reactions. Sue Clarke 2007

Hidden allergens in the classroom: John Scott points out some danger areas in the classroom. 2007

Bullying: Autistic and allergic children are easy targets for school bullies – find out how to help your child and how to educate teachers and pupils around them, from FAAN News and Nick Dubin.

Children’s allergy service on the NHS: introducing the new state-of-the-art allergy clinic at the Evelina Children’s Hospital in London, UK. By Michelle Berriedale-Johnson. 2007

Teen Troubles: Analysis of the teenage brain and ideas for the best way to help your teenager live stress-free when managing allergy and intolerance. By anne Munoz Furlong. 2006

Tips for food allergic and intolerant children starting school: Gail, Sinfield, a mother of two allergic children, and Foods Matter’s Allergy Agony Aunt, gives some invaluable advice.

Teenagers and Anaphylaxis: Information for parents and children about workshops on awareness and confidence among teenagers with severe allergies, providing invaluable feedback for trainers themselves on current thinking among the age group. By Jennifer Percival. 2004

Playschools and allergies: an article about dealing with allergies, epilepsy and coeliac disease in children at a playschool in Cambridge. By Susan Lister. 2004

 

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Research Reports

Association between childhood allergic diseases, educational attainment and occupational status in later life: systematic review protocol. Oct 2017

A British Medical Journal article presenting details of a planned study to review research considering the impact of allergies on school grades and job outcomes. We await the results of this study with great interest.

A preliminary study of gut dysbiosis in children with food allergy. Oct 2017

Preliminary evidence of differences in the gut bacteria of children with food allergies, compared to those without.

The coexistence of psychiatric and gastrointestinal problems in children with restrictive eating in a nationwide Swedish twin study August 2017

This large-scale study, looking at nearly 20,000 children in Sweden, found that those with restrictive eating habits were much more likely to have co-existing psychiatric or gastrointestinal conditions. This suggests that in children who present early with restrictive eating patterns it may be important to consider the possibility of co-occurring disorders.

Can Early Omega-3 Fatty Acid Exposure Reduce Risk of Childhood Allergic Disease? July 2017
This interesting review study (full-text available) reviews the current state of the research looking at omega 3 consumption and the development of allergic disease. Consumption of oily fish and/or fish oils in pregnancy may reduce the risk of infants going on to develop allergic diseases. This is an important study that highlights a practical step pregnant women may want to take to reduce allergic risk in their offspring.

Correlation between serum vitamin D status and immunological changes in children affected by gastrointestinal food allergy. July 2017
Another study which looks at the link between vitamin D and food allergy. Lower levels of vitamin D in children were found to be associated with stronger immune responses to food allergens. This is an association study, so we cannot know whether vitamin D levels lead to changes in immune response, vice versa or that they are both mediated by some other independent factor. However, this evidence that an association exists is extremely interesting and is a promising avenue for more research to explore whether vitamin D could play a therapeutic role in children with food allergies.

Food allergy response capabilities of mothers and related factors. June 2017
How successfully food allergy can be treated in children depends, to a large part, on the parents’ ability to manage the dietary needs. This paper highlights the need for multidisciplinary support for parents to help them deal with the challenges of this condition.

"Healthcare seems to vary a lot": A focus group study among parents of children with severe allergy. June 2017
This study also looks at quality of life of families of children with allergies. It was felt that care differed according to many factors and that support and understanding was sometimes lacking. A more patient-centred approach is suggested.

Bullying and quality of life in children and adolescents with food allergy. June 2017
This review takes a look at evidence suggesting that children with food allergies are more likely to suffer from bullying. It is also reported that the specific nature of this bullying sometimes extends to being touched with foods to which they are allergic or having their food deliberately contaminated. This is a huge concern – particularly in the case of anaphylaxis.

Growth of Children with Food Allergy March 2017
This review study finds that children with food allergies have stunted growth. This is found even when their nutritional needs are being met and when they are under the care of a dietician. This suggests further research is important to enable exploration of the reasons for growth faltering in children with food allergies.

Impact of elimination diets on nutrition and growth in children with multiple food allergies. March 2017
This review looks at growth and nutrition in children with multiple food allergies. Growth needs to be considered from the point of view of multiple exclusions but also from the perspective of inflammation which can impact the absorption of nutrients.

Review suggests that the immunoregulatory and anti-inflammatory properties of allergenic foods can provoke oral tolerance if introduced early to infants' diets. Feb 2017
More research to suggest that feeding infants allergenic foods early in life may be linked to a better ability to tolerate these foods.

The emotional, social, and financial burden of food allergies on children and their families. March 2017
This article reviews research looking at the emotional, social, and financial impact of food allergy on children and their families. The significant impact on children and families in each of these areas suggests that a multidisciplinary approach is critical to helping families cope with the multitude of issues that can result from food allergies.

Establishing the prevalence of low vitamin D in non-immunoglobulin-E mediated gastrointestinal food allergic children in a tertiary centre. Jan 2017 This study assessed vitamin D levels in children with gastrointestinal food allergy at Great Ormond Street Hospital. It was found that children with non-IgE mediated gastrointestinal food allergy are at risk of vitamin D insufficiency and deficiency. The Full article is available for free.

The Establishment of Cow's Milk Protein Allergy in Infants is Related with a Deficit of Regulatory T cells (Treg) and Vitamin D. Jan 2017
Establishment of Cow’s Milk Protein Allergy (CMPA) in infants was related with lower Regulatory T cells and vitamin D levels. These immune alterations could be crucial factors behind the CMPA establishment and they could constitute a therapeutic target for treatment of CMPA.

Yogurt consumption in infancy is inversely associated with atopic dermatitis and food sensitization at 5 years of age: a hospital-based birth cohort study. Jan 2017
This study looked at regular consumption of yoghurt in infancy in over 1,500 children. It was found that the children who regularly consumed yoghurt were less likely to develop food sensitivities or atopic dermatitis at 5 years of age. This shows a useful preventative step that can be taken to reduce the chances of developing food allergies. The Full text is article for free.

Allergic Sensitization at School Age is a Systemic Low-grade Inflammatory Disorder. December 2016

Introducing Allergenic Food into Infants' Diets: Systematic Review.
November 2016
This evidence-based review explores the association between timing of introduction of potentially allergenic foods to infants and development of food allergies. ‘Results found that delayed introduction of solid foods in general and allergenic foods in particular was not associated with decreased risk for allergic diseases among high and low-risk infants. Later introduction was associated with increased risk for allergy development.’ The authors make some interesting practical suggestions based on their findings… ‘For infants at low risk for development of food allergies, providers should advise caregivers to introduce potentially allergenic foods with other solid foods between 4 and 6 months of age when children show an interest in eating solids. Caregivers of infants at high risk for development of food allergies are recommended to introduce peanuts between the ages of 4 and 6 months and work with providers to create an individualized plan for introduction of other allergenic foods.’

Could Helicobacter Pylori be used to downgrade allergic reactions? November 2016

Pre- and probiotics for allergy prevention: time to revisit recommendations?
October 2016
‘Recent guidelines from the World Allergy Organization recommend the use of probiotics for the primary prevention of eczema in pregnant and breastfeeding mothers of infants at high risk for developing allergy and in high risk infants.’ Probiotics are a source of beneficial bacteria that are introduced into the gut through oral consumption. This article discusses some of the issues around our current understanding of the research informing this advice.

Does concurrent breastfeeding alongside the introduction of solid food prevent the development of food allergy? October 2016
This study found no evidence that introducing solids, or food allergens, whilst breastfeeding has an allergy-preventative effect.

Assessment of IgE-mediated food allergies in children with atopic dermatitis. September 2016
More than one quarter of children with atopic dermatitis were found to have food allergies. The researchers suggest that all children with atopic dermatitis should be screened for food allergy.

Giving antibiotics to children increases allergy risk September 2016
Findings were recently presented at the European Respiratory Society International Congress in London. These suggest that the risk of developing both asthma and hay fever increases in children exposed to antibiotics early in life. This research has the potential to guide clinical practice in terms of encouraging more judicious use of antibiotics and also looking at how we might mitigate the disruption to healthy gut bacteria caused by antibiotics.

Timing of Allergenic Food Introduction to the Infant Diet and Risk of Allergic or Autoimmune Disease: A Systematic Review and Meta-analysis. September 2016
This review, of multiple research studies into food allergy, found that early introduction of egg and peanut is associated with a lower risk of developing allergies to these foods.

Early weaning is beneficial to prevent atopic dermatitis occurrence in young children. February 2016

Recent studies suggest that early rather than late introduction of allergenic foods reduces the risk of food allergy. The preferred timing of food introduction might be sooner than the current recommendation, and might apply not only to high-risk infants. April 2016

Diagnosis and treatment of pediatric food allergy: an update 2015

Management of simple food allergy by community paediatricians in Australia appears feasible and acceptable to paediatricians and families alike. November 2015

Recent accumulated evidence suggests that exposure to allergens early in life may promote immune tolerance and contribute to prevent infant food sensitization. May 2014

Alexithymia (the sub-clinical inability to identify and describe emotions in the self resulting in poor emotional awareness, social attachment, and interpersonal relating) higher in food-allergic versus healthy children and young adults. September 2015

Food-allergic schoolchildren have a probability of being bullied approximately 2 times higher than healthy peers, in an Italian study. September 2015

Food sensitisation prevalence is highest in infancy and declines after 12 months of age. Food sensitisation at 12 months can predict children at greater risk of adolescent sensitisation and probable food allergy at 12 and 18 years. August 2015

Cow's milk allergy was observed frequently in children with resistant to pharmacologic treatment of GERD. Combined skin prick and specific IgE tests, atopy patch test and oral food challenge is essential for avoidance of unnecessary elimination diet. August 2015

Specific epicutaneous immunotherapy prevents sensitization to new allergens in a murine model. June 2015

Feeding difficulties in children with food protein-induced gastrointestinal allergies. October 2014

The majority of food allergic children who passed an oral food challenge subsequently ate target food regularly and their family's quality of life improved. Adverse reactions were rare and never serious. August 2015

There is a substantial disagreement between SPT and sIgE for diagnosing allergic sensitization in young children, which increases with age for food sensitization. November 2014

Iodine deficiency a risk for children with severely restricted diets. June 2015

Early, aggressive treatment of patients with infantile atopic dermatitis significantly reduces food allergy incidence by 18 months of age. February 2015

German study suggests that regular vaccinations may protect children from allergic disease. December 2014

Mothers managing the diets of children with food allergies say the role of dietary consultants should extend to emotional support and advocacy on parents' behalf with school officials and other care providers. December 2014

Providing parents of allergic children with detailed, individual advice from a dietician is a key component of effective food allergy care. December 2014

Early probiotic supplementation may provide protection against hypersensitivity to food allergens by attenuating inflammatory responses. May 2014

Parents of young children with food allergies should take care not to over protect. Report here. September 2014

Ability of schools in Wisconsin to deal with food allergy questionable. August 2014

The case for a children's multidisciplinary food allergy clinic. May 2014

Could thermal food processing alter food proteins in infant foods to reduce allergenicity with a potential to increase oral tolerance? December 2013

Childhood milk and egg allergies worry parents and caregivers more than peanut allergies. July 2014

An assessment of the mental health care needs and utilisation by families of children with a food allergy. Novemebr 2013

Reviews show that sub-lingual (under the tongue) allergy drops can be beneficial for paediatric allergy patients as well as adults. May 2013

Food-allergic children lag behind their peers on weight and body-mass index (BMI) growth charts, especially if they have milk allergy. February 2013

Bullying is common among food allergic children but less that 50% of parents are aware that it is happening although the children quality of life is condsiderably better when the parents are aware of the problem. January 2013

Airborne particles inside classrooms can be more toxic than those outside. August 2012

Epidemic proportions: food allergies double in ten years. June 2012

Inconsistent use of food allergy emergency action plans in Mississippi. June 2011

Food allergies in children cause anxiety and loneliness, have dramatic impact on their quality of life. February 2011

First study of its kind finds children with food allergies are often victims of bullying. October 2010

Biological reasons why teenagers may take greater risks – and therefore be in more danger of experiencing a serious allergic reaction. June 2010

Sending an allergic child to his first school. July 2009

 



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