By Frederik Joelving
11:32 AM EDT, June 25, 2012
NEW YORK (Reuters Health) - Babies with life-threatening allergic reactions to milk or egg often don't get prompt treatment, despite their caretakers having been given medicine to counter the attacks, a new government-funded study shows.
Researchers followed more than 500 infants with known or suspected food allergies for three years. The families had been told about the allergies and how to avoid trigger foods and had also been given an injector containing the drug epinephrine, which can stall an allergic attack.
Still, as many as 72 percent of the children had an allergic reaction during the study. And of the 11 percent who had severe attacks - which can involve breathing trouble, blood pressure drops and hives or swelling - less than a third got epinephrine.
"The children who should have received epinephrine in our study did not go on to die, luckily, but it is a risk when the reaction is not treated promptly," said Dr. Scott H. Sicherer, an expert in childhood allergies at Mount Sinai School of Medicine in New York, who worked on the study.
"We need to emphasize for the families that this is a safe medication," he told Reuters Health. "If they are in doubt, they should give it anyway. Nothing bad will happen from that."
About 8 percent of children in the U.S. have food allergies and studies show the number is rising, said Sicherer, whose findings were published Monday in the journal Pediatrics.
The new results come from a long-running study of children from five U.S. cities. At the outset, the kids were between three and 15 months old and had known or likely allergies to milk and/or egg.
Most allergic reactions were accidental and caused by parental forgetfulness or lack of supervision. Others had to do with misreading food labels or cross-contact during food preparation, such as using a spoon to stir a cup of coffee with milk and feed the baby.
"The lesson is, it's very important to be very vigilant," said Sicherer, adding that "we as the physicians have to make sure we educate the parents."
Because half of the reactions happened when somebody other than the parents were taking care of the children, Sicherer stressed parents' role in passing on care instructions to others.
About half of people with food allergies will experience a life-threatening reaction, known as anaphylaxis, at some point, according to Dr. Kari Nadeau, an allergy expert at Stanford University School of Medicine in California who was not involved in the study.
The reason kids didn't get epinephrine when needed typically had to do with caretakers not recognizing the reactions, not having the drug at hand or being too afraid to administer it.
"I think people have a hard time getting over the hurdle of a shot, but it is a very small needle," Nadeau told Reuters Health. "It's key that people should carry the EpiPen and feel free to use it as appropriate -- it's the only lifesaving medication."
So far, there is no proven treatment against food allergies, although researchers are working on a therapy.
Sicherer recommended the website http://www.cofargroup.org/ for families with children with food allergies. Among other educational material, the website includes a checklist for parents here: http://bit.ly/MB4NkU.
Dr. Wayne Shreffler, director of the Food Allergy Center at Massachusetts General Hospital in Boston, said that 95 percent of severe allergies are due to ingestion. "That's where we need to focus our education efforts," he told Reuters Health by email.
SOURCE: http://bit.ly/La0pXU Pediatrics, online June 25, 2012.
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