Stress of having Food Allergy
For a parent, having a child with food allergy is stressful, having a child with multiple food allergies makes it even harder. Imagine the amount of food preparation needed to feed your child. Going out to restaurants and ordering food is a nightmare! My patients say that it is so stressful to travel or to go out and eat that they mainly stay at home!
Food Immunotherapy
The mainstay management of food allergy is to avoid the food allergen. However, we do have treatments available for food allergy and one of them is food immunotherapy. It is a process of slowly introducing food that the person is allergic at small amounts and gradually increasing it over time. Prevention of food allergy is still the best approach. However, once food allergy has developed, food immunotherapy can help desensitize a person to reduce accidental exposure that can cause life threatening reactions. A subset of patients on food immunotherapy do develop tolerance in which the food allergy is outgrown or cured.
Treatment of Multiple Food Allergies
Cow’s milk and Egg are the most common food allergy in children and we have a protocol for helping these food allergies. But what if the child is allergic to many other foods? I want to share with you, our Allergy Immunology Clinic approach.
I want to introduce Sunshine (not her real name). Sunshine has multiple food allergies with multiple reactions in the past. Unfortunately from all these reactions, she has become a picky eater. I don’t blame Sunshine, as after having so many reactions to foods I too would be wary to eat anything unfamiliar. Parents are keen to see what could be done to help her.
We know that one of the ways to help a child outgrow their food allergies is to induce immune tolerance to the foods. One method is through food immunotherapy. The challenge is how to perform food immunotherapy if Sunshine does not want to eat the food. The plan is to utilize a multiple food protein mix and hide it in something that Sunshine enjoys eating. The skin prick testing was done to offending foods, food allergen mix and also the vehicle to determine the degree of sensitization.
You can see above, that there are many reactions on the back to the culprit foods. The SEMUA food protein mix which contains all the reactive proteins also tested positive indicating that it contains everything necessary to perform the planned food immunotherapy.
Based on the skin prick test, we decided that we can proceed to food immunotherapy using the vehicle that was tested negative to hide the food allergens.
The aim is to introduce a small dose that will not elicit a reaction, we chose 1/32 of a teaspoon of mixed food allergen based on the skin test size. We then mixed it into the puree to be given to patient.
It was a successful food introduction! Sunshine enjoyed eating the puree which contained the food protein mix. She was monitored closely in clinic for 1 hour after she finished eating the puree. Parents were counselled what to expect and what to do at home. The journey has only just started. We will slowly increase the dose at each subsequent visit. We will also monitor for possible chance of tolerance with repeat skin prick testing in the future.
Step by Step
The first step of the journey of food immunotherapy begins with a proper evaluation. Together, with shared decision making. we can determine if food immunotherapy is an option. Successful introduction of the first dose is the first step of the journey. Together we will take more steps and continue on the journey.
The hope of the journey is complete resolution of the food allergy. However, not everyone can have complete resolution of food allergy. At the least, we hope that by taking increasing steps towards higher doses of food immunotherapy, we can prevent accidental exposures of even small amounts of food allergens that will cause a severe reaction. I tell my patients: Step by step, we continue to step forward. Each step is better than before.
Information you can use
- Food immunotherapy is an approach that can be used to treat allergy
- Food immunotherapy is done by Allergist/Immunologist by gradually increasing the dose of the offending food allergen
- Multiple food allergen immunotherapy can be safely performed with proper evaluation
- Skin prick test is used to determine sensitization and also resolution of the food allergy
- Not everyone can outgrow or have their food allergy cured by food immunotherapy
- Step by Step, we continue to move forward. Each step forward is better than before
If you need help
If you are suffering from food allergy, please seek proper evaluation. Allergist/Immunologist specialists are trained to take care of these conditions and the Allergy Immunology Clinic is ready to serve your needs
