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Background
Food-allergic children frequently avoid other highly allergenic foods. The NIAID 2010 guidelines state that individuals with an IgE-mediated food allergy should avoid their specific allergens and physicians should help patients to decide whether certain cross-reactive foods also should be avoided. Patients at risk for developing food all...
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Context 1
... most common allergies in the first child with food allergy were peanut (48%), milk (23%), egg (17%), and tree nut (15%) (Figure 1). At the time of diagnosis, 68% of parents reported that their child had a positive skin test, 54% of parents report that a history of reaction de- termined diagnosis, and 24% had a positive blood test for the food. ...
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Citations
... Many parents report that they hesitate to try new foods for their children and healthy siblings and felt anxious after food allergy was diagnosed 21,22 . Mothers stated that they were more anxious especially on the day of the oral food provocation test compared to the other days 23 . ...
Aim:Patients with food allergy and their families have poor quality of life, anxiety, depression, and stress compared to healthy individuals, and the Caregiver Burden is high in the parents. In our study, it was aimed to evaluate the anxiety disorder that may accompany the mothers of food allergic patients aged 0-2 years, and to examine the Caregiver Burden in the mothers of food allergic patients.Materials and Methods:A questionnaire about sociodemographic data, Hospital Anxiety Depression Scale (HADS), Psychological Symptom Checklist (SCL 90-R), and Zarit Caregiver Burden Scale were administered to the mothers of food-allergic children aged 0-2 years and the mothers of healthy children (MHC) as the control group.Results:Sixty seven mothers of children with food allergy and 74 MHC were enrolled in the study. Zarit Caregiver Burden Scale was significantly higher in the mothers of children with food allergy than in the MHC (p=0.018). Mothers of food allergic children had a significantly higher overall score on the general SCL 90-R scale (p=0.045). While the hospital anxiety scale score was significantly higher in the mothers of children with a food allergy, there was no difference in the HADS (p=0.045, p=0.825, respectively).Conclusion:Evaluation of mothers’ emotional status such as burden, anxiety, and depression and coping with food allergy strategies can be neglected. Therefore, the requirement of psychosocial support for the mothers of children with food allergy, especially in the young age group, should be evaluated and provided when necessary.
... Many parents report that they hesitate to try new foods for their children and healthy siblings and felt anxious after food allergy was diagnosed 21,22 . Mothers stated that they were more anxious especially on the day of the oral food provocation test compared to the other days 23 . ...
Aim: Patients with food allergy and their families have poor quality of life, anxiety, depression, and stress compared to healthy individuals, and the Caregiver Burden is high in the parents. In our study, it was aimed to evaluate the anxiety disorder that may accompany the mothers of food allergic patients aged 0-2 years, and to examine the Caregiver Burden in the mothers of food allergic patients. Materials and Methods: A questionnaire about sociodemographic data, Hospital Anxiety Depression Scale (HADS), Psychological Symptom Checklist (SCL 90-R), and Zarit Caregiver Burden Scale were administered to the mothers of food-allergic children aged 0-2 years and the mothers of healthy children (MHC) as the control group. Results: Sixty seven mothers of children with food allergy and 74 MHC were enrolled in the study. Zarit Caregiver Burden Scale was significantly higher in the mothers of children with food allergy than in the MHC (p=0.018). Mothers of food allergic children had a significantly higher overall score on the general SCL 90-R scale (p=0.045). While the hospital anxiety scale score was significantly higher in the mothers of children with a food allergy, there was no difference in the HADS (p=0.045, p=0.825, respectively). Conclusion: Evaluation of mothers' emotional status such as burden, anxiety, and depression and coping with food allergy strategies can be neglected. Therefore, the requirement of psychosocial support for the mothers of children with food allergy, especially in the young age group, should be evaluated and provided when necessary. ÖZ Amaç: Besin alerjisi olan hastalar ve aileleri sağlıklı bireylere göre düşük yaşam kalitesi, anksiyete, depresyon ve strese sahip olup, ebeveynlerde bakım veren külfeti yüksektir. Çalışmamızda 0-2 yaş arası gıda alerjisi hastalarının annelerine eşlik edebilecek anksiyete bozukluğunun değerlendirilmesi ve gıda alerjisi olan hastaların annelerinde külfetin incelenmesi amaçlandı. Gereç ve Yöntem: Gıda alerjisi olan 0-2 yaş arası çocukların annelerine ve kontrol grubu olarak sağlıklı çocukların annelerine sosyodemografik veriler, Hastane Anksiyete ve Depresyon Ölçeği (HADÖ), Psikolojik Belirti Tarama Listesi (SCL 90-R) ve Zarit Bakıcı Yükü Ölçeği ile ilgili anket uygulandı. Bulgular: Çalışmaya gıda alerjisi olan 67 çocuk annesi ve sağlıklı çocuğu olan 74 anne alındı. Zarit Bakım Veren Külfet Ölçeği puanı, gıda alerjisi olan çocukların annelerinde sağlıklı çocukların annelerine göre anlamlı olarak daha yüksekti (p=0,018). Besin alerjisi olan çocukların anneleri, genel SCL 90-R ölçeğinde anlamlı olarak daha yüksek bir genel puana sahipti (p=0,045). Besin alerjisi olan çocukların annelerinde HADÖ puanı anlamlı olarak yüksekken, Hastane Depresyon Ölçeği puanında fark yoktu (sırasıyla p=0,045, p=0,825).
... McHenry i Watson [27] upozoravaju na to da je važno uvijek ostati s malim djetetom kada jede ili pije. Ako dijete već ima alergiju, predlaže se razgovor s dijetetičarom i djetetovim liječnikom. ...
Uvod : Astma je kronična upala dišnih putova. Uzroci su alergije, virusne respiratorne infekcije i nadražujuće tvari iz zraka. Broj oboljelih povećava se, a pritom prednjače djeca. Ishrana majke tijekom trudnoće te ishrana djeteta u prvoj godini života imaju važan utjecaj na razvoj i tijek bolesti. Metode : Upotrijebljena je narativna analiza, pregled stručne i znanstvene literature. Pretraživanje literature temeljilo se na istraživačkom pitanju Kako ishrana u ranom djetinjstvu utječe na rizik za razvoj astme i alergijskih bolesti?. Rezultati : Analizom stručne literature utvrđeno je da ishrana majke ima važnu ulogu pri razvoju astme i alergijskih bolesti kod djece. Dokazi upućuju na to da je pravilno uravnotežena i raznolika ishrana važna za djetetovo zdravlje te da smanjuje rizik od nastajanja bolesti. Stručnjaci tijekom trudnoće ne preporučuju izbjegavanje određenih namirnica kao što su kikiriki, orasi i školjke, osim u slučaju ako je majka alergična na njih. Rasprava i zaključak : Zbog povećane učestalosti astme i alergijskih bolesti, osobito kod djece, potrebno je istaknuti važnost i utjecaj raznolike ishrane tijekom trudnoće te dojenja tijekom prvih šest mjeseci djetetova života. Različite dijete tijekom i nakon trudnoće te tijekom dojenja nisu se pokazale učinkovitima u sprječavanju razvoja astme i alergijskih bolesti kod djece.
... 29,30 Most parents reported to feel anxious when introducing new foods not only to their child with FA but also to the younger siblings. 31,32 Even after a negative oral food challenge (OFC), maternal anxiety before the OFC has been found to be correlated to a following limited level of change in the child's nutritional habits. 33 A study on the burden of EAI among adolescents with FA and their parents showed that the burden was not associated with QoL, perceived disease severity, illness perception or trait anxiety, but it was associated with self-reported compliance with carrying the EAI. ...
Background:
Food allergy (FA) is recognized as a growing public health burden affecting 5 to 10% of children worldwide. Several unique features specific to FA elicit high levels of emotional distress and anxiety in patients and caregivers, the first among all the possibility of a life-threatening reaction. Anxiety disorders are highly prevalent in patients with chronic disease, but remain undertreated despite significant negative consequences on patient health.
Objective:
This review aimed to offer a comprehensive overview of literature data on FA and anxiety of the last two decades.
Methods:
A review of the medical and psychological literature from the year 2000 (Medline PubMed and PsycINFO) was done using the keywords "anxiety" and "food allergy". Clinical implications for disease management, various manifestations in different target groups, proper interventions, possible explanations on the nature of the association between FA and anxiety have been discussed, as well as limitations and further research directions.
Results:
The relationship between FA and anxiety is attributed to FA-specific fears and anxiety, rather than a general propensity towards anxiety. Some anxiety - short lived and related to key events - is to be expected and may even be helpful if it sustains allergens avoidance and preparedness to emergency. However, some data reported that increased anxiety did not improve adherence. Rather, high levels of anxiety have been demonstrated counterproductive and related to maladaptive coping.
Conclusion and clinical relevance:
Further research is needed to elucidate the association between FA and anxiety, especially to understand biopsychosocial directions of the underlying mechanisms and to build proper, effective, standardized protocols of intervention. Clinicians must be aware of the association between FA and anxiety, understand their role in recognizing maladaptive anxiety and encouraging to seek psychological support when needed.
... Parents may avoid enjoyable activities such as dining out, travelling, and shopping. In the USA, 41.8% of parents are not comfortable going on vacation during which they spend a night away from home [7,64,65]. In turn, children are either excluded from social events or need to be accompanied by their parents [7]. ...
Health-related quality of life (HRQL) is influenced by physiological, psychological, and environmental variables and can be best understood by considering the interactions of factors that cut across multiple levels. One of the most important issues relating to treatment in food allergy is to identify, describe, and define predictors that may contribute to modify HRQL outcomes. The research presented demonstrates that measures of HRQL are able to distinguish key features of known groups (e.g. relating to reaction severity, treatment, allergen type/number, expectation of outcome) and delineate impact on hitherto unknown groups (e.g. relating to personality types and coping styles). This heterogeneity may explain why HRQL or other patient-related outcomes may differ in individuals during, or following any treatment or intervention. Patient-reported outcomes are relatively poorly defined to date. Since HRQL has only been studied in relatively few oral immunotherapy trials to date, primarily looking at caregiver HRQL, it is unclear which factors, measures, or subscales are most predictive of short- and/or long-term treatment outcomes for which type of patient, and which time points for measurement are most informative. A standardised protocol that incorporates HRQL and other relevant patient-related outcome measures and agreed definitions of outcomes would allow for the comparison of efficacy of food allergy treatments between centres, trials, or countries. Further evidence-based research aimed at exploring the effects of interventions on outcomes in food allergy is needed, including the influence of patient and parent factors on protocol design. To this end, it is vital that patient-related outcomes such as improved HRQL are seen as a primary outcome and are measured at multiple intervals during the trial duration and beyond. The creative use of methods and designs (both qualitative and quantitative) to better understand the role of HRQL in immunotherapy treatment trials will enable improved modelling of the costs, risks, and benefits of any treatment. Systematic analysis and modelling of antecedent factors, mediators, and outcomes will be important to boost intervention effects and to maximise the overall benefits of treatment.
... Food allergy and specifically peanut allergy has a tremendous psychological burden on children and their families [4][5][6][7][8][9][10]. Having one food allergy impacts the introduction of other allergenic foods in allergic children and their siblings [11]. ...
In children, a diagnosis of peanut allergy causes concern about accidental exposure because even small amounts of peanut protein could trigger an allergic reaction. Contamination of toys, books or other items by peanut butter in areas where individuals have eaten may occur in hospital waiting rooms and cafeterias. It is not known if hospital cleaning wipes are effective in removing peanut allergen.
The purpose of this study was to determine whether cleaning peanut contaminated items with common household and hospital cleaning wipes would remove peanut allergen.
5 mL of peanut butter was evenly smeared on a 12 inch by 12 inch (30.5 by 30.5 cm) square on a nonporous (laminated plastic) table surface, a plastic doll, and a textured plastic ball, and 2.5 mL was applied to smooth and textured book covers. Samples for measurement of Ara h 1 were collected prior to the application of the peanut butter (baseline), and after cleaning with a common household wipe and two commercial hospital wipes. A monoclonal-based ELISA for arachis hypogaea allergen 1 (Ara h 1), range of detection 1.95-2000 ng/mL, was used to assess peanut allergen on each item. The samples were diluted 1:50 for testing.
At baseline, there was no detectable Ara h 1 allergen on any item at baseline. Detectable Ara h 1 was detected on all products after applying peanut butter (range 1.2-19.0 micrograms/mL). After cleaning with any product, no Ara h 1 was detected on any item.
Table surfaces, book covers and plastic toys can be cleaned to remove peanut allergen Ara h 1 using common household and hospital cleaning wipes. Regular cleaning of these products or cleaning prior to their use should be promoted to reduce the risk of accidental peanut exposure, especially in areas where they have been used by many children.
... 'Prevention is better than cure' and various research projects are focused on primary prevention and try to determine whether allergen avoidance or a free diet is the best strategy during pregnancy, lactation period and infancy for food allergy prevention; so far, results are controversial. European guidelines for primary prevention of food allergy collected and analyzed current evidencebased recommendations in order to provide useful and simple advice to families [13] as it appears that advice given from health care professionals about introduction of other potentially allergenic foods in the diet of children with pre-existing food allergy and their siblings varies radically [107]. ...
Food allergy is increasing; as a consequence, food-induced anaphylaxis is also becoming a growing problem. Our understanding of the mechanisms of tolerance is still basic and requires much more research before it becomes helpful in guiding our interventions. However, empirical approaches with oral immunotherapy and food introduction manipulation appear promising, although standardization is required before employing them on a large scale. Furthermore, education and public health measures can be helpful for the increasing proportion of the population at risk.
Background
Parenting a child with food allergy (FA) can lead to impaired quality of life and family functioning. Anxiety is a critical component of FA-associated distress and a potential target for therapeutic intervention. This systematic review aimed to clarify the concept of FA-specific anxiety (FAA) and its antecedents, consequences, and correlates, and to determine the extent to which existing FA-specific outcome measures capture symptoms of parental distress and FAA.
Methods
Medline, Embase, PsycINFO, and CENTRAL were searched for qualitative and quantitative studies examining distress or anxiety in parents of children with FA through August 2020. This review was registered with PROSPERO (CRD42020208316) and conducted in accordance with PRISMA guidelines.
Results
98 studies were included in the final narrative synthesis. Most participants were mothers, and reporting of demographic data was limited. Parents identified anxiety as the most burdensome form of FA-specific emotional distress. Several allergy-related factors as well as medical and psychosocial interventions were associated with reduced parental anxiety and distress. However, affective, cognitive, and behavioural dimensions of FAA were only partially addressed by existing measures for general anxiety symptoms and FA-specific parental factors.
Conclusions
FAA contributes to distress and functional impairment among parents of children with FA. Current FA-specific parent measures fail to adequately capture dimensions of FAA, suggesting that further work is needed to improve the assessment and monitoring of FAA and its impacts. Characterization of this construct represents an initial step in developing standardized methods for assessing and monitoring FAA in clinical populations.
There is no defined standard of care around tree nut introduction in a peanut allergic child, and the role of screening prior to tree nut introduction is controversial. There is some evidence that peanut allergic children are at increased risk of tree nut allergy, with approximately 23‐68% of children with co‐existent peanut/tree nut allergy. In some studies, it has been shown that tree nut allergy in children has the potential to be a severe allergy. However, this appears to be age‐specific as infant anaphylaxis in general tends to be milder, and there has been no fatality reported on first ingestion of an allergen in infancy. Familial hesitancy has been identified as a possible condition for undertaking screening tests prior to allergen introduction. Indeed, there has been some limited evidence that caregiver hesitancy may exist in peanut allergic families with tree nut introduction. However, pre‐emptive screening has the potential to overdiagnose tree nut allergy, and delay introduction (which could paradoxically increase risk). As a result, the decision is best made in the context of shared decision making and patient preference sensitive care.
Background: Food allergy (FA) reactions range from mild to severe with differences in age appearing to be an important factor associated with reaction severity.
Objective: To define differences in oral food challenge (OFC) reaction severity in pediatric patients from infancy to adolescence using objective clinical outcomes and standardized reaction grading tools.
Methods: Retrospective review of all positive OFCs at two large institutions between September 2016 and February 2019. Reaction severity was defined by presence of cardiovascular, neurologic, lower respiratory or laryngeal symptoms (CV/N/LR/L), epinephrine requirement and grading using two established FA reaction scales. Results: Infants and toddlers demonstrated fewer reactions involving CV/N/LR/L symptoms compared to older age groups. Epinephrine was also required less frequently during reactions in infants and toddlers, compared to older age groups. There was no difference in reaction severity in infants and toddlers based on clinical history of eczema. Increasing age was significantly correlated with increased epinephrine requirement (R 2 =0.12, p=0.002), elevated CoFAR score (R 2 =.012, p=.003), and approached significance for increased PRACTALL score (R 2 =.005, p=.057). History of asthma and sesame allergy were identified to be positively correlated with more severe reactions.
Conclusion: Infants and young toddlers demonstrate less severe reactions during OFCs compared to older age groups supporting early food introduction practices. In children under 12 months of age, severe reactions are most rare calling into question screening practices using specific allergy testing prior to food introduction. Standardized reaction grading tools may be valuable instruments to categorize reaction severity during OFCs.
