Dietary management of breastfed children with food allergy

Hilary Allen; Robert J. Boyle

doi:10.1111/cea.14073

Symposium on ‘Nutrition and health in children and adolescents’ Session 5: Risk and management of food allergy in children Dietary management of food allergy in children

Proceedings of The Nutrition Society ◽

10.1079/pns2006516 ◽

2006 ◽

Vol 65 (04) ◽

pp. 412-417 ◽

Cited By ~ 6

Author(s):

Kate E. C. Grimshaw

Keyword(s):

Food Allergy ◽

Children And Adolescents ◽

Dietary Management ◽

Nutrition And Health

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Food Intolerance: Our Practice

Nutrition and Health ◽

10.1177/026010608700500403 ◽

1987 ◽

Vol 5 (3-4) ◽

pp. 119-135

Author(s):

J.M. Littlewood ◽

Anita MacDonald

Keyword(s):

Food Allergy ◽

Clinical Presentation ◽

Food Intolerance ◽

Dietary Management

This paper describes the clinical presentation of food allergy and/or intolerance (F.A.I.). The role of a diagnostic dietary trial is reviewed. Finally dietary management is discussed.

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The Level of Knowledge of Dietitians About Dietary Management of Children with Food Allergy

Asthma Allergy Immunology ◽

10.21911/aai.6006 ◽

2016 ◽

Author(s):

Tayfur Giniş ◽

Nevra Koç ◽

Hakan Güvenir ◽

Cansu Çetin ◽

Müge Toyran ◽

...

Keyword(s):

Food Allergy ◽

Dietary Management ◽

Level Of Knowledge

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Dietary Management of Eosinophilic Esophagitis: Tailoring the Approach

Nutrients ◽

10.3390/nu13051630 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1630

Author(s):

Pierfrancesco Visaggi ◽

Lucia Mariani ◽

Veronica Pardi ◽

Emma Maria Rosi ◽

Camilla Pugno ◽

...

Keyword(s):

Food Allergy ◽

Eosinophilic Esophagitis ◽

Immunoglobulin E ◽

Wheat Gluten ◽

Skin Tests ◽

Dietary Therapy ◽

Dietary Management ◽

High Power Field ◽

Advantages And Disadvantages

Eosinophilic esophagitis (EoE) is a unique form of non-immunoglobulin E-mediated food allergy, restricted to the esophagus, characterized by esophageal eosinophil-predominant inflammation and dysfunction. The diagnosis requires an esophago-gastroduodenoscopy with esophageal biopsies demonstrating active eosinophilic inflammation with 15 or more eosinophils/high-power field, following the exclusion of alternative causes of eosinophilia. Food allergens trigger the disease, withdairy/milk, wheat/gluten, egg, soy/legumes, and seafood the most common. Therapeutic strategies comprise dietary restrictions, proton pump inhibitors, topical corticosteroids, biologic agents, and esophageal dilation when strictures are present. However, avoidance of trigger foods remains the only option targeting the cause, and not the effect, of the disease. Because EoE relapses when treatment is withdrawn, dietary therapy offers a long-term, drug-free alternative to patients who wish to remain off drugs and still be in remission. There are currently multiple dietary management strategies to choose from, each having its specific efficacy, advantages, and disadvantages that both clinicians and patients should acknowledge. In addition, dietary regimens should be tailored around each individual patient to increase the chance of tolerability and long-term adherence. In general, liquid elemental diets devoid of antigens and elimination diets restricting causative foods are valuable options. Designing diets on the basis of food allergy skin tests results is not reliable and should be avoided. This review summarizes the most recent knowledge regarding the clinical use of dietary measures in EoE. We discussed endpoints, rationale, advantages and disadvantages, and tailoring of diets, as well as currently available dietary regimens for EoE.

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TEST (Trial of Eczema allergy Screening Tests): protocol for feasibility randomised controlled trial of allergy tests in children with eczema, including economic scoping and nested qualitative study

BMJ Open ◽

10.1136/bmjopen-2018-028428 ◽

2019 ◽

Vol 9 (5) ◽

pp. e028428 ◽

Cited By ~ 1

Author(s):

Matthew J Ridd ◽

Louisa Edwards ◽

Miriam Santer ◽

Joanne R Chalmers ◽

Lisa Waddell ◽

...

Keyword(s):

Food Allergy ◽

Randomised Controlled Trial ◽

Qualitative Study ◽

Controlled Trial ◽

Screening Tests ◽

Dietary Management ◽

Allergy Testing ◽

Dietary Restrictions ◽

Feasibility Randomised Controlled Trial ◽

Randomised Controlled

BackgroundEarly onset eczema is associated with food allergy, and allergic reactions to foods can cause acute exacerbations of eczema. Parents often pursue dietary restrictions as a way of managing eczema and seek allergy testing for their children to guide dietary management. However, it is unclear whether test-guided dietary management improves eczema symptoms, and whether the practice causes harm through reduced use of conventional eczema treatment or unnecessary dietary restrictions. The aim of the Trial of Eczema allergy Screening Tests Study is to determine the feasibility of conducting a trial comparing food allergy testing and dietary advice versus usual care, for the management of eczema in children.Methods and analysisDesign: A single centre, two-group, individually randomised, feasibility randomised controlled trial (RCT) with economic scoping and a nested qualitative study. Setting: General Practioner (GP) surgeries in the west of England. Participants: children aged over 3 months and less than 5 years with mild to severe eczema. Interventions: allergy testing (structured allergy history and skin prick tests) or usual care. Sample size and outcome measures: we aim to recruit 80 participants and follow them up using 4-weekly questionnaires for 24 weeks. Nested qualitative study: We will conduct ~20 interviews with parents of participating children, 5–8 interviews with parents who decline or withdraw from the trial and ~10 interviews with participating GPs. Economic scoping: We will gather data on key costs and outcomes to assess the feasibility of carrying out a cost-effectiveness analysis in a future definitive trial.Ethics and disseminationThe study has been reviewed by the Health Research Authority and given a favourable opinion by the NHS REC (West Midlands – South Birmingham Research Ethics Committee, Reference Number 18/WM/0124). Findings will be submitted for presentation at conferences and written up for publication in peer-reviewed journals, which may include mixed-method triangulation and integration of the quantitative and qualitative findings.Trial registrationISRCTN15397185; Pre-results.

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