Published September 15, 2022
Yale New Haven Children’s Hospital has launched its Pediatric Food Allergy Prevention Program, among the first of its kind in the northeast, to help families reduce the odds that their young children will develop food allergies.
Currently, nearly 6 million children and 26 million adults in the United States have food allergies, and accidental ingestions of allergens result in 9,500 hospitalizations annually. Research suggests careful, early introduction of allergenic foods reduces the chance a child will develop a life-long allergy and can improve the quality of life of families.
Exposing young children to allergenic foods has gained popularity since several studies found it effective in those who were predisposed to peanut allergies. There is increasing evidence that introduction of allergenic foods in the first year of life provides the greatest opportunity to reduce development of food allergies.
Taking these findings outside the lab, Lauren and her husband Tyler of Danbury, CT were excited to start Brody, who was six months old at the time, on solid food. However, at the first introduction of peanut butter Brody developed head to toe hives.
“Of course it happened after our pediatrician’s office was closed,” said Tyler. “We were on the phone with the after-hours line while rushing to the closest pharmacy for Benadryl. We knew it was important to expose our son to peanut butter, but no one told us what to do in the event our son had a reaction the first time.”
The couple investigated next steps for introducing other allergens to their son and how to manage this existing allergy.
“Many clinics had us avoiding allergens and then starting treatment around age 5,” said Lauren. “We wanted to be proactive early and find a program that gave us the best chance at prevention.”
When Brody was just under a year, Lauren and Tyler connected with Stephanie Leeds, MD, a pediatric allergist at Yale New Haven Children’s Hospital. Dr. Leeds introduced them to the concept of preventing food allergies through eating food from an early age.
When Lauren became pregnant with her second child, she also wanted to be proactive in preventing food allergies for her unborn child. She learned that Dr. Leeds and Dr. Julie Flom, another pediatric allergist at Yale New Haven Children’s Hospital, were developing a program for food allergy prevention counseling and she scheduled a consultation.
In the Food Allergy Prevention Program, Dr. Flom explains that the best window to start introducing allergens in many infants is from about 4 to 6 months and that early introduction of food allergens for infants is possible even if other household members have food allergies.
This is where Julia Shook Munoz, RD, a clinical dietitian specializing in food allergies, comes in. Dietitians specializing in food allergies work with allergists to ensure families are equipped to manage a child’s allergy while providing meals that meet the child’s nutritional needs.
“With every child, the goal is a fun and colorful diet that takes culture into consideration,” said Munoz. “Many families can accomplish this at home by introducing the top nine allergens one at a time and monitoring for a reaction. Typically, if there is an initial reaction, the first one is mild, but a signal that should be noted.”
In discussing food allergy, Dr. Flom says allergy tests can be a useful tool in a clinical setting, but there can be false positives and results require the expertise of a clinical team to interpret. On the other hand, the heavily marketed at-home food sensitivity tests are not backed by any evidence to diagnose a food allergy, which might lead to unnecessary avoidance (and potentially increase risk of food allergy long term). The best test is what happens when a child eats the food, and the Food Allergy Prevention Program is developed to support families in this endeavor.
Lauren and Tyler now provide Brody a balanced diet with rotating ingredients including tree nuts, fruit, and oatmeal. In fact, Brody has also undergone oral immunotherapy to peanuts under the care of Dr. Leeds and successfully passed a peanut butter challenge. He was able to celebrate last Halloween by eating a chocolate peanut butter cup.
Lauren and Tyler recently welcomed their second son and they have an individualized plan and open communication with the team at the Food Allergy Prevention Program for when he is ready to start solids.
“Food allergies can impact everyday activities like going to the playground or even what daycare options are available,” said Dr. Leeds. “Guidance on managing food allergies has changed dramatically over the past few years. It is important that caregivers have early access to accurate information about prevention initiatives that can significantly impact their child’s future.”
