About 7.6% of children have food allergies, while less than half of those have an epinephrine auto-injector prescription, according to a new study based on parent surveys.
Peanut, milk and shellfish were the most common allergens.
Researchers surveyed a nationally representative sample of the parents of more than 38,000 children and excluded those whose reactions appeared to be oral allergy syndrome or food intolerance. Their findings were published today in “The Public Health Impact of Parent-Reported Childhood Food Allergies in the United States,” (Gupta RS, et al. Pediatrics. Nov. 19, 2018, https://doi.org/10.1542/peds.2018-1235.
The results indicated about 7.6% or an estimated 5.6 million U.S. children have a food allergy and 40% of those children have more than one. Black children were more likely to report a food allergy than white children.
About 2.2% of children were allergic to peanut, 1.9% to milk, 1.3% to shellfish, 1.2% to tree nut, 0.9% to egg and 0.6% to fin fish.
About 42.3% reported a severe allergic reaction, which was most common with peanut, tree nut and shellfish. Only 40.7% of children with a food allergy had an epinephrine auto-injector prescription.
“All allergens can cause severe, potentially life-threatening reactions, so all FA (food allergy) patients require counseling on proper anaphylaxis management,” authors wrote.
Several of the same researchers performed a similar survey in 2009-’10 and found 8% of children had food allergy, but the criteria they used at that time were not as stringent. Using the previous standards, current prevalence would have been higher, likely due in part to increased awareness, authors wrote.
They also noted the exclusion of a significant number of children whose parents believed they had an allergy but whose symptoms did not meet their criteria. Including those patients would have put prevalence at 11.4%.
“This discrepancy underscores the importance of improving patient access to physicians trained in the accurate diagnosis of FA to prevent placing families under the social, emotional, and economic burden of unnecessarily avoiding foods to which they are not truly allergic,” authors wrote.
Guidance on food allergies has evolved in recent years following the findings of the Learning Early About Peanut allergy (LEAP) study that found early peanut exposure to be beneficial to infants who are at risk of peanut allergy. The Academy subsequently endorsed guidelines calling for early introduction based on an infant’s risk level.
Researchers said their study, which breaks down allergies by age, may provide a reference point for future studies on the impact of the peanut guidelines.
“Understanding reported prevalence, types of FA, associated symptoms and severity, diagnosis and management practices, and determinants of FA is critical for clinicians, researchers, and policymakers in their efforts to address this important public health issue,” they wrote.