Up to one out of every nine food exposures causing allergic reactions in kids is non-accidental, with parents and other caretakers purposefully giving their children known food triggers, a new study suggests.
Authors of the study, published Monday in the journal Pediatrics, said they are not completely sure why it's happening.
"In terms of purposeful exposures, those percentages haven't been reported before," said Dr. David Fleischer, assistant professor at National Jewish Health in Denver, the lead author of the study. "Maybe parents were testing their children to see if they had outgrown their allergy. There's going to be a follow-up study, going back to families and asking exactly why caretakers were giving these foods on purpose."
Another finding was that at least 70 percent of the 500 infants followed in the study had at least one allergic reaction over the study period, and more than 50 percent of the infants had more than one reaction -- despite the fact that parents or caregivers had already been informed of the child's allergy.
Taken together, the findings suggest that even after a food allergy diagnosis is made, children with allergies are still at risk.
Elizabeth Goldenberg of Ontario, Canada, is intimately familiar with these risks. Her 10-year-old son, Jacob, loves basketball, enjoys computer games, and is learning to play the piano. But with even the smallest exposure to nuts, he could die.
Jacob has a severe allergy to peanuts and tree nuts, confirmed by a certified allergist. When the diagnosis was made, Goldenberg realized that there was much she had to learn about how to keep her son safe.
"When he was diagnosed, I understood a little bit about food allergies," said Goldenberg, who is also author of the Onespot Allergy Blog. "But I was at the bottom of a very steep learning curve. I was actually sitting in the allergist's office with a snack containing trace amounts of peanuts. I was about to give him the exact thing he shouldn't be eating…I had no idea what to do next."
With nearly 8 percent of children in the United States affected by food allergies, researchers across the United States are trying to better understand how to counsel parents, such as Goldenberg, in dealing with the diagnosis.
The new study is the first of its kind to look at the frequency and circumstances of food reactions after families were counseled on avoidance. The researchers wanted to identify areas for improvement in parent education, as well as the specific reasons why children with known allergies were developing reactions.
Unlike most studies, which use surveys of allergic reactions, this research followed infants prospectively, or over the course of years.
"There really aren't a number of large studies that have reported reactions in a prospective way," Fleischer said. "There also aren't a lot of studies looking at this very young age population."
What the researchers found was that most food exposures leading to allergic reactions were accidental, with milk, egg, and peanut being the most common culprits. The majority of reactions were attributed to a lack of vigilance -- forgetting to check ingredients, for example -- but over half of these incidents occurred when food was being provided by caretakers other than parents.