Severe allergic reactions in infants often untreated

Severe allergic reactions among babies with food allergies are common, but caregivers fail to give potentially life-saving injections when infants are at risk of arrested breathing in about two-thirds of cases, U.S. researchers have found.

Parents can be reluctant to inject epinephrine

Severe allergic reactions among babies with food allergies are common, but caregivers fail to give potentially life-saving injections when infants are at risk of arrested breathing in about two-thirds of cases, U.S. researchers have found.

To find out about the frequency, circumstances and responses to food allergies among infants, researchers studied 512 infants aged three to 15 months who were diagnosed with allergies to milk, eggs or peanuts or likely had such an allergy.

Potentially life-saving epinephrine injections are often not administered even when they are available and needed. (Stock)

Over three years, reactions were reported in more than half of the children.

"There was a high frequency of reactions caused by accidental and non-accidental exposures," Dr. Scott Sicherer, of Mount Sinai School of Medicine in New York City and his co-authors concluded.

"Undertreatment of severe reactions with epinephrine was a substantial problem."

About one in 10 reactions were severe, and of those, only 30 per cent were treated with epinephrine, a potential life saver.

"One thing we can learn from the study is the importance of reminding parents and caregivers [on] reading food labels, being extra careful in food preparation and not being afraid to administer epinephrine if necessary if a child is in distress and needs to be treated because of a severe reaction," said CBC’s medical specialist Dr. Karl Kabasele.

Recognizing reactions

Some caregivers in the study said they were afraid to inject epinephrine, which shows the need for education and reassurance about the treatment, the researchers said.

They said other factors included lack of recognition of the severity of a reaction and unavailability of epinephrine.

In just over half of the reactions, the food was provided by someone other than the parents.

Nearly 89 per cent of the reactions were accidental and 11 per cent were purposeful exposures to avoided foods.

Some reactions may have been missed, parents' recall about the reactions could have been incomplete and they may have been reluctant to report purposeful exposures, the researchers said.

In some cases, reactions occurred to a food that was given in a larger amount than before, a nuance for doctors to consider when taking a medical history of young children with possible food allergies.

Most of the participants were white and middle class, and the findings may not apply for other populations.

An earlier Canadian study of children with an average age of eight suggested an annual rate of 14 per cent for peanut allergies.

The research was funded by the U.S. National Institutes.