Dietary management of IgE and non‐IgE‐mediated food allergies in pediatric patients

Author:

Venter Carina1ORCID,Roth‐Walter Franziska23ORCID,Vassilopoulos Emilia4ORCID,Hicks Allison1ORCID

Affiliation:

1. Section of Pediatric Allergy and Immunology, Children's Hospital Colorado University of Colorado Aurora USA

2. Messerli Research Institute, Department of Interdisciplinary Life Sciences University of Veterinary Medicine Vienna Vienna Austria

3. Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria

4. Pediatric Unit Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan Italy

Abstract

AbstractFood allergies (FA) consist of both IgE and non‐IgE‐mediated entities, with varying phenotypes and overlapping and different considerations for each specific disease presentation. In general, all FAs place children at increased risk for inadequate nutritional intake and negative impacts on their nutritional status, as well as negative impacts on the quality of life for the entire family. To minimize these untoward effects, a multidisciplinary approach should be taken, including consultation and management with a dietitian trained in the varying presentations of FA. Families should be instructed on label reading as a first line of nutritional management. During a nutrition consultation, the age of the child, growth, and nutritional status should be considered. Food refusal should be assessed and addressed. Families should be educated on avoidance and appropriate substitutions. In the case of cow's milk allergy, a suitable specialized formula should be suggested if the infant is not breastfed or if breast milk supply is not sufficient. Other mammalian milk should be avoided and careful consideration should be given before plant‐based milk is used in young children. Specific food allergies may differ in terms of advice provided on the level of avoidance required, whether precautionary advisory labels should be avoided, and if a maternal avoidance of the allergen during breastfeeding should be advised. The role of immunonutrition on overall health should be discussed.

Publisher

Wiley

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