AAAAI 2019—Oral food challenges in infants: how safe are they?


  • Emily Willingham, PhD
  • Conference Reports
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Takeaway

  • Food-based oral food challenges are largely safe and well-tolerated among infants, with anaphylaxis a rare event.
  • Infants who have peanut anaphylaxis tend to have egg allergy and severe eczema.

Why this matters

  • Oral food challenges are the common approach for diagnosing suspected food allergy, but their safety in infants is not well established.

Key results

  • Infants had either oral food challenge (n=50) or observed first ingestions (n=28).
  • 70% were a success.
  • 12% (6/50) had anaphylaxis with oral food challenge:
    • None mild.
    • 3 moderate.
    • 3 severe.
    • Epinephrine administered in all cases, with 2 doses in 3.
  • With observed first ingestions, 1 case of anaphylaxis (severe), epinephrine administered.
  • 6/7 of the anaphylaxis cases involved peanut challenge; the other was egg.
  • No emergency department transfers or hospital admissions.

Study design

  • Frequency, outcomes of oral food challenge, observed first ingestions among infants in an allergy clinic, 2017-2018.

Limitations

  • Relatively small population; not peer-reviewed.