Sometimes very restrictive, food allergy affects many children. In Switzerland about 5% are concerned. New therapeutic leads now make it possible to consider a cure. How to treatment with Oral Immunotherapy for food allergies in Children. Lets discuss:
Oral Immunotherapy Treatment for Food Allergies
For parents, an allergic child is often a source of stress. It is difficult for them to control their food intake (nursery, school, processed products). Unlike an intolerance that causes an exaggerated digestive reaction to a food, but without ever threatening the patient’s life, the food allergy, linked to a disruption of the immune system, can in the most serious cases lead to a reaction. severe respiratory illness (anaphylaxis). In children, the main foods responsible for allergies are cow’s milk, eggs, nuts or peanuts.
In most cases, the allergy is suspected when introducing the first foods to the baby. The usual signs are jet vomiting, repeated diarrhea or constipation, or asthma. All of this usually against the backdrop of stunted growth. Confirmation of the diagnosis of food allergy is made in an allergist, after examination of the clinical picture completed by skin, blood and sometimes oral tests. These tests need to be reevaluated regularly during childhood – every two or three years – because it happens that many allergies heal spontaneously over time.
The predatory scheme, a must
Once the diagnosis of allergy has been made by the doctor, an exclusion regime must be put in place. The offending food will be totally removed from the child’s diet. Hence the importance of ensuring the composition of industrial products and the establishment of an Individualized Reception Protocol (IAP) at school or nursery. This system of exclusion, which must be conducted with rigor, is sometimes very restrictive, hence the interest aroused by new desensitization therapies.
“It is also important to take into account the risk of cross-allergies,” explains Professor Philippe Eigenmann of the Pediatric Allergy Service at Geneva University Hospitals (HUG). For example, a child allergic to cow’s milk should avoid eating sheep’s milk or goat’s milk, and a child allergic to nuts will avoid peanuts “unless previous consumption has not shown an allergic reaction”.
How to prevent allergy in children
While some food allergies are linked to a genetic predisposition, other risk factors exist. The late integration of certain foods, for example. It thus appears that starting dietary diversification early, from the age of four months, without delaying the introduction of foods at risk of allergy, is beneficial. Maintaining regular consumption of risky foods would also help maintain tolerance. On the other hand, there is nothing to indicate that the exclusion of a food in the pregnant woman makes it possible to reduce the risk of allergy in the child. “For a long time, it was thought that some allergens should be avoided during pregnancy, but the effectiveness of this method is not proven,” says Professor Philippe Eigenmann of the Pediatric Allergy Service of the HUG. “Conversely,
To desensitize or increase the threshold of tolerance to a food, this is what offers specific immunotherapy. The principle is simple: you heal evil with evil. Numerous observations have indeed shown that the regular administration of a food, at minimal and then progressive doses, allowed in the long term to reduce the risk of allergic reaction. To treat a food allergy in children, one can proceed to an oral immunotherapy. It involves ingesting regularly (every two or three days) a small dose of the offending food. The body gradually develops a tolerance to a dose of increasingly large allergen. This therapy, whose effectiveness for certain types of allergies has been demonstrated, has allowed for example the daughter of Maria, 8 years old, to finish with her egg allergy. After a first step performed in a hospital to eliminate a risk of serious allergy, reintroduction continued at home. “I introduced into her diet, day after day, increasing doses of cooked egg, explains the mother. We then integrated raw eggs little by little, up to a maintenance dose equivalent to half a egg.
But oral immunotherapy is not a miracle solution. Very demanding, it must be applied scrupulously several years without interruption, at the risk of returning to the point of departure, that is to say losing the tolerance acquired. It also carries a risk of a major allergic reaction, even in case of low food intake.
Although promising some hope, oral immunotherapy is not systematically indicated. “We do not practice it in routine treatment. It’s something we’re discussing but it’s not easy to put in place, says Professor Eigenmann. It is offered instead in very sensitive patients, who are unlikely to naturally lose their allergy.
And the patch?
Other therapeutic approaches, still experimental, seem promising, especially in terms of constraints for the patient. The first is to place the food under the tongue daily for a few minutes, while the second is to apply it on the skin, thanks to a patch changed regularly.
Although their effectiveness has not yet been confirmed in children, these methods seem to have fewer side effects and open the door to great therapeutic advances in healing. “It’s much easier to patch than to eat the food every day,” says the HUG specialist. It is likely that we will soon find a simple and effective treatment of food allergy.
What to do in case of accidental ingestion
Parents of allergic children are well aware of this, and despite sustained attention to maintaining a predatory diet, it is necessary to have a first aid kit at all times. It should contain an oral antihistamine for urticaria that occurs soon after ingestion, as well as an adrenaline pen for anaphylaxis.
If vomiting occurs after ingestion – without further complications – oral rehydration should be given. If the child, in addition to vomiting, becomes lethargic, emergency hospital care is necessary.