Ensure good control of eczema and intermittent wheezing
Investigations – Blood tests for specific IgEs (RASTs) are of limited valueand not recommended. . We will arrange all necessary investigations during MDT clinic. We strongly advise parents against pursuing alternative allergy testing including hair strand analysis and York testing which are not validated and the results will not be considered in clinic.
Dietary advice – If the allergen is clear this should be removed from the diet until seen in clinic. Please do not recommend removal of food groups from the diet that are already tolerated, or the delayed introduction of other allergenic food groups, as this could cause allergy to these foods in the future. Children who are sensitised to, but tolerant of, a food may lose tolerance and develop allergy if that food is withdrawn from the diet.
For detailed information regarding ongoing dietary advice, including weaning advice for high risk babies, please see advice leaflets in Supporting Information for Parents and Healthcare professionals.
Siblings – the presence of a sibling with food allergy does NOT increase the risk of food allergy on its own. All food groups should be introduced in a timely fashion, with referral to clinic should an immediate type reaction occur. Useful information for parents regarding this can be found in the BSACI Summary for Parents leaflet (see supporting information).
Allergy management plan – Please put an allergy management plan in place prior to being seen in clinic. This must include an appropriate antihistamine, management of wheeze, adrenaline autoinjectors if appropriate, and a BSACI management plan – link in Supporting Information.
Indications for adrenaline autoinjector carriage are (2 to be available at all times):
- Previous anaphylactic reaction to any allergen
- Previous idiopathic anaphylactic reaction
- Allergy to Peanut
- Immediate type allergic reactions to multiple food groups
- Concerns regarding adherence to allergen avoidance eg teenagers
- Parental anxiety where there is a history of an immediate type allergic reaction
Please ensure that the primary carers are trained in the use of an adrenaline autoinjector at the time of prescription. There are useful You Tube videos available to support training.
Vaccinations – All vaccinations, including MMR and seasonal influenza, are safe to be given in primary care. Please see the Department of Health Immunisation against Infectious Disease Guide (Green Book) (link in Supporting Information).