D1.274 - Evaluating adherence to and effectiveness of food allergy advice in parents of infants under 6 months old suffering from atopic dermatitis

In preventing food allergies, protecting the skin (sensitization pathway for food allergens) and early allergen introduction are key factors. French allergists have issued recommendations.¹ Our allergology service has implemented day hospitals, for infants under 6 months suffering from atopic dermatitis (AD), with a dermatology consultation,  assessment of environmental allergen exposure, and advice on early introduction.

Retrospective, monocentric study. We contacted the 43 parents of children who attended this prevention day hospital. AD assessment, frequency of consumption of different allergens, and reasons for non-consumption. Descriptive statistical analysis and McNemar test for comparing allergen consumption.

Response rate of 47.6%. AD was stable in 40% and improved in 55%. Only one child regularly consumed all recommended allergens. Reasons for non-consumption were: parents not consuming the food (36.8%), child's refusal (26.3%), consistency challenge (21.1%), small size of allergens (10.5%), and fear of a reaction (5.3%).

35% of parents received conflicting advice regarding introduction. Regular egg consumption was higher than for the other allergens (p<0.001).

In terms of prevention, advice regarding the skin seems easier to follow than allergen introduction (except for egg). The reasons are diverse: cultural factors, regularity challenges, child's refusal, and reluctance from family, friends, or other medical professionals.

Abrams' study underlines the struggle professionals face in advising on the early introduction of peanuts.²

Broadcasting these recommendations to the general public seems crucial.

1-Sabouraud D et al. Primary prevention of food allergy in 2021: Update and proposals of French-speaking pediatric allergists. Arch Pediatr. 2022 Feb;29(2):81-89. 

2-Abrams EM et al. Knowledge gaps and barriers to early peanut introduction among allergists, pediatricians, and family physicians. J Allergy Clin Immunol Pract. 2019 Feb;7(2):681-684.