Ready-to-use introduction schedules for first exposure to allergenic foods in children at home.
BACKGROUND
The vast majority of children will undergo their first exposure to common allergenic foods at home. However, the first exposure may lead to clinical reactions. It has been proposed to introduce allergenic foods gradually into the diets of children at risk for food allergy, but no practical dietary advice has been devised.


OBJECTIVE
The aim of this study was to devise safe introduction schedules for common allergenic foods for use at home, based on the challenge doses as administered in double-blind, placebo-controlled food challenge (DBPCFCs) in children who were never exposed previously to these foods.


METHODS
Seventy-two DBPCFCs were performed in 63 children as a first known exposure. The incrementing challenge doses were converted into equivalent portions of these foods in their usual household form and incorporated in introduction schedules. The feasibility of the introduction scales was tested in parents of the children attending our clinic.


RESULTS
Based on the results of the positive challenges (37) in which severe reactions did not occur, detailed introduction schedules and a reference photograph of the required increasing amounts of food were devised for use at home. Feasibility testing showed that, when using these introduction schedules, parents portioned the initial doses significantly lower than without detailed instructions.


CONCLUSIONS
The introduction schedules and reference photograph provide information for parents to introduce the required amounts of allergenic foods in initial low doses at home. This is expected to improve the safety of this procedure.
Vlieg-Boerstra
B J
BJ
Department of Paediatrics, Division of Paediatric Pulmonology and Paediatric Allergy, University Medical Centre Groningen, University of Groningen, the Netherlands.
Dubois
A E J
AE
van der Heide
S
S
Bijleveld
C M A
CM
Wolt-Plompen
S A A
SA
Oude Elberink
J N G
JN
Kukler
J
J
Jansen
D F
DF
Venter
C
C
Duiverman
E J
EJ
D000284:Administration, Oral; D000293:Adolescent; D000485:Allergens / Q000276:immunology; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D004032:Diet / Q000592:standards*; D004044:Dietary Proteins / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005240:Feasibility Studies; D005260:Female; D005512:Food Hypersensitivity / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010290:Parents / Q000193:education; D012882:Skin Tests
D000485:Allergens; D004044:Dietary Proteins