Allergists realize people who are severely allergic to a food can experience great anxiety when encountering the food in any form. Kids, in particular, can get extremely nervous about the idea of being close to someone eating peanuts or peanut butter.
An article in Annals of Allergy, Asthma and Immunology, the scientific publication of the American College of Allergy, Asthma and Immunology (ACAAI), illustrates most kids can be near food allergy triggers without fear.
"We developed the proximity food challenge to help ease anxiety in kids with food allergies," says allergist Chitra Dinakar, MD, ACAAI Fellow and lead author of the article. "The challenge allows kids with food allergies - such as to peanut butter or milk - to not only be in the same room with the food, but also to breathe in the air and have the food placed on their skin. Kids see for themselves it is safe to be near their food allergen as long as they don't eat it or get it into their eyes, nose or scraped skin. It's a great relief."
Some people with food allergies cut back on social activities or flights for fear of coming into accidental contact with food allergens. Children with food allergies are occasionally assigned to separate "allergy-free" tables in the school lunchroom, leaving them feeling self-conscious, as well as anxious that being near the food could cause a reaction. Most people with food allergies only react to ingesting the allergen. Only a very small percentage of people have a severe reaction to breathing in dust or vapor from the allergen, for example, the protein from shelling peanuts or cooking shellfish.
"We've done dozens of proximity food challenges," says allergist Jay Portnoy, MD, ACAAI past president and co-author of the article, "and the majority of children have not suffered a reaction. Actually, only one child had a hive appear. Most kids are initially scared, but when they don't have a reaction, their fears are eased, and they have a new sense of freedom. They have more confidence in being a part of their community."
Dr. Dinakar urges those with food allergies to talk to their allergist about a proximity food challenge. The one-hour procedure allows families a new alternative for evaluating ability of the child with food allergies to tolerate casual exposure, and enables them to undergo exposure to the suspect food in a controlled, safe setting.
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