Natural history of severe reactions to foods in young children

Abstract

Nine children with very severe adverse reactions to foods during the first 2 years of life were followed to determine the subsequent course of their reactions. Cautious challenges were given in these children over a period of time. Three of nine children can tolerate the offending food in usual portions; four of nine can tolerate small amounts of the offending food; and two children continue to have reactions to small amounts of the offending food. At some time each of these children have exhibited significant positive wheal and flare reactions when skin tested with extracts of the offending food. This study demonstrates that some children with severe reactions to foods may lose their frightening reactivity to foods over time. Very careful challenges in these patients are thus justified to save families from prolonged anxiety about accidental ingestion, which inevitably occurs.