ÎIndividuals with FA and their caregivers should receive education and training on how to interpret ingredient lists on food labels and how to recognize labeling of the food allergens used as ingredients in foods. Products with precautionary labeling, such as ''this product may contain trace amounts of [allergen]'' should be avoided. (B-III)
ÎThere are no medications currently recommended to prevent IgE- mediated or non-IgE-mediated food-induced allergic reactions from occurring in an individual with existing FA. (A-II)
Treatment ÎTreatment for food-induced anaphylaxis should focus on the following: (A-II)
> Prompt and rapid treatment after onset of symptoms (see Table 2) > Intramuscular (IM) epinephrine as first-line therapy > Other treatments, which are adjunctive to epinephrine dosing
ÎAllergen-specific immunotherapy or immunotherapy with cross-reactive allergens is NOT recommended for treating IgE-mediated FA. (A-III)
Immunizations
ÎAlthough consensus recommendations for MMRV vaccine vary from the different organizations, children with egg allergy, even those with a history of severe reactions, should receive vaccines for measles, mumps, and rubella (MMR) and for MMR with varicella (MMRV). (A-III)
Note: The safety of this practice has been recognized by ACIP and AAP and is noted in the approved product prescribing information for these vaccines.
Pregnancy and Infancy
ÎRestricting maternal diet during pregnancy or lactation as a strategy for preventing the development or clinical course of FA is NOT recommended. (A-III)
ÎAll infants should be exclusively breast-fed until 4 to 6 months of age, unless breastfeeding is contraindicated for medical reasons. (A-III)
ÎUsing soy infant formula instead of cow's milk infant formula is NOT recommended as a strategy for preventing the development of FA or modifying its clinical course in at-risk* infants. (A-II)
ÎConsider using hydrolyzed infant formulas, as opposed to cow's milk formula, as a strategy for preventing the development of FA in at-risk* infants who are not exclusively breast-fed. (B-II)
Note: Cost and availability of extensively hydrolyzed infant formulas may be weighed as prohibitive factors.
ÎThe introduction of solid foods should NOT be delayed beyond 4 to 6 months of age. Potentially allergenic foods may be introduced at this time as well. (B-III)
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