Achi news desk-
With nearly 600,000 Canadian children dealing with food allergies, some caregivers and their children face a feeling of constant worry.
Rebecca Cooper from St. Thomas, Ont., is one such caregiver. Her 13-year-old son Bergen Eckert is allergic to peanuts, sesame, chickpeas, as well as most other nuts except almonds.
Even though it’s all known, Cooper says she’s constantly worried when she goes into a “new food environment.”
“Things like birthday parties or sleepovers, they just weigh me down a lot more with him,” she told Global News.
Before the COVID-19 pandemic, Eckert began a therapy called oral immunotherapy (OIT), which for decades has seen food allergens presented in very small amounts and then gradually increasing doses until they can eat a certain amount without reaction.
Although they could not continue due to the pandemic and her concerns about hospital safety, Cooper said her son was able to tolerate the therapy to some extent.
“I know there are a lot of parents who would (consider OIT) and … I understand that because I was a parent who wanted to do that at one point,” Cooper said.
“I think there are a lot of guidelines that could be very helpful.”
Dr. Douglas Mack, McMaster University professor in the Department of Paediatrics, along with several other researchers from around the world have released new guidelines with the hope of helping to improve OIT.
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Recommendations include providing a “robust” standardized education process to help clinicians better prepare caregivers and patients for OIT, ensuring adequate parental supervision for the therapy, and identifying risk factors that may prevent the use of OIT.
“We know that if we adequately prepare these families, it can be safer, more effective, more successful and have a much, much smoother course,” she said. “The families feel empowered, and I think overall they get a better outcome.”
According to the study, the guidelines provide recommendations for clinicians to implement but there is no mandatory requirement from any governing body for them to be used.
Food Allergy Canada executive director Jennifer Gerdts, who is also the mother of two adult males with allergies, said OIT has shown success, even among those who stopped after the treatment stopped working.
“There is some relief in the quality of life, and a reduction [in] concern,” he told Global News.
He said the new guidelines for OIT could improve how it is administered among patients, adding that patients would have a better understanding of the treatment and the potential risks associated with it.
OIT has been carried out in clinics and in hospitals, but it also takes place at home under the guidance of an allergist. However, some parents may not have had any formal training or informed consent process on the therapy.
“They are basically amateur medical professionals with no significant training,” Mack told Global News.
“It’s no use if the families fall apart on us and the therapy ends. It doesn’t help the kids and it doesn’t help the whole scenario in the long run.”
According to the American Academy of Allergy Asthma and Immunology, OIT used for allergens such as peanuts, eggs and milk has shown to desensitization in about 60 to 80 percent of patients studied. However, he notes that it is not yet “certainly known” whether desensitization can protect patients from accidental exposures in the real world.
Gerdts said one of the major barriers to accessing OIT is cost, noting that some people may have to pay. He argued that policymakers needed to take more steps to make allergy treatment more widely available.
“This is a chronic disease that can be treated, but the big elephant in the room is access,” he said. “All these things are good and healthy. But if you can’t access it, it’s not going to have enough of an impact on the community.”
The guidelines can also help determine whether OIT will be successful by identifying risk factors, such as uncontrolled asthma or lack of food, that could prompt the end of therapy. In addition, recurrent severe reactions requiring epinephrine may also lead to treatment discontinuation, according to Mack.
“Those are just some of the reasons why we would say, listen, it’s time we seriously consider whether this is in the best interests of your child, and if perhaps simply avoiding the food would be better for you,” he said. He said.
Mack added that he recognizes the burden of asking caregivers to monitor children during OIT, but the hope is that by properly preparing parents and patients for the daily therapy, it could lead to better success.
