New research published in Clinical & Experimental Allergy suggests that exposing young children to small amounts of foods they are allergic to—rather than avoiding them completely—may be a safer and more effective approach to managing food allergies. This method, known as oral immunotherapy (OIT), has been shown to reduce the severity of allergic reactions following accidental exposure and improve long-term outcomes.
Traditionally, food allergy management has relied on strict avoidance and carrying emergency medication such as epinephrine. However, this new review highlights the potential risks of this approach, particularly in preschool-aged children. Avoidance does not eliminate the risk of accidental exposure, which can lead to severe reactions. Additionally, delaying exposure until later in life may mean missing a critical window of opportunity where controlled introduction of allergens is safest and most effective.
One of the key findings of the study is that children who avoid allergens throughout early childhood may develop fear and anxiety around these foods. Even if they outgrow their allergy naturally, they might not reintegrate the food into their diet, potentially leading to re-sensitization and an increased risk of future allergic reactions. In contrast, OIT, when administered under medical supervision, can help build tolerance and reduce the likelihood of severe reactions.
Dr. Lianne Soller, lead author from the University of British Columbia, emphasizes that this research represents a fundamental shift in allergy management. “Moving from strict avoidance to controlled exposure in early childhood not only reduces the risk of severe reactions but also helps prevent long-term negative consequences of living with food allergies,” she explains.
Despite the promising results, experts agree that further research is needed to better understand the long-term effects of OIT, its impact on children’s quality of life, and the best practices for its implementation. While evidence supporting the safety and effectiveness of OIT in preschoolers is growing, it is essential that families consult healthcare professionals before making any decisions. The introduction of allergens should only be done under medical supervision, and parents should never attempt this approach on their own. Science continues to advance, but in the meantime, it is crucial to follow the guidance of healthcare professionals to ensure the safest and most effective management of food allergies.
Associate Professor at University of Granada