SEATTLE — Milk allergy was the most common food allergy among children age <5 years in the U.S., but only around one in four young children with milk allergies had prescriptions for epinephrine auto-injectors, according to researchers here.
In a nationally representative survey of >50,000 U.S. households with children, the milk allergy prevalence was 1.9% among U.S. children, with just over half of children with food allergies age <1 year having a milk allergy, reported Christopher Warren, PhD, of the Northwestern Feinberg School of Medicine in Chicago, and colleagues, at the American College of Allergy, Asthma, and Immunology (ACAAI) annual scientific meeting.
“Children in the U.S. spend their early years drinking milk, so it’s important to know that many of them — at least in the first few years — may be allergic,” Warren said.
The survey-based study also suggested that just 26% of milk-allergic U.S. children are prescribed epinephrine auto-injectors, which is the lowest prescription rate among the top nine food allergies, said co-author Ruchi Gupta, MD, MPH, also of Northwestern.
ACAAI spokesperson Neeta Ogden, MD, said the finding was of concern, but not particularly surprising.
“Milk allergies don’t tend to set off the same alarms that peanut and other food allergies do,” Ogden told MedPage Today. “The perception, even among many pediatricians, is that milk allergies just cause eczema, and that they are not life threatening. That may be true for some children, but it is not true for all of them.”
Gupta told MedPage Today that pediatricians, and other healthcare professionals, often miss milk allergies in young children, or misdiagnose them as lactose intolerance or other conditions.
“It is important to know the distinction because food allergies can be life threatening,” she said. “It is important to know that up to age 5, milk allergy is the most common food allergy and up until the teen years, is the second most common food allergy.”
The randomized, cross-sectional survey conducted from October 2015 to September 2016 was administered to 53,575 parents from a representative sample of U.S. households with children. Data regarding demographics, allergic symptoms and severity, diagnosis, and baked milk tolerance were collected and analyzed as weighted proportions.
Adjusted models were estimated to examine association of these factors with odds of milk allergy.
“Our findings suggest that while milk allergy is relatively common during infancy, many children are likely to outgrow their milk allergies,” Warren noted. “We observed that while an estimated 53% of food-allergic infants under age 1 have a milk allergy, the number drops to 41 percent of 1-2-year-olds, 34 percent of 3-5-year-olds and 15% of 11-17-year olds.”
Gupta noted that while many kids are likely to outgrow milk allergies, a significant percentage of teenagers still have them. “The take-home message to clinicians is that children with IgE-mediated milk allergies need to have epinephrine,” she said.
Study author R Gupta reported consulting for Aimmune Therapeutics, Mylan, and Thermo Fisher Scientific.