Background and objective: The incidence of food allergy among children is on the rise. Children who are diagnosed with a food allergy receive long-term treatment for allergy management from allergy specialists, nurses and dieticians. This management may include the prescription of an adrenaline autoinjector (AAI) if the child is at risk of a severe allergic reaction (anaphylaxis). Therefore, it is important that parents of children with allergies are trained in the recognition of anaphylaxis and in the correct administration of an AAI. However, many parents are unable to correctly administer an AAI when assessed. The aim of this study is to review the current literature on caregiver’s and paediatric patients’ ability to use an AAI. Methodology: An electronic search to evaluate AAI technique in caregivers and children with food allergy was conducted. A total of 323 articles were screened in which 10 studies were reviewed. Results: Seventy-eight percent of parents who had never been trained in the use of an AAI were unable to trigger it. In studies where paediatric patients’ ability to use an AAI was assessed, a mean score of 7.78/9 was derived for AAI knowledge among adolescents. Conclusion: Caregivers and patient’s ability to use an AAI was inconclusive, and further research should address the validation of an assessment tool for AAI use. A significant improvement in AAI use was found after an educational intervention. This highlights the need for improved education for allergic individuals and their caregivers, and further study should explore what are the best educational methods to meet these needs.

Background: Anaphylaxis is a systemic, life-threatening reaction and its prevalence is rising amongst adolescents and young adults (AYA) with food allergies. The likelihood of fatal anaphylaxis is disproportionately high in this population. The effective management of anaphylaxis can be done by adhering to various food allergy-related self-care behaviours, namely avoidance of allergens, carriage and use of adrenaline auto-injectors (AAI). Unfortunately, compliance of AYA to these behaviours is believed to be suboptimal and the likely reason behind their increased rates of fatal anaphylaxis. Methodology: To evaluate the adherence to food allergy-related self-care behaviours amongst adolescents and young adults with anaphylaxis an electronic search was conducted utilizing PubMed, MEDLINE, and CINAHL plus to identify relevant studies. 175 article abstracts were screened, and 26 remained which were read in full to determine which best satisfied the inclusion and exclusion criteria. Ultimately, 10 articles were selected for this review. Results: The compliance to food allergy-related self-care behaviours amongst AYA founded to be suboptimal. AAI design, peer influence, and emotional attitudes of AYA were found to be the most significant factors influencing AYA compliance to self-care behaviours. Conclusions: The adherence of AYA to food allergy-related self-care behaviours is subopti-mal and evidence on the factors affecting AYA compliance has been largely contradictory. AAI design, peer influence, and emotional attitudes are significant factors influencing AYA adherence. Therefore, further research directed at these factors is imperative in facilitating the design of guidelines to maximize the adherence of AYA to food allergy-related self-care behaviours.

IgE-mediated cow’s milk protein allergy (CMPA) is one of the most prevalent food allergies in early childhood. Though the cornerstone of management involves the strict avoidance of milk products while awaiting natural tolerance, research increasingly shows that the rates of resolution are slowing down. Therefore, there is a need to explore alternative pathways to promote tolerance to cow’s milk in pediatric populations. This review aims to combine and appraise the scientific literature regarding the three CMPA management methods: avoidance, the milk ladder, and oral immunotherapy (OIT) and their outcomes in terms of efficacy, safety, and immunological effects. Cow’s milk (CM) avoidance virtually protects against allergic reaction until natural tolerance occurs, with hypoallergenic substitutes available in the market, but accidental ingestion represents the main issue for this strategy. Introduction to baked milk using the milk ladder was designed, with most CMPA patients successfully completing the ladder. Similar to baked milk treatment, many OIT protocols also demonstrated decreased IgE and increased IgG4 levels post protocol, as well as a reduction in wheal size diameter. Though these strategies are shown to be safe and effective in CMPA, future clinical trials should compare the safety and effectiveness of these three management strategies.

Adrenaline auto injectors (AAI) are the mainstay of treatment in anaphylaxis. However, many caregivers of children with food allergies are unable to administer an AAI when assessed. One proposed factor for this finding is the lack of training and familiarity of the different AAI devices. The aim of this study is to explore the usage of different brands of adrenaline auto-injectors among caregivers of children with food allergies in Ireland. A cross-sectional study method was employed using an online questionnaire. An amount of 121 (75.58%) caregivers reported that their child carried an Epipen®, 25 (15.82%) carried Jext®, and 12 (7.59%) carried Anapen®. An amount of 48.73% (n = 77) of caregivers had switched brands of AAI at least once before, with lack of availability of their usual device at their pharmacy being the most common reason for this. Factors associated with change were a household income >100,000 € (70% vs. 44.9% of those with less income; p = 0.04) and parents ≥40 years old (59.6% vs. 32.8% of patients whose parents younger; p < 0.01). When asked what they preferred about a particular AAI brand, caregivers appreciated a simple design with minimal steps involved in administration, clear colour coding, online resources, formal training from a healthcare professional, and first-hand experience in using the AAI. These findings show, for the first time, that switching brands is a common occurrence among caregivers of children with food allergies. These findings support the EAACI recommendation to train parents regularly in all available brands of AAI and to retrain parents when switching to different devices.

Background and objectives: IgE-mediated egg allergy is commonly found in the paediatric population. Traditionally, management of egg allergy was through egg avoidance. The Irish College of General Practitioners and other paediatric societies across the globe recommend reintroducing egg into the diet to improve tolerance and quality of life. Oral immunotherapy (OIT) has been emerging as a potential method to induce desensitisation and even long-term tolerance in children with egg allergy, with many trials reporting significant differences after its implementation. The aim of this study is to combine and appraise the literature on OIT methods that have been trialed to improve tolerance in paediatric populations with IgE egg allergy and their outcomes. Methodology: A search strategy based on the objectives of this review was used to conduct electronic searches on PubMed and Wiley Online Library. After the application of filters, 152 articles were obtained and after application of the inclusion and exclusion criteria, ten articles satisfying the criteria of this review were identified.