Allergy

Food allergies, especially those related to young children, occur when the immune system mistakes certain foods for harmful substances. Common allergens include peanuts, tree nuts, milk, eggs, wheat, soy, fish, shellfish and sesame seeds. 

Research shows early introduction of allergenic foods might lower the risk of food allergies. Paediatric guidelines now recommend introduction of allergenic foods such as peanuts and eggs to infants at around 4 to 6 months old. For those diagnosed with food allergies, early management is key to preventing accidental exposure and unwanted reactions, thus improving their quality of life.

The food ladder provides a structured approach to reintroducing allergenic foods (e.g. egg and milk) into the diet of individuals with food allergies. It involves starting with small, well-tolerated amounts of the allergen in specific forms (e.g. baked egg in muffins), and gradually increasing the quantity and allergenicity. For example, the milk ladder begins with baked milk products and progresses to less processed forms of milk (e.g. cream soup and boiled milk). This method helps build tolerance and can be tailored to individual needs and responses.

Oral Immunotherapy (OIT) is a treatment that involves consuming small, increasing amounts of an allergenic food under medical supervision. The goal is to desensitise the immune system to the food allergen, allowing patients to tolerate more significant amounts without severe reactions. OIT typically begins with very low doses and gradually increases over several months. This treatment requires close monitoring by healthcare providers to manage any adverse reactions. 

Our OIT protocol comprises high dose and low dose treatments. Most patients can tolerate normal daily intake doses after high dose treatment (e.g. 9 peanuts, 120 ml milk or 1 egg) while those with low dose treatment can tolerate a small amount (e.g. 1 peanut) which can substantially reduce the risk of reactions from accidental intake.