Guidelines on allergy prevention and FPIES in the latest issue of the MJA
The second MJA issue for 2019 is out now and features a range of articles of interest to GPs. Among the research papers and letters this month are a summary of guidelines for infant feeding for allergy prevention, and a guidelines summary and practice recommendations for food protein‐induced enterocolitis syndrome.
The Australasian Society of Clinical Immunology and Allergy have provided a summary of the guidelines for infant feeding and early onset allergy prevention. Originally published in 2016, the article describes recent changes to recommendations.
Specifically, the guidelines now recommend the introduction of solid foods at around six months of age, peanut and egg in the first year, and no longer recommend hydrolysed formula for prevention of allergic disease. The article also discusses methods for introducing peanuts to the diet of high risk infants.
Elsewhere in the latest issue, a narrative review outlines the lack of understanding of food protein‐induced enterocolitis syndrome (FPIES), a non‐IgE gastrointestinal‐mediated food allergy that predominantly affects infants and young children. The authors of the article explain that diagnosis of FPIES is hampered by lack of awareness and is regularly misdiagnosed as sepsis or gastroenteritis.
The article includes recommendations from the 2017 international consensus guidelines to assist in treating patients with FPIES. Recommendations include ensuring fluid resuscitation for acute presentations, consideration of ondansetron for management of an acute FPIES reaction, and managing the condition through the avoidance of the trigger food.
You can hear Professor Dianne Campbell, Chair of Paediatric Allergy and Clinical Immunology at the University of Sydney and the Children's Hospital, Westmead, discuss FPIES on the MJA Podcast.
The issue also features a calendar of conferences in Australia and New Zealand in 2019.