Objectives: Within this article we sought to discuss the recent changes in the management
of children with food allergies from a Dietitian’s perspective. The mainstay of treatment for
food allergy remains allergen avoidance, however over recent years a move towards a more active
approach to allergy management has meant changes in practice, such as the introduction of baked
milk and egg in the diets of some children with IgE mediated milk and egg allergy and safe selective
nut eating for some children with single or multiple nut allergies.
Methods: During the article we review the evidence and provide practical advice on aspects of food
allergy management including the introduction of baked milk and egg in to the diets of children
with IgE mediated milk and egg allergy who are baked milk and/or egg tolerant; discussing challenge
criteria, challenge protocols and practical dietary advice post negative challenge.
Conclusion: Following on from this we explore the use of the safe selective nut eating in children
with single or multiple nut allergies including discussion around how clinical practice has changed
in recent years, the preliminary results of the PRONUT study and finally move onto the provide
practical guidance that safe selective nut eating.