26 May 2022

Nervous parents need help navigating allergy prevention

Clinical

Experts are warning parents to be wary of "natural" skin creams that may contain food products, as these up the risk of developing an allergy.


Nervous parents may need help navigating new allergy advice and protecting their children against lesser-known risks, such as how to safely feed them potential allergens and what skin products to avoid.  

Many parents might not realise that their child’s risk of developing food allergies had increased through topical exposure before that food was ingested, said Maria Said, CEO of Allergy & Anaphylaxis Australia, and co-chair of the National Allergy Strategy. 

The main risk of this was from using one of the many skincare products that contain food ingredients, she told doctors at the Australasian College of Dermatologists’ Annual Scientific Meeting

“If a baby is sensitised to a food through their skin rather than their gut, the child is more likely to develop an allergy to that food,” said Ms Said. 
“It’s a real issue, especially for babies with eczema who haven’t yet been introduced to foods. 

“Are we all up on what creams and lotions contain food allergens? How many people know that Bepanthen contains a nut oil?” 

But this risk could be reduced by avoiding moisturisers with food ingredients, washing hands before applying moisturiser to infants and being careful with “natural” moisturiser products, she said. 

There were also reports of adults developing allergies after using skincare products containing food such as goat’s milk, Ms Said said. 

“Anything that says it’s ‘natural’ rings alarm bells because it often has food of some sort, whether it’s nut oils, sesame oil, milk or egg. Food should be eaten, not placed on the skin.” 

People with inflammatory skin conditions should be especially cautious of skin products with goat’s milk or other potential allergens, according to new Victorian research. 

The paper, published in Clinical & Experimental Allergy, catalogued seven cases in which patients with conditions such as atopic dermatitis went on to have anaphylaxis after ingesting goat’s milk or cheese products, following a period of using goat’s milk skin products. 

“Our findings provide novel evidence of the origins of adult-onset milk allergy and adds to the growing body of evidence that use of foodstuffs as therapy for inflammatory skin conditions can lead to the development of new food allergies.” 

Some parents have been left uncertain about the allergy guideline backflip, which went from advising parents to avoid potential allergens in their young children to encouraging them to, according to Ms Said.  

“They’d heard about fatalities to peanuts and people didn’t know how to introduce the common allergy-causing foods,” she said. “We’d see people taking their babies to hospital car parks and feeding them there because they were just so frightened.” 

The Australasian Society of Clinical Immunology and Allergy (ASCIA) now advises parents to introduce common allergy-causing foods to babies’ diets at around six months, when the baby is ready, before their first birthday but not before four months. 

But parents needed more advice about how to introduce these foods safely, Ms Said said.  

“There has been an increase in choking in babies,” she said. “So we have to be conscious that when we’re encouraging parents to introduce these foods early that we’re telling them to introduce them in the right form.” 

Infants should be given well-cooked egg, smooth peanut butter, other nut pastes, wheat, and cow’s milk such as yogurt or cheese. 

These foods, and other potential allergens such as shellfish, sesame and soy, need to be kept in the child’s diet at least twice a week. But Ms Said noted that parents didn’t need to worry about giving all the potentially allergenic foods twice each week. Instead, they could simply focus on foods that were regularly in the family diet.  

But this meant that there was a need for doctors and parents with food allergies themselves to discuss how to safely introduce foods to their children. 

Ms Said also emphasised that doctors needed to explain that food allergies could not be prevented in all children.