Question special

This is certainly an interesting and exciting article, and will shape our approach to food allergy in the future. To get us started, I thought it would be interesting to discuss a clinical question regarding what the experts have historically been doing in their clinic with patients like those in the study. As briefly discussed in the background portion of the paper, the guidelines (about whether avoidance or introduction of peanut would be more effective for prevention of peanut allergy) have changed over the past 17 years. Recently, we have not been recommending avoidance, but the recommendations are complicated, and cases are often even more complicated than the guidelines cover.

For your infant patients with severe eczema, egg allergy, or both, what had previously been your approach to introduction of peanut? What about other foods such as milk, wheat, soy? At what age have you been performing testing and by what method (challenge; skin testing; serum IgE or some combination)?