RX Review: Closing knowledge gaps in pediatric allergy management
In part 4 of this 5-part series, panelists discuss gaps in pediatric food allergy care, stressing better diagnosis, education, and management.
In this Contemporary Pediatrics and HCPLive RX Review discussion, moderator Brian Schroer, MD, speaks with Colleen Kraft, MD, and Russell Traister, MD, about the most pressing gaps in clinician knowledge surrounding management of pediatric food allergy and anaphylaxis.
Kraft identifies a need for better understanding of IgE-mediated versus non-IgE-mediated allergies, emphasizing their differing treatment approaches. She also highlights uncertainty around when to refer patients for immunotherapy and how to assess whether food allergies may be outgrown. Additionally, she notes the complexity of diagnosing mixed IgE and non-IgE conditions, such as eosinophilic esophagitis in infants with reflux.
Traister stresses the ongoing challenge of educating primary care providers on early allergen introduction. While many now recognize its benefits, practical concerns remain—such as appropriate serving sizes, timing, and ensuring caregivers understand how to introduce allergens safely.1
Schroer points out that standardized allergy education is inconsistent across medical training programs. He and Traister agree that proprietary food allergy panels create confusion, often leading to unnecessary food restrictions. They emphasize that history is more valuable than broad testing and that proper training on interpreting results is essential to prevent harm from misdiagnosis or unnecessary dietary limitations.
Our Panelists:
Brian Schroer, MD, is an allergist-immunologist at the Cleveland Clinic Children's Hospital. Board-certified in internal medicine, pediatrics, and allergy and immunology, Schroer serves as the moderator for this panel discussion.
Colleen Kraft, MD, is a clinical professor of Pediatrics at the Keck School of Medicine of USC and an attending physician at the Children’s Hospital Los Angeles. In addition to these roles, Kraft is also the former president of the American Academy of Pediatrics.
Russell Traister, MD, is a pediatric allergy and immunology specialist at Allegheny Health Network’s Pediatric Institute. Board-certified in allergy, immunology, and internal medicine, Traister serves as the third panelist for our discussion.
Reference:
1. Chan ES, Abrams EM, Hildebrand KJ, Watson W. Early introduction of foods to prevent food allergy. Allergy Asthma Clin Immunol. 2018;14(Suppl 2):57. Published 2018 Sep 12. doi:10.1186/s13223-018-0286-1
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