New research from UCLA Health shows that emergency room visits for food-induced allergic reactions have climbed steadily since national guidelines began recommending early introduction of allergenic foods to prevent allergies. The findings, appearing in The Journal of Allergy and Clinical Immunology: Global, underscore the need for further research into how early allergens should be effectively introduced to babies.
Why it matters
Food-induced allergic reactions are a major driver of pediatric emergency department (ED) use and can lead to life-threatening anaphylaxis. The most recent national guidelines encouraging earlier introduction of allergenic foods in infancy aim to prevent food allergy development, but the impact of these recommendations on real-world clinical outcomes has been unclear. Understanding whether these guideline changes correlate with patterns of ER visits for food reactions helps inform clinical guidance and parental counseling.
What the study did
Researchers conducted a retrospective analysis of 67,059 pediatric emergency room encounters at UCLA between 2013 and 2024. They identified food-induced allergic reactions (FIRs), including food-induced anaphylaxis (FIA), among children aged 0–5 years. Trends were assessed over time in infants (0–1 years) and children aged 2–5 years. Researchers also evaluated differences in ER visit rates before (2013–2016) and after (2022–2024) national early allergen introduction guidelines, adjusting for clinical and demographic factors known to contribute to food allergy.
What they found
ER visits for food-induced reactions and anaphylaxis rose significantly over time among infants, increasing more than fourfold from 2013 to 2024. Infants in the post-guideline period (2022–2024) had more than twice the odds of presenting with a food-induced reaction compared with the pre-guideline period (2013–2016) after adjusting for related clinical/demographic factors that contribute to food allergy.
No significant increase in food reaction or anaphylaxis rates was observed in children aged 2–5 years.
Rates of refractory (severe) anaphylactic reactions remained stable across age groups.
Infants with preexisting eczema were at especially high risk for ED visits due to food reactions.
From the experts
“These findings suggest that while early allergen introduction may reduce long-term allergy risk, it also coincides with increased emergency visits for food reactions in infancy,” the authors note. “This highlights the need for more guidance for parents, particularly in high-risk infants, to ensure safe implementation of early feeding recommendations.”
What’s next
Further research is needed to measure guideline adoption directly, explore factors contributing to increased ED utilization, and develop strategies to support families in recognizing and managing food reactions in infants.
