{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T12:49:13Z","timestamp":1776257353973,"version":"3.50.1"},"reference-count":31,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE:<\/jats:title>\n                  <jats:p>To examine circumstances of allergic reactions to foods in a cohort of preschool-aged children.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>We conducted a prospective, 5-site observational study of 512 infants aged 3 to 15 months with documented or likely allergy to milk or egg, and collected data prospectively examining allergic reactions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Over a median follow-up of 36 months (range: 0\u201348.4), the annualized reaction rate was 0.81 per year (367\/512 subjects reporting 1171 reactions [95% confidence interval: 0.76\u20130.85]). Overall, 269\/512 (52.5%) reported &amp;gt;1 reaction. The majority of reactions (71.2%) were triggered by milk (495 [42.3%]), egg (246 [21.0%]), and peanut (93 [7.9%]), with accidental exposures attributed to unintentional ingestion, label-reading errors, and cross-contact. Foods were provided by persons other than parents in 50.6% of reactions. Of 834 reactions to milk, egg, or peanut, 93 (11.2%) were attributed to purposeful exposures to these avoided foods. A higher number of food allergies (P &amp;lt; .0001) and higher food-specific immunoglobulin E (P &amp;lt; .0001) were associated with reactions. Of the 11.4% of reactions (n = 134) that were severe, 29.9% were treated with epinephrine. Factors resulting in undertreatment included lack of recognition of severity, epinephrine being unavailable, and fears about epinephrine administration.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>There was a high frequency of reactions caused by accidental and nonaccidental exposures. Undertreatment of severe reactions with epinephrine was a substantial problem. Areas for improved education include the need for constant vigilance, accurate label reading, avoidance of nonaccidental exposure, prevention of cross-contamination, appropriate epinephrine administration, and education of all caretakers.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2011-1762","type":"journal-article","created":{"date-parts":[[2012,6,27]],"date-time":"2012-06-27T07:29:18Z","timestamp":1340782158000},"page":"e25-e32","source":"Crossref","is-referenced-by-count":228,"title":["Allergic Reactions to Foods in Preschool-Aged Children in a Prospective Observational Food Allergy Study"],"prefix":"10.1542","volume":"130","author":[{"given":"David M.","family":"Fleischer","sequence":"first","affiliation":[{"name":"National Jewish Health, Denver, Colorado;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamara T.","family":"Perry","sequence":"additional","affiliation":[{"name":"University of Arkansas for Medical Sciences, Little Rock, Arkansas;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Atkins","sequence":"additional","affiliation":[{"name":"National Jewish Health, Denver, Colorado;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert A.","family":"Wood","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine, Baltimore, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. Wesley","family":"Burks","sequence":"additional","affiliation":[{"name":"Duke University Medical Center, Durham, North Carolina and University of North Carolina, Chapel Hill, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacie M.","family":"Jones","sequence":"additional","affiliation":[{"name":"University of Arkansas for Medical Sciences, Little Rock, Arkansas;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice K.","family":"Henning","sequence":"additional","affiliation":[{"name":"The EMMES Corporation, Rockville, Maryand; and the"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald","family":"Stablein","sequence":"additional","affiliation":[{"name":"The EMMES Corporation, Rockville, Maryand; and the"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugh A.","family":"Sampson","sequence":"additional","affiliation":[{"name":"Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott H.","family":"Sicherer","sequence":"additional","affiliation":[{"name":"Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2012,7,1]]},"reference":[{"issue":"1","key":"2021120900183791100_B1","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.1542\/peds.2011-0204","article-title":"The prevalence, severity, and distribution of childhood food allergy in the United States.","volume":"128","author":"Gupta","year":"2011","journal-title":"Pediatrics"},{"issue":"6","key":"2021120900183791100_B2","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1542\/peds.2009-1210","article-title":"Food allergy among children in the United 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