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Allergy therapy: Parents, doctors push for standardized protocols

An Ontario mother is raising awareness and pushing for a change in guidelines for allergy desensitization after her nine-year-old daughter died during therapy.

Like many other children, Brooklyn Secor has food allergies, particularly cow’s milk and goat’s milk, and her parents say they’ve spent years avoiding exposure to reduce the risk of allergic reactions and anaphylaxis .

The girl’s mother, Christina Secor, told CTV News that they decided to try desensitization at the recommendation of an allergist, feeding Brooklyn small amounts of milky foods to help her body adapt. allergy and hopefully avoid life-threatening allergic reactions.

“It sounds like this is just a simple thing we can do at home to increase her stamina and it will benefit her in the long run,” Secor said.

Studies have shown that allergy desensitization therapy can be effective, but experts warn it needs to be done carefully and under supervision.

For more than six months, Secor, who lives in Woodstock, says they add “baked milk crumbs” to Brooklyn’s food once a day. Brooklyn hasn’t had any prior reactions to his doses of baked milk and has generally felt healthy throughout the process, Secor said.

But one evening in May, Secor said Brooklyn started feeling sick after eating a muffin with these milk granules, a rash caused by her restricted airways. Secor said she gave Brooklyn Benadryl and two doses of epinephrine through the EpiPen.

Secor said Brooklyn started convulsing minutes later, her lips and ears turning purple. She said she turned over on her side, in case she vomited and called 911, but the situation got worse.

“I called 911 again and they kept asking me if she was breathing, and I said, ‘I don’t know. I don’t know if she’s breathing,” said Secor. “She was gray and she didn’t move.”

Brooklyn died on the way to the hospital. A coroner’s report later confirmed the death was caused by anaphalyxis after she was exposed to the milk allergen.

Now, Secor wants other parents to be aware of the risks of allergy desensitization therapy.

“I want to raise awareness, to make sure that people know the risks involved, as well as to make sure that they do their research,” Secor said. “You need to make sure you have all the information on it and if something happens you don’t hesitate with the EpiPen.”

PLEASE Apologize for the STANDARD ANALYSIS

Some doctors have warned of the need to standardize procedures for so-called food scales – tools designed to guide parents in home desensitization to milk and food allergies. is different.

Harold Kim, assistant clinical professor at McMaster University and formerly president of the Canadian Society of Allergy and Clinical Immunology, says there is a need for in-depth conversations between doctors and families before at the start of the food ladder.

Without them, he told CTV News there could have been as many tragic cases as Secor’s daughter.

“I think it’s likely to happen again, and there’s certainly a risk it will happen again. So I think we need to look at the factors involved in making it risky. riskier for children,” explained Kim.

Studies have shown that allergic desensitization is safer if:

  • It is done in children aged five and under

  • Other health problems, such as asthma, are well controlled during treatment

  • Parents are told exactly what to do when a child feels sick from therapy

“If we have children with those risk factors, then we have to try to control for those variables… and then we have to have a higher degree of awareness that patients who are more susceptible to allergies will more responsive,” Kim said.

Secor says she received nothing from the allergist.

“We don’t have any papers or anything,” she said.

While Secor isn’t trying to discourage parents from treating allergies, she says she wants them to understand that there are big risks.

“I’m not saying don’t do it… I heard that it has great benefits for humans, that’s amazing… [But] you really need to be careful,” saidSecor.

Kim said there is “no universally accepted standardized procedure” for most allergens, including milk, when it comes to desensitization. He said the exception was peanuts, but said that therapy for other allergenic foods should be required to follow the same process.

While the food-ladder approach has been safe for “the vast majority of children,” Kim said it requires a “very cautious” approach. He added that Brooklyn’s death will likely “raise the level” of discussion and concern in the medical community about immunotherapy regimens.

“I think [her death] would lead to a more conservative and hopefully more standardized approach to doing this,” he said.

Even so, Secor said her daughter’s death left her wondering what else she could do. Secor said she has felt guilty since the incident and feels she could have saved Brooklyn’s life if she had given her epinephrine sooner.

“It was a tiny, tiny piece of muffin, and I never thought she would die from it,” Secor said. “It seems hard to believe, but I want to make sure no one else hesitates and you get the EpiPen right away.”

However, doctors say parents should not be to blame and that there should be better safeguards for desensitization therapy.

Dr. Carina Venter, who co-wrote the paper on the need for standard step-by-step immunotherapy for dairy allergies, told CTV News that many parents reported feeling uncertain about how to use the method. How to safely access the food ladder at home.

“We’re learning all the time, but we really need to standardize allergen approaches and allergen introductions,” she said.

While tips and procedures have improved over time, Venter said the COVID-19 pandemic has highlighted the need for accessibility to home healthcare, including immunotherapy.

“COVID has really put us into the future,” she said. “We now have to manage patients at home with procedures like oral immunotherapy, which we usually do mostly in hospitals.” .

“I think it really taught us that we had to expand the way we practice allergies or maybe even other aspects of medicine.”

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