Untangling the web of symptoms that can signal an allergic response requires a team with deep knowledge and access to the latest research. With three locations in the area, Allergy Partners of Fredericksburg gives families access to the largest physician-owned national allergy and immunology specialty group. Four local providers and dedicated office staff help guide children and adults through the journey of diagnosis, treatment and ongoing management to ensure allergies do not get in the way of enjoying everyday life.

 

As our March expert, Allergy Partners offers expertise on food allergies—a problem that impacts an estimated 1 in 13 American children and 1 in 10 adults, according to Food Allergy Research & Education. This information comes from Allergy Partners’ four board-certified, fellowship-trained providers, who see patients from offices in Fredericksburg, Spotsylvania and Stafford.

 

How prevalent are food allergies in American youth, and what are the most common foods that cause allergic reactions? 

 

Food allergies have dramatically increased in prevalence over the last 20-30 years. Egg and milk allergies are the most common. Although 90% of children will eventually outgrow their egg or milk allergy only 15-20% of individuals will outgrow an allergy to peanut or tree nuts.  

 

The most common food allergies include: 

·       Peanuts 

·       Tree nuts 

·       Shellfish 

·       fish 

·       Eggs 

·       Milk 

·       Soy 

·       Sesame 

 

 

What has changed in recent years about our understanding of how food allergy works, especially in children? 

 

In the early ‘90s and 2000s, the recommendation was to hold off on introducing potentially allergic foods until children were much older. During that time, we witnessed a significant increase in the incidence of food allergies, particularly peanut, in children. From 2005 to 2015, the prevalence of peanut allergy among children in Western countries actually doubled, according to a pivotal study known as the Learning Early About Peanuts—or LEAP—Trial. The LEAP Trial taught us that children exposed to peanuts early on were significantly less likely to develop peanut allergy. Consequently, the pendulum has now swung in the other direction and physicians are now stressing the importantance of early introduction of foods -between 4 to 6 months of age—as this is felt to represent an ‘immunologic window’ by which to develop tolerance to otherwise allergenic foods. 

 

 

How do you work with families to help them figure out what is causing what may look like an allergic reaction in their child? 

 

The most important part in determining the cause of a suspected food allergy is the clinical history or story. Oftentimes, what a parent or even another doctor might think is a food allergy can be something else entirely. There are a lot of adverse food reactions which can mimic food allergy.  Additionally, viruses and vaccines can sometimes trigger rashes and hives which can mimic a food allergy. The important thing to know about food allergy is that it is consistent and reproducible meaning that every time you eat that food you are going to see a reaction. A comprehensive medical history in combination with allergy testing (skin testing and lab work) is the gold standard for diagnosing and quantifying a food allergy.   

 

 

What is new in 2025 when it comes to treatment options for food allergy? 

 

For patients diagnosed with a food allergy, there are now a variety of treatment options available. The emerging data on young children is especially encouraging, with studies showing that earlier intervention produces a greater chance of long-term remission of food allergy. This is thought to be due to an increased degree of immunoplasticity within the infant/toddler immune system when compared to adults. In essence, the younger someone is, the easier it is to teach their immune systems to be less allergic to a food. 

 

Oral immunotherapy (OIT) is the oldest treatment for food allergy and involves administering escalating doses of a food allergen to achieve desensitization. The first report of OIT being used for food allergy was published over 100 years ago in 1908. OIT targets a relatively large dose of the food allergen between 300 and 2000 milligrams. For peanuts this would be equivalent to 3-10 peanuts or a teaspoon of peanut butter. OIT can achieve bite protection for most patients and can result in some individuals ultimately being able to freely eat the food. More recently sublingual immunotherapy (SLIT) has been introduced for the treatment of food allergy. SLIT uses much lower doses of a food than OIT, typically less than 4mg (about 1/100 of a peanut), decreasing the potential for adverse reactions. SLIT/OIT hybrid protocols are also in use and can combine the benefits of both treatment modalities.

 

Last, but not least, Xolair, a medication which has been used to manage allergic asthma in children and adults for two decades, is now approved for treatment of food allergies in patients 1 year and older. Xolair can very rapidly, reliably and safely increase the amount of a food that an allergic patient can tolerate before anaphylaxis occurs. The largest study of Xolair for food allergy, the OUTMATCH trial, was recently completed at Johns Hopkins and demonstrated this medication’s safety and effectiveness in adult and pediatric patients. Xolair can be used in combination with OIT/SLIT desensitization regimens and is especially ideal for patients who have a combination of food allergy, hives and asthma.

 

Overall, groundbreaking progress has been made in the management of food allergy over the last few years. The benefits of treating food allergy extend beyond preventing anaphylactic reactions. Studies have shown that patients with food allergies score higher on measurements of generalized anxiety. This is understandable when they live in a world where a single bite of food might result in a trip to the emergency room. These same studies show a decrease in anxiety scores, after food allergy patients undergo treatments such as OIT or SLIT. The constantly evolving therapeutic landscape for managing food allergies, makes it vital that patients with this condition follow up regularly with a specialist who is board-certified in Allergy and Immunology to determine what treatment options are best for them.

  

To learn more or to schedule an appointment for an evaluation for allergy or immune problems, visit www.allergypartners.com/fredericksburg/.