Parental perceptions and dietary adherence in children with seafood allergy

Allergy to seafood (fish, mollusc and crustacean) is increasing and is now a leading cause of food anaphylaxis, but there is only limited data on the impact of seafood allergy on affected children and their families.

We assessed dietary adherence and perceptions of seafood allergy amongst the parents of 94 children presenting to a specialist allergy clinic with proven seafood allergy, by means of a postal questionnaire and cross-referencing the data obtained to clinical records.

One-quarter of parents were unable to correctly recall the dietary advice provided. Nonetheless 89% of parents implemented a safe diet, but over half followed a more stringent elimination than that recommended. One-fifth of the children had subsequent allergic reactions to seafood after diagnosis, and these were generally a result of accidental rather than intentional exposure or cross-contamination. Provision of an adrenaline auto-injector device was associated with increased adherence to dietary advice. Oral food challenges had a beneficial effect on parental perceptions and were helpful to parents in managing their child's allergy.

Seafood allergy has a significant adverse effect on anxiety and stress in the families of affected children. Parental recall of dietary advice is variable and many tend to impose more stringent dietary avoidance than that recommended. Despite this, subsequent accidental reactions are common. Thus, the avoidance of seafood in children may be more difficult than often presumed.