Food Allergy Diagnosis in Early Childhood: Journey Mapping Study With Parents and Pediatricians

Food allergy (FA) in early childhood can be challenging for families, even before a diagnosis is made, as parents often experience anxiety and have to change their routines. Research integrating parental and pediatrician perspectives during the pre-diagnostic phase is scarce. This study aimed to develop a journey map illustrating the FA pre-diagnostic process in early childhood from both perspectives. We triangulated 30 transcripts (16 parent interviews; 11 interviews and three focus groups with pediatricians) from two qualitative studies within the Food Allergy Biomarker Application Consortium (NAMIBIO App) using qualitative content analysis and data visualization. Four phases emerged: (non-)awareness, suspicion, healthcare seeking, and diagnostics. Parents were often unaware of FA risks, even with risk factors present. Pediatricians hesitated to address FA risk proactively, due to lacking specific guideline recommendations and concerns about triggering parental health-related anxiety. Both parents and pediatricians mentioned gaps in communication between pediatricians and midwives. During the suspicion phase, families searched for information or adjusted feeding practices while symptoms were often vague. Healthcare seeking often involved lengthy referrals. Pediatricians reported knowledge gaps among colleagues regarding FA. In the diagnostic phase, parents perceived delays in diagnosis; pediatricians mentioned limited resources, particularly for oral food challenges. Integrating both perspectives revealed shared concerns and different views on how to improve the process. Key intervention points to improve the pre-diagnostic process include clear, up-to-date guidelines, risk communication and improved interdisciplinary collaboration to reduce uncertainty and promote parental confidence.