A team from National Jewish Health (NJH) in the US found that more than 70 per cent of preschoolers with documented or suspected food allergies suffered a significant reaction during the three-year study period.
They also found that caregivers failed to administer the medication "epinephrine" in 70 per cent of the severe and potentially life-threatening reactions.
David Fleischer, a NJH paediatrician who led the study, said: "Our findings clearly point to a need for parents and other caregivers to be even more vigilant in avoiding allergenic foods and treating reactions appropriately."
"They also suggest several strategies that both caregivers and healthcare workers can pursue to make mealtime safe for food-allergic children."
The study, published in the journal Pediatrics, followed 512 children aged 3-15 months for an average of three years, documenting all allergic reactions to food.
Over the three-year period, the children experienced 1,171 allergic reactions to food. While 145 (28 per cent) had no allergic reactions, 98 (19 per cent) had one reaction and 269 (53 per cent) had more than one reaction, the team found.
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Just over 11 per cent (134) of the reactions were categorised as severe, and included symptoms such as swelling in the throat, difficulty breathing, a sudden drop in blood pressure, dizziness or fainting. Almost all of the severe reactions were caused by ingestion of the allergen rather than inhalation or skin contact.
Only 30 per cent of the severe reactions were treated with epinephrine, a medication that caregivers can administer to reduce symptoms while waiting for medical care.
Reasons for the under treatment included failure to recognise severity of the reaction, not having epinephrine (EpiPen) available and fears about epinephrine administration, the researchers found.
"It is very important for caregivers of food-allergic children to carry an EpiPen with them at all times, know how to recognise a serious reaction and how to use an EpiPen," said Dan Atkins, co-author of the study. "Correctly using an EpiPen at the right time can save a life." (More)