Food Allergy Risk Reduction Program

The Learning Early About Peanut Allergy (LEAP) Study demonstrated a dramatic reduction in the rate of peanut allergy among high risk infants by early exposure to peanut. An accompanying editorial describe the results as compelling and recommended that physicians take appropriate action.  At the Dallas Food Allergy Center we have developed the Food Allergy Risk Reduction (FARR) Program modeled on the procedures used in the LEAP study.

What is FARR?

In the FARR program, appropriately selected infants under one year of age who have not had a reaction to the food of concern are skin tested to that food. Infants whose skin test is negative or mildly positive are then challenged with the food (milk, egg or peanut) over a several hour period. If there is no reaction, the parents are instructed to administer the specified quantity of food at least three times a week.

Who should consider FARR?

The LEAP study only enrolled infants who had severe eczema or egg allergy. Such children are those most likely to benefit from FARR. We know, however, that many children with food allergy do not meet those criteria. In an effort to identify who might be a candidate for FARR, we have developed a Food Allergy Risk Reduction Scoring System.

This scoring system is based on an extrapolation from limited data about the risk factors for the development of food allergy. This system reflects our best estimate of the importance of known risk factors but has not been validated by prospective studies. This scoring system is intended to serve as a guide but decisions about FARR should be made in consultation with your allergist.

Risk Factor Points
Eczema prior to age 3 months 10
Severe eczema beginning after 3 months 7
Any eczema 5
History of food allergy 7
Any wheezing illness 3
Sibling or parent with food allergy 3
Family history of atopy but not food allergy 2

 

Score FARR Recommendation
≥6 Strongly suggest
4-5 Suggest
2-3 Neutral
<2 Not generally recommended

Other factors to consider include a weakly positive blood food allergy test, parental concerns about food allergy and food allergic siblings or other family members in the home.

FARR is not necessary for an infant already eating the food of concern without any adverse reactions. FARR would rarely be appropriate for a child with no personal or family history of allergy. Children with a strongly positive blood food allergy test are not good candidates for FARR.

Interested in learning if FARR is appropriate for your patient or family?

If you are interested in learning more about FARR and if your child is eligible for the program, please contact our office at 972-566-7788. Most insurance policies cover this treatment. We invite you to contact us and find out how we can help your child as well as your whole family live without a fear of food.