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Background Over the last two decades, researchers have placed increasing attention on understanding how food allergy affects the health‐related quality of life (HRQL) and psychosocial well‐being of children and teens. In response, a number of reviews have been published that aim at synthesizing the literature. However, many of these papers focus narrowly on HRQL or suffer from methodological limitations. Method The current review aims to fill this gap by providing a comprehensive overview of the burden of pediatric food allergy by synthesizing the quantitative and qualitative literature. Results Findings from the present review provide evidence of reduced HRQL among children and teens with food allergy, particularly older children and those with more severe manifestations of the condition. In comparison to HRQL, the link between food allergy and psychosocial functioning is less clear; however, some evidence can be cited linking food allergy to greater levels of psychological distress. Qualitative evidence suggests that the burden of pediatric food allergy largely stems from worries surrounding exposures outside of the home and the social consequences of the condition. The current review also highlights several gaps in the literature, including a paucity of longitudinal research, research focused on predictors of psychological distress among children and teens with food allergy as well as a dearth of studies comparing rates of bullying in food‐allergic and non‐food‐allergic samples. Conclusion More emphasis should be placed on not only alleviating the social and psychological consequences of food allergy, but also on identifying and assisting those most acutely burdened by the condition.

Background The impact of childhood food allergy on household costs has not been examined in Canada. The current study sought to examine differences in direct, indirect, and intangible costs among Canadian families with and without a food-allergic child. Methods Families with a child with a specialist-diagnosed food allergy (cases) were recruited from two tertiary pediatric allergy clinics in the Province of Manitoba, Canada, and matched, based on age and sex, to families without a food-allergic child (controls). Cost data for the two groups were collected via an adapted version of the Food Allergy Economic Questionnaire (FA-EcoQ). Consideration was given to income, defined as above vs. below the provincial annual median income. Results Results from 35 matched case/control pairs revealed that while total household costs did not significantly differ between cases and controls, food-allergic families did incur higher direct costs ($12,455.69 vs. $10,078.93, p = 0.02), which were largely attributed to spending on food. In contrast, cases reported lower, but not statistically significant, total indirect costs compared to controls ($10,038.76 vs. $12,294.12, p = 0.06). Families also perceived their food-allergic child as having poorer quality of life relative to their healthy peers. Lastly, stratification of the analyses by annual income revealed several differences between the higher and lower income groups. Conclusions Relative to families without a food-allergic child, food-allergic families incurred higher direct costs across a number of different areas.

Background Food allergy has a known impact on quality of life (QoL), but this has not been extensively studied during the COVID-19 pandemic. Objective The objective of this mixed methods study was to characterize the levels of anxiety of mothers of food allergic children aged 0-8 years, compared to families without a food allergic child, as well as health-related quality of life (HRQL) amongst food allergic children during the COVID-19 pandemic. Methods In a mixed methods study of Canadian mothers of children 0-8 years, food allergic cases and non-allergic controls provided demographic data, and completed age-appropriate anxiety questionnaires between 14-28 April 2020. Cases also provided food allergy-related data, and completed the Food Allergy Quality of Life Questionnaire (FAQLQ). In-depth interviews were subsequently conducted with purposefully-selected cases. Results Of N=580, 5.5% were cases and 94.5% were controls. For mothers with children 0-1.5 years, anxiety levels did not differ between cases and controls. For mothers with children 1.5-8 years, anxiety levels were higher in cases vs. controls (p<0.05). Amongst cases, neither overall nor domain-specific FAQLQ scores differed between age groups (0-3 vs. 4-7 years), even after adjustment for confounding variables, including childcare during the pandemic. Qualitatively, 3 themes were identified: Unexpected challenges of food shopping; Less food-related food anxiety during the pandemic; and Differences/delays in food allergy testing and therapy. Conclusion Mothers with food allergic children reported high anxiety and poor HRQL. Yet, qualitatively, day-to-day food allergy management was better during the pandemic.

Purpose of Review Food allergy management and treatment require dietary modification, are associated with significant burdens, and affect food choices and behaviours. Emerging therapies, such as oral immunotherapy (OIT), provide a glimmer of hope for those living with the condition. Some burdens have received substantial focus, whereas many knowledge gaps on the significance of other impacts, including economic burden, remain. Recent Findings Evidence from many countries, but disproportionately from the United States, supports that food allergy carries significant healthcare and societal costs. Early introduction for the prevention of food allergies is theoretically cost-effective, but remains largely undescribed. Unique considerations, such as those to cow’s milk protein allergy, which affects a substantial proportion of infants, and adrenaline autoinjectors, which have a high cost-per-use, require a balance between cost-effectiveness to the healthcare system and adverse outcomes. Household costs have largely been explored in two countries, but owing to different healthcare structures and costs of living, comparisons are difficult, as are generalisations to other countries. Stock epinephrine in schools may present a cost-effective strategy, particularly in economically disadvantaged areas. Costs relating to OIT must be examined within both immediate benefits, such as protection from anaphylaxis, and long-term benefits, such as sustained unresponsiveness. Summary Although the absolute costs differ by region/country and type of food allergy, a consistent pattern persists: food allergy is a costly condition, to those who live with it, and the multiple stakeholders with which they interact. Supplementary Information The online version contains supplementary material available at 10.1007/s40521-022-00306-5.

Pediatric food allergy is associated with direct, indirect and intangible costs. However, it remains unclear if intangible costs of pediatric food allergy influence parental career choices. Using data from 63 parents whose children had been diagnosed by a pediatric allergist with food allergy, we sought to (a) establish perceived life status of families with a food allergic child, and (b) to describe any career limitations viewed as attributable to food allergy. Compared to responding parents whose children had one to two food allergies, those with three or more food allergies had significantly poorer perceived life status (ß − 0.74; 95%CI − 1.41; − 0.07; p < 0.05). Overall, 14.3% of parents (all mothers) reported career limitations due to food allergy. Two of the 7 mothers (28.6%) who reported career limitations due to their child's food allergy fell below Statistics Canada cut-off for low-income, after tax dollars (LIM-AT). One of the three mothers who had changed jobs because of their child's food allergy was below the LIM-AT. No fathers reported food allergy-related career limitations. In conclusion, mothers of children with multiple food allergies reported worse perceived life status that may be partly explained by food allergy-related career limitations.

Background Children are often diagnosed with an antibiotic allergy, with little investigation to confirm whether it is a true allergy. Recent studies support the use of oral challenges to confirm antibiotic allergy. Yet, little is known about families' perceptions of these challenges, or experiences of living with a misdiagnosis, often for many years. Objective To describe how families with a child previously labelled as “antibiotic allergic,” but who has subsequently been delabelled, perceive the experience of misdiagnosis and subsequent delabelling. Methods We performed semi‐structured interviews with parents whose children had recently completed a graded oral challenge for antibiotic allergy. Interview transcripts were analysed concurrently, but independently, by two investigators, using content analysis. Results A total of 15 parents (14 individual interviews; 1 mother‐father dyad) participated. Children were, on average, 5.04 ± 4.5 years and were first diagnosed in infancy (mean age: 1.82 ± 1.48 years) subsequent to a rash (14/14; 100%), and commonly at a walk‐in clinic (6/14; 42.9%). We identified four themes: (1) A red, raised rash results in a quick diagnosis despite a lack of testing, (2) sensitive care allays concerns, (3) delabelling brings relief, but also mystery and calls for proper diagnoses, and (4) quick diagnoses are reckless, but manageable through downward comparisons. Conclusion and Clinical Relevance These findings underscore the importance of a careful physical examination and clinical history of the patient, but also an ongoing dialogue to support families, both of which would ideally begin at the time of initial investigation.

Currently, little is known about the relationship between COVID-19-related media consumption and mental health among Canadian parents. Consequently, the current study aimed to investigate the associations between the consumption of COVID-19-related news and mental health in a large sample of Canadian families. We recruited 924 Canadian parents, between April 14th and August 9th 2020, to participate in an online survey, which assessed their demographics, media consumption patterns, and their levels of anxiety, and depression. Relationships between COVID-19-related media consumption and parental mental health were analyzed using a series of multiple regression analyses. Multiple regression was also used to examine whether pediatric health status (i.e., chronic disease vs. no chronic disease), parent health status, and the prevalence of COVID-19 in the participant’s province of residence moderated the relationship between news consumption and parental mental health. Greater consumption of news related to COVID-19 was associated with higher levels of depression, and anxiety after controlling for a number of covariates. Contrary to predictions, neither the prevalence of COVID-19, parent health status, nor child health status significantly moderated the relationship between media consumption and parental mental health.