Integration of Early Introduction Guidelines for the Primary Prevention of Food Allergy into Infant Well Child Checks within a Pediatric Primary Care Setting

Food allergy (FA) impacts 1 in 13 children with a rising prevalence. It impairs family quality of life. Annually, $10 billion is spent on hospitalizations, outpatient, and ER visits. A systematic review of the literature demonstrates a striking reduction in peanut and egg allergy when infants are fed these foods early and often. Currently, poor implementation of early introduction (EI) guidelines exists. Guided by the Iowa Model, the purpose of this evidence-based practice DNP pilot is to integrate a recent update to EI guidelines into the infant well-child check (WCC) workflow at a general pediatric clinic with the primary aim to increase infant consumption of cooked egg and peanut. A multi-pronged approach which includes staff education; an educational patient handout; and an EMR template for 4, 6, and 9-month WCCs were found to be effective at achieving benchmark goals. Families with older children with FA and those who live far away from emergency services will likely need additional support with EI. Additionally, more dietary options for infant safe forms of cooked or baked egg are needed for younger infants. Looking into the future, the IMPACT trial has shown that some infants and toddlers will obtain remission of peanut allergy following early OIT and EI may be an important tool for earlier detection and treatment of FA.