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Food Allergy Nottingham Service
The online allergy assessment (coming soon) form is the first pictorially-led online self-assessment tool to be developed for diagnosing possible food allergy in infants and children, based on the principles of an allergy focused clinical history. A personalised report is produced from the answers given online, with indications as to:
  • whether the infant or child may be suffering from food allergy
  • whether the allergy is likely to be IgE or non-IgE mediated
  • what tests are required to confirm the allergy
  • whether there is a need to rule out the differential diagnoses of gastro-oesophageal reflux or lactose intolerance before undertaking a trial of cow’s milk exclusion for possible non-IgE mediated cow’s milk protein allergy
There are no validated tools currently available for identifying infants and children who may be suffering from food allergy. Currently, diagnosis rests with GP’s and paediatricians who may not be familiar with the NICE food allergy guidelines and who struggle to find sufficient time to undertake a detailed allergy focused clinical history. There is a role for health visiting team staff to support GP’s in this process. However, this tool would enable families to undertake the allergy focused history in the comfort of their own home and then be able to discuss the outcomes raised by the generated report with their GP or paediatrician.

The research process takes time and whilst ethics approval is being sought, it is an ideal opportunity to try out the tool and refine it, based on feedback from both patients and health professionals. Please feedback to FANS with any comments that you may have, whether they are positive or negative. This process involving user feedback will help to support the ethics proposal. Equally, if you have photos of some of the conditions covered by the tool and feel it would be good to include them, please let FANS know, via the contact page.

The research proposal includes two main objectives:

1. To validate the online allergy self-assessment tool against clinical outcome i.e. did the conclusions of the tool confer with whether the infant/ child developed a food allergy
2. Longitudinal follow up of patients diagnosed with food allergy to describe the course of their allergy/ allergies, treatments used and clinical outcomes

Further details on the research project will be posted as the proposal develops.

FANS projects and publications

Member of the Allergy care pathways for children; food allergy working group. Published by RCPCH (2011)
A series of 6 allergy care pathways have been produced consisting of an algorithm and competencies required by health professionals to undertake the steps.
The pathway process was published in Archive of Diseases of Childhood 2011; 96(Suppl 2): i25–i29. doi:10.1136/adc.2011.214502

Member of the NICE food allergy guidelines development group. Published in 2011.
Diagnosis and assessment of food allergy in children and young people in primary care and community settings

Waddell L, 2011. Living with food allergy JFHC vol 21 (4); 21-28
Practical article to support health professionals in the community identify symptoms associated with possible food allergy in infants and how to undertake a diagnostic workup and assessment as outlined in the NICE food allergy guidance, 2011.

Joint author of the Nottinghamshire Area Prescribing Infant Feeding Guidance, 2012: ‘Guidance on the management of lactose intolerance and cow’s milk protein allergy and the prescription of specialised infant formula
The guidance mirrors NICE recommendations and provide tools to implement their recommendations

Waddell L, 2012. Infants and pre-school children in Oxford Handbook of Nutrition and Dietetics. Eds J Webster-Gandy, A Madden, M Holdsworth, 2nd edn. Oxford: Oxford University Press. Pp 237-278

Waddell L, 2012. Infantile colic- an insight for healthcare professionals. Webinar.
Detailed overview of current evidence on the diagnosis and management of infantile colic and first line approaches that can be taken in primary care to support families of infants with this condition

Waddell, L, 2013. Management of infantile colic JFHC vol 23 (3); 17-22
Practical article including a stepwise, algorithmic approach to the management of infantile colic, including ruling out food allergy as a cause of colic.

Waddell, L, 2013. Diagnosing food allergy when there is no dietitian; practical advice for nurses and doctors. Invited speaker. BSACI Annual Meeting, 2013. Allergy across the ages. Telford International Centre, 9th July2013

"Our mission is to provide a patient-centred service that supports early recognition,
diagnosis and treatment of food allergy in children, thereby enhancing quality of life"
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