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News
Oral immunotherapy for food allergies is largely safe for preschoolers, but a new Canadian study flags who's most at risk. Only 5.2% of nearly 1,900 children needed epinephrine, with higher IgE levels, multiple food treatment, and the early buildup phase driving the most risk. Most reactions were mild, and severe cases were rare.
A large Canadian registry study offers reassuring news for families and clinicians: epinephrine use during oral immunotherapy (OIT) for food allergies in preschool children is uncommon, and when reactions do occur, they're mostly mild. The prospective, multicenter study tracked nearly 1,900 children under 6 years old receiving OIT between 2017 and 2024.
That said, certain kids face a higher level of risk. Children with elevated baseline IgE levels specific to their food allergen, those being treated for multiple foods simultaneously, and those with more atopic conditions (like eczema or asthma) were significantly more likely to need epinephrine. The early buildup phase — particularly the first few dose escalations — was the riskiest window, and a notable share of reactions happened at home during daily dosing.
By the Numbers
Why it matters: OIT is a growing treatment option for food-allergic children, and this study helps clinicians identify which preschoolers need closer monitoring — especially during early dose escalations and home dosing — while reinforcing that the therapy is broadly safe for this age group.
