Assess the reaction settings (home, restaurant, on holiday, party, childcare) to identify exposure risks. The majority of the allergic reactions in infancy happen during weaning when new foods are introduced.
A—Allergen
Identify the suspected allergen (e.g., cow’s milk, egg, peanut). Assess cross-reactivity or rare allergens for comprehensive evaluation.
T—Timing
Evaluate the time from exposure to symptoms. IgE-mediated reactions occur within minutes to two hours; non-IgE-mediated reactions are delayed, appearing hours to days later.
E—Exposure
Identify the exposure route—ingestion, skin contact, or inhalation.
R—Reproducibility
IgE-mediated allergies can occur on first contact, while non-IgE reactions typically develop or worsen with repeated exposure. FPIES may present as early as the first or second ingestion.
S—Symptoms
Document reaction severity, systems involved, and timing. IgE allergies cause acute hives, angioedema, or anaphylaxis, while non-IgE allergies present delayed gastrointestinal or skin symptoms, often with multisystem involvement.
X—Treatment
Treatment given, how carers and professionals responded to the reaction.
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