Do Babies Outgrow a Sesame Allergy?

A sesame allergy occurs when the body’s immune system overreacts to proteins in sesame seeds, causing reactions from mild to severe. Its prevalence is increasing, affecting an estimated 0.2% to 0.8% of children globally and 0.1% to 0.2% of the U.S. population. This rise is partly due to increased use of sesame in foods and improved diagnostic methods.

Likelihood of Outgrowing a Sesame Allergy

The prognosis for outgrowing a sesame allergy is less favorable than for other common childhood food allergies like milk or egg. While many children outgrow milk or egg allergies by adolescence, only an estimated 20% to 30% of children with a sesame allergy develop tolerance. Those who outgrow it do so by around age six. This contrasts with milk and egg allergies, where 60% to 80% of young children may tolerate these foods by age 16.

Factors that may influence the likelihood of outgrowing a sesame allergy include the initial severity of the allergic reaction and specific IgE (sIgE) levels to sesame. Children with higher sIgE levels may have a lower chance of outgrowing their allergy. The presence of other food allergies is also common, with more than half of patients with sesame allergy also being allergic to peanuts or tree nuts. Unlike milk or egg allergies, sesame allergy tends to affect children and adults to a similar degree, often persisting into adulthood.

Managing a Sesame Allergy

Managing a baby’s sesame allergy involves strict avoidance of sesame and its derivatives. Parents should carefully read food labels, as sesame can be listed under various names like tahini, benne, or gingelly. Since January 1, 2023, sesame must be declared on food labels for products regulated by the FDA, but older products may not have this clear labeling. Sesame seeds are tiny and can easily cross-contaminate other foods, particularly in bakeries or deli counters.

Preventing cross-contamination at home requires separate utensils, equipment, and surfaces for food preparation. Foods without labels or with uncertain ingredients should be avoided. Recognizing allergic reaction symptoms is important, ranging from hives, itching, and swelling to more severe signs like vomiting, diarrhea, wheezing, and trouble breathing.

An emergency action plan is essential for managing a sesame allergy, especially due to the risk of anaphylaxis. This severe, potentially life-threatening reaction can cause widespread symptoms, including a drop in blood pressure. Carrying two doses of an epinephrine auto-injector, such as an EpiPen, is recommended for anyone at risk of anaphylaxis, and caregivers should be trained in its proper use. Regular follow-up with an allergist is beneficial for ongoing management, including guidance on avoidance and determining if a child has outgrown the allergy, often confirmed through an oral food challenge.

Emerging Therapies and Research

Current research explores new approaches to manage sesame allergy beyond strict avoidance. Oral immunotherapy (OIT) is a promising area, involving the gradual introduction of increasing amounts of sesame allergen under medical supervision to desensitize the immune system. Studies show OIT for sesame is safe and effective; one study found 71% of children reached a maintenance dose, with 19% progressing towards it, potentially achieving remission or liberalizing their diet.

While OIT shows promise, it is a long-term process requiring discipline and close medical supervision. Research also investigates combining OIT with medications like omalizumab to enhance tolerance. Other emerging diagnostic tools, such as basophil activation tests, are under development to improve the accuracy of sesame allergy diagnosis and potentially reduce the need for oral food challenges. These ongoing research efforts offer hope for more effective treatments and improved quality of life for individuals with sesame allergy.

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