EC Paediatrics

Introduction and Aims: Evaluate the Quality of Life (QoL) in mothers of Food-Allergic (FA) children and explore the relationship between scores of QoL domains and The CoMiSS^TM.

Methods: An observational, prospective cohort study of children referred for initial evaluation of FA. Inclusion criteria: mothers capable of answering the WHOQOLBREF; not receive any psychological intervention; children ≤ 36 months and diagnosis of FA. Exclusion criteria: children with chronic co-morbidities. The WHOQOL-BREF and The CoMiSS^TM were administered at the diagnosis (T0), and The WHOQOLBREF was reapplied at least eight weeks after children were asymptomatic (T1).

Results: 86 mothers/children were evaluated. Children's median (months) age was 5,3, and the duration of symptoms was 4.0. Children are adequate in birth weight/length and nutritional conditions. There were positive, highly significant Spearman intercorrelations between the different QoL domains of the WHOQOL-BREF. Also, a negative correlation between the children's Total CoMiSS^TM score and the WHOQOLBREF scores domains. The questionnaire was reapplied to 34 mothers at T1, and the median interval between the two questionnaires was nine months. There was no statistically significant difference between T0 and T1 for four WHOQOL-BREF domains, Overall QoL and Satisfaction with Health. A small Effect Size was observed for the Facets of the Physical domain (Mobility, Sleep, and Rest), the Psychological domain (Positive Feelings, Body Image, and Appearance, Negative Feelings), and the Environment domain (Participation and Support of Leisure Activities).

Conclusion: The WHOQOL-BREF was appropriate for evaluating the QoL. Mothers demonstrated no improvement in QoL after the child had adequate milk formula and was asymptomatic.

Keywords: Quality of Life; Food Allergy; Cow's Milk Protein Allergy; Children; Parents; Mothers

1. De Martinis M., et al. “New Perspectives in Food Allergy”. International Journal of Molecular Sciences21 (2020): 1474.
2. Grimshaw KEC., et al. “Incidence and risk factors for food hypersensitivity in UK infants: results from a birth cohort study”. Clinical and Translational Allergy6 (2015): 1.
3. Loh W and Tang M. “The Epidemiology of Food Allergy in the Global Context”. International Journal of Environmental Research and Public Health15 (2018): 2043.
4. Savage J., et al. “The Natural History of Food Allergy”. The Journal of Allergy and Clinical Immunology: In Practice 42 (2016): 196-203.
5. Cummings AJ., et al. “The psychosocial impact of food allergy and food hypersensitivity in children, adolescents and their families: a review”. Allergy65 (2010): 933-945.
6. Howe L., et al. “What affects quality of life among caregivers of food-allergic children?” Annals of Allergy, Asthma and Immunology1 (2014): 69-74.
7. Warren CM., et al. “Epidemiology and Burden of Food Allergy”. Current Allergy and Asthma Reports20 (2020): 6.
8. Westwell-Roper C., et al. “Food-allergy-specific anxiety and distress in parents of children with food allergy: A systematic review”. Pediatric Allergy and Immunology 11 (2022): 33.
9. Proctor KB., et al. “A systematic review of parent report measures assessing the psychosocial impact of food allergy on patients and families”. Allergy77 (2022): 1347-1359.
10. Beken B., et al. “Maternal anxiety and internet-based food elimination in suspected food allergy”. Pediatric Allergy and Immunology30 (2019): 752-759.
11. Yrjänä JMS., et al. “Parental confusion may result when primary health care professionals show heterogeneity in their knowledge, attitudes, and perceptions regarding infant nutrition, food allergy, and atopic dermatitis”. Allergologia et Immunopathologia4 (2018): 326-333.
12. World Health Organization. “Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee”. World Health Organization Technical Report Series 854 (1995): 1-452.
13. De Onis M., et al. “Development of a WHO growth reference for school-aged children and adolescents”. Bulletin of the World Health Organization85 (2007): 660-667.
14. Skevington SM., et al. “The World Health Organization's WHOQOL-BREF quality of life assessment: Psychometric properties and results of the international field trial. A Report from the WHOQOL Group”. Quality of Life Research2 (2004): 299-310.
15. Fleck MP., et al. “Aplicação da versão em português do instrumento abreviado de avaliação da qualidade de vida “WHOQOL-bref”. Revista de Saúde Pública2 (2000): 178-183.
16. Vandenplas Y., et al. “A workshop report on the development of the Cow's Milk-related Symptom Score awareness tool for young children”. Acta Paediatrica4 (2015): 334-339.
17. Varni JW., et al. “Peds QLTM Gastrointestinal Symptoms Scales and Gastrointestinal Worry Scales in pediatric patients with functional and organic gastrointestinal diseases in comparison to healthy controls”. Quality of Life Research24 (2015): 363-378.
18. Ganz PA., et al. “Menstrual History and Quality-of-Life Outcomes in Women with Node-Positive Breast Cancer Treated with Adjuvant Therapy on the NSABP B-30 Trial”. Journal of Clinical Oncology29 (2011): 1110-1116.
19. Tyedin K., et al. “Quality of life: An important outcome measure in a trial of very early mobilisation after stroke”. Disability and Rehabilitation32 (2010): 875-884.
20. Lieberman JA and Sicherer SH. “Quality of life in food allergy”. Current Opinion in Allergy and Clinical Immunology3 (2011): 236-242.
21. Resnick ES., et al. “Development of a questionnaire to measure quality of life in adolescents with food allergy: the FAQL-teen”. Annals of Allergy, Asthma and Immunology5 (2010): 364-368.
22. Williams NA and Hankey M. “Support and negativity in interpersonal relationships impact caregivers' quality of life in pediatric food allergy”. Quality of Life Research24 (2015): 1369-1378.
23. Gupta RS., et al. “Food allergy knowledge, attitudes and beliefs: Focus groups of parents, physicians and the general public”. BMC Pediatrics8 (2008): 36.
24. Elizur A., et al. “Natural course and risk Factors for persistence of IgE-mediated Cow's milk allergy”. The Journal of Pediatrics3 (2012): 482-487.
25. Lopes JF., et al. “Labeling food allergens in the packaged food pyramid groups in Brazil: analysis of descriptions, ambiguities, and risks (2022).
26. Dunn Galvin A and Hourihane JO. “Psychosocial mediators of change and patient selection factors in oral immunotherapy trials”. Clinical Reviews in Allergy and Immunology55 (2018): 217-236.
27. Greenhawt M. “Food allergy Quality of Life”. Annals of Allergy, Asthma and Immunology5 (2014): 506-512.
28. Van Oers HA., et al. “Anxiety and depression in mothers and fathers of a chronically ill child”. Maternal and Child Health Journal18 (2014): 1993-2002.
29. Polloni L and Muraro A. “Anxiety and food allergy: A review of the last two decades”. Clinical and Experimental Allergy50 (2020): 420-441.
30. Annunziato RA., et al. “An assessment of the mental health care needs and utilization by families of children with a food allergy”. Journal of Health Psychology18 (2013): 1456-1464.
31. Knibb RC., et al. “The effectiveness of interventions to improve self-management for adolescents and young adults with allergic conditions: A systematic review”. Allergy75 (2020): 1881-1898.
32. Corr M., et al. “A new and better normal: the impact of Covid-19 on the planning and delivery of children's services: a rights review”. Northern Ireland Commissioner for Children and Young (2021): 1-118.