Dr Alice Hoyt is a board-certified allergist and author of Navigating Food Allergies: A Parent's Guide to Care, Coverage and Confidence. In this episode, she explains why the word cure has no place in allergy vocabulary, what the evidence says about allergic reactions on planes, and how parents can transition food allergy responsibility to the child who has to live with it.

Five key takeaways:

1. Precautionary labelling on food packaging is not regulated, so families must assess risk case by case with their allergist.

2. The science does not support airborne peanut reactions on planes, but the psychological response to proximity to an allergen is real and valid.

3. Oral immunotherapy teaches the body to tolerate an allergen by introducing very small, controlled amounts over time, but tolerance must be maintained through regular exposure.

4. Early introduction of allergens, starting as early as four months, prevents allergies from developing, it does not test whether an allergy already exists.

5. Transitioning allergy management tasks to children should start early, with age-appropriate responsibilities building over time so they are independent by adulthood.

Dr Alice Hoyt is a board-certified allergist and the author of Navigating Food Allergies: A Parent's Guide to Care, Coverage and Confidence. She helps families make evidence-based decisions about food allergy diagnosis, management and treatment.

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1. [03:45] Precautionary labelling is not regulated. There is no standardised definition of what may contain means, so families must assess risk with their allergist case by case.

2. [06:30] The science does not support that someone three rows back eating peanut will cause anaphylaxis. Peanut is heavy, it floats down to the tray table, it does not become aerosolised unless in a lab.

3. [08:15] I can see the look on my husband's face when he sits next to someone eating something that could kill him with one bite. He is a physician, he is evidence-based, but that response is real.

4. [12:00] One part of the book that stands out is the roadmap for transitioning responsibilities of managing a food allergy over to your child, starting young with age-appropriate tasks.

5. [17:20] Oral immunotherapy takes very small amounts of allergen, like five milligrams of peanut when one peanut has 300 milligrams, and teaches the body to tolerate it over time.

6. [19:45] The sooner we start oral immunotherapy, the more likely the child will freely eat the allergen. I see kids started under two eating PB&J sandwiches by kindergarten.

7. [21:30] We never want to say something is a cure. A cure means you apply it, the condition goes away, you remove the cure, and it does not come back. With OIT, if you stop, the allergy may return.

8. [25:00] Early introduction is not testing whether they are allergic. We know at four months it is highly unlikely they are allergic, so we feed the food to grow tolerance and prevent the allergy.

9. [28:10] The allergen that really makes allergists uncomfortable is cashew. We are finding more and more kids with cashew allergies, and very small amounts can cause robust reactions.

10. [30:45] The sensationalisation of food allergy, the fear-mongering, the over-promising and under-delivering, those are the things on social media that really bother me.

My Health Focus is not a medical service. The information provided is for general informational purposes only and does not constitute medical advice, diagnosis, or treatment.

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