Maya Gharfeh MD @MayaGharfeh
Wife | Mom | Christ follower | BC Allergist/Immunologist |#wacotown | #tweetiatrician | #foodallergy |#healtheducator | #allergyblogger allergistmama.wordpress.com Waco, TX Joined August 2016-
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Food allergies aren't the same for everyone—they differ by age, lifestyle, and emotional well-being. As healthcare providers, we must go beyond simple diagnosis and avoidance, offering care that’s customized to each patient’s unique needs.
Infants with eczema need consistent skincare and liberal use of thick emollients. These barriers protect the skin and may reduce the risk of developing food allergies.
Avoiding high-risk places like certain restaurants is wise, but daily safety starts with handwashing. Teaching kids to wash before eating helps reduce cross-contact risks.
Up to 60% of peanut-allergic patients may show sensitization to legumes like chickpeas or lentils. Testing should be guided by clinical history to avoid unnecessary food avoidance and potential new allergies.
Extensive food avoidance can lead to nutritional deficiencies in allergic patients. Ongoing monitoring is key to support healthy growth and development.
Although 40–60% may test positive for legumes, only 10–20% actually react. With peanut allergy, cautious introduction of chickpeas or lentils at home—alongside epinephrine—is often safe and informative.
Beyond medical advice, providers serve as a reliable source of support for food allergy patients. Building trust helps address both clinical needs and emotional concerns.
EOE involves both IgE and non-IgE pathways, requiring tailored treatment based on pathology response. Ongoing coordination with GI specialists is essential for effective management.
Food challenge decisions are based on history, test results, and patient motivation. Even with uncertain outcomes, challenges may be worth it if the food holds significant value for the patient.
Testing should be guided by clinical history, not fear. Broad food panels without clear reason can lead to false positives and unnecessary dietary restrictions.
Asthma increases the risk of severe anaphylaxis in food-allergic patients. Consistent asthma control must be a priority at every clinical visit.
Originally used for asthma, Omalizumab now shows promise for food allergy by blocking IgE and preventing allergic reactions. A breakthrough in managing allergic responses.
Dairy and egg OIT can involve mild reactions during buildup, but reaching maintenance is possible. Success depends on working with a trusted, experienced allergist.
Dairy and egg OIT can involve mild reactions during buildup, but reaching maintenance is possible. Success depends on working with a trusted, experienced allergist.
Epinephrine is the only effective treatment for anaphylaxis and should be used confidently. Antihistamines can support relief of skin symptoms but are never a substitute for epi.
Children with eczema are at higher risk for food allergies, making early intervention crucial. Following LEAP guidelines for food introduction can help prevent allergic progression.
Misinformation around food allergies is widespread—from vaccine fears to testing myths. Addressing these in the exam room builds trust and empowers informed decision-making.
While caution is important, the risk of allergic reactions from surfaces like playgrounds is generally low. Awareness without excessive worry is the key for safe play.
Always use interpreters and translated materials to support patient understanding. Clear communication builds trust and ensures informed, inclusive care.
Food isn’t always the root cause—stress and lifestyle play a major role in gut symptoms. Tracking emotions, meals, and symptoms can help reveal deeper patterns.

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