“There definitely should be some more help for families”: a call for federal support for families managing pediatric food allergy

This study is part of an overarching, mixed methods, intervention study involving Winnipeg families with children age < 6 years, who have allergist-diagnosed cow’s milk allergy. Each family received a home-delivered, subsidy kit of milk allergy-friendly foods (valued at ~$50 per kit) every second week between March and August 2022. Approximately one month prior to the end of the study, a parent from each family completed an in-depth, semi-structured interview (Table 1 ) moderated by an experienced qualitative interviewer (MG) and supported by a research assistant (MB or ZH). Interviews were audio-recorded and transcribed verbatim. Data were analysed thematically [ 10 ] by two research assistants (MB and ZH) who worked independently, and who had regular discussions with two experienced qualitative researchers (MG and JP). Descriptive data, collected at baseline, were analysed using Stata® Version 17.0 (College Station, TX). This study was approved by the University of Manitoba Health Research Ethics Board HS25168 (H2021:340). Eight parents, all from different families, completed qualitative interviews. On average, families were composed of 4.38 ± 1.78 members, and had an average monthly household income of $3764.29. The median index child was age 2 years and with equal numbers of boys and girls represented. All index children had milk allergy; other reported allergies included peanut (4/8), egg (4/8) and soy (each n = 3/8). Parents were, on average, age 29.9 ± 4.4 years, most (n = 5) had post-secondary education and few (n = 2) had food allergy themselves. In our thematic analysis, we identified one theme: “There definitely should be some more help for families.” This theme, which was indeed a participant quote, captured what parents perceived to be the most meaningful type of support for families with young children managing food allergy. Within this theme, parents described various ways in which they would benefit from financial support to help offset the price of foods, ranging from “ gift cards ” to continued subsidies, such as that provided by our intervention. Interestingly, parents spoke against a tax credit. For example, one parent noted: [I] would prefer probably the subsidy like this portion of it rather than a tax credit . In contrast, others described how they would have preferred an enhanced ability to select their own foods, rather than being restricted to those provided by the subsidy, as the desire to select their own foods was important. This was captured in quotes from parents who succinctly expressed their sentiments: for people, like to pick, whatever they want like the difficulties of finding dairy-free items in Winnipeg . While food procurement was perceived as challenging for some families, a more frequently described concern was the cost of allergy-friendly foods, which was cost-prohibitive for some, particularly as the child may refuse the food. As one participant described: [Additional support] would be a huge relief for a lot of people especially if allergies are new, like you don’t really want to be spending $7 to $10 on one new product just for your child to say I am not eating it… that is the big stressful part of it Another parent also spoke to the high cost of allergy-friendly foods: How expensive things really are! There is nothing that has a label of allergy-friendly that is cheap in any way. So trying to, you know, bring in an income and also pay for food at the same time is horrible. So many people go through and I believe [additional support] can help so many people. While families in our study appreciated the subsidy, families spoke about what they perceived to be the best way to provide additional support to offset the cost of allergy-friendly foods. These perceptions were elegantly captured in the statement of one participant: I would say actually like helping with the cost of food items would be like the best.

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