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Table 3 Physician focus groups: quotations from pediatricians (Ped) and family practitioners (FP) arranged by domain.

From: Food allergy knowledge, attitudes and beliefs: Focus groups of parents, physicians and the general public

Domain: Definition & Diagnosis
Definition  
Anaphylaxis ▪ (Ped): "A sudden distressing feeling that is difficulty breathing, possibly associated with swollen tongue and rapid heart rate [and] drop in blood pressure."
  ▪ (FP): "A life threatening reaction to some offending agent..."
  ▪ (FP): "including impending circulatory collapse"
Common Allergens ▪ (FP): "Peanuts...like nuts. What comes after that, I guess milk...wheat."
  ▪ (FP): "Fish. Strawberries are fairly common too I think."
  ▪ (Ped): "...shellfish, eggs, wheat, soy."
  ▪ (Ped): "Tomatoes."
Prognosis & Development of Tolerance ▪ (Ped): "I really do not know.... I have no concept of what percent outgrow [food allergy]"
  ▪ (FP): "One would think that [food allergies] are [more] prevalent the older you get because you [would] have more chance [s] to develop more allergies."
  ▪ (Ped): "So far all my milk protein allergy victims that have reached the age of two today have in fact outgrown the milk protein allergy."
Breastfeeding & Solid Food Introduction ▪ (Ped): "Generally [if] there is a family history of peanut allergy, I suggest they wait [to introduce peanut] until three [years]. Then if there is no family history, [I suggest they wait] until two [years]."
  ▪ (FP): "I do not think I have ever specifically given anticipatory guidance about [when to introduce] peanuts."
 Interviewer: Do you have any recommendations that you give to breastfeeding mothers? (Ped): "Nothing specific." (FP): "I do not give a particular diet instruction other than to avoid caffeine."
 Interviewer: What are the risk factors for the development of food allergy? (FP): "I wonder if breastfeeding [would] decrease [the] risk of developing food allergies, but maybe women who breastfeed attempt to delay introduction of solids to the baby. So I am not sure." (Ped): "If you start [solids] earlier there is an increased risk of allergy because your baby's gut is more permeable, and those substances will go through and can stimulate their immune system. So it is better ▪ to delay."
Diagnosis  
Diagnostic Criteria ▪ (Ped): "I do not ever treat eczema as food-related. It may be. It may not be. I never took it serious [ly] enough to react that way. Treat it [with] a little basic hydrocortisone or emollients. It gets better and move on."
  ▪ (FP): "I actually kind of find out about a food allergy at the back end of an investigation for maybe persistent asthma or a persistent dermatological condition [rather] than discovering [food allergy] by testing. That has been my experience."
Reliability of Clinical History ▪ (Ped): "I have seen some fish allergies, and [allergies to] tree nuts. I am not sure how seriously to take them. I have one family that believes that their child has a citrus allergy despite the fact that I have told them it is probably just a response to the acid in the citrus, but they have self-diagnosed [this allergy]."
  ▪ (FP): " [When making a diagnosis, I rely on] a parent telling me that there is some kind of skin breakout after eating something."