American College of Allergy, Asthma and Immunology (ACAAI)/American Academy of Pediatrics (AAP) symposium-What was served in the past year: Food allergy nontreatment.

Food allergies are increasing, with 1 of 13 children in the United States affected. This article discusses articles chosen by the author for inclusion in the American College of Allergy, Asthma and Immunology/American Academy of Pediatrics Symposium Hot Topics in Pediatric Allergy and Immunology, specifically on updates in food allergy nontreatment, and provides a focused review with Podium to Practice Takeaways for each article. Food allergies with delayed presentation of symptoms from the time of exposure, such as food protein-induced enterocolitis syndrome and alpha-gal syndrome (AGS), are highlighted. Both food allergies are increasingly seen by clinicians. Food challenges play an important role in the diagnosis, management, and resolution of these conditions. As such, clinicians should understand the pattern of reaction severity over time in food protein-induced enterocolitis syndrome to assist families in deciding when, where, and how oral food challenges should be scheduled. Regarding AGS, it is imperative that physicians understand risk factors for the development of alpha-gal sensitization and the expected symptomatology. In addition, clinicians need to provide counseling that allows for appropriate but not excessive food avoidance based on allergenicity. Finally, the article addresses the concern that has arisen about the safety of gelatin-containing vaccines in patients with AGS and reports that reactions to gelatin-containing vaccines seem to be rare.