Children & Food Allergies: How You can Help Manage Your Child's Allergies
An estimated 1 in 20 children has a food allergy, a condition that can be severe, requiring strict avoidance of the triggering food(s) and prompt treatment of any allergic reaction. Foods can also trigger a variety of symptoms that are not classic allergies. It is important to seek a diagnosis so your child can safely enjoy nutritious foods that are not a problem and avoid foods that cause symptoms.
A food allergy occurs when the immune system, designed to fight infection, mistakenly attacks food proteins. Symptoms of a food allergy reaction can include vomiting, diarrhea, an itchy rash (ranging from just around the mouth and face to total-body hives), mouth and throat itchiness and swelling, difficulty breathing, and wheezing. Most true food allergy reactions occur within minutes after the food is ingested. In some cases, chronic symptoms such as persistent itchy skin rashes, eczema, or chronic gut symptoms (e.g. vomiting, pain, poor growth) are the result of food allergy.
The intensity of an allergic reaction may range from mild to severe at different times, partly depending on how much of an allergenic food the child has eaten, or whether it was cooked. However, certain highly allergic children need to swallow only a very small amount of an offending food to have a serious allergic reaction.
Common Food Allergens
Any food may cause an allergic reaction, but 90% of food allergies in children are caused by just 6 common foods or food groups: milk, eggs, peanuts, tree nuts, soy, and wheat. Allergies to fruits and vegetables are much less common and usually less severe.
How Serious Are Most Food Allergies?
Some foods are more likely than others to cause severe reactions, such as peanut, tree nuts, and seafood. Your child's general health may influence the severity of the allergy. Children with asthma are at a higher risk for severe reactions. Although a food allergy can cause severe reactions, fatalities are rare and often attributed to a delay in appropriate treatment. For those with a potentially acute multi-system severe food allergy (anaphylaxis), it is important to learn how to strictly avoid the trigger foods, and understand how to recognize and promptly treat a severe allergic reaction.
Managing Food Allergies
There are currently no cures for food allergies. Management is based on avoiding the food and being prepared to treat an allergic reaction should the food be eaten accidentally. Anti-histamines can help mild symptoms such as itching and hives, but an epinephrine injection is necessary for severe symptoms or breathing difficulties (e.g. throat swelling, wheezing). If epinephrine needs to be given, the child should then be taken immediately for emergency medical care, or if necessary, 911 called.
If your pediatrician believes there is any risk that your child could have a severe allergic reaction (an anaphylactic reaction) to food, your pediatrician will recommend that you-and your child, when old enough to use it by himself-always carry an epinephrine autoinjector device in case of accidental ingestion of the food. The devices are easy to use and the medication is safe, but it is important to be familiar with the device being prescribed so that there is no delay in providing emergency treatment. A child at risk for anaphylaxis should also wear medical identification.
Be sure to provide full information about your child's food allergy to school and camp personnel and child care providers. Children should be warned never to share or taste another child's food. Update information regularly at the start of each school year and as new facts become available. In this regard, it is important to report accurate information, such as definite food allergies, not minor food sensitivities.
Food Allergies May Go Away With Time
Many children outgrow food allergies - more than 85% of allergies to milk, egg, wheat, and soy resolve during childhood, often before school age. Only about 1 in 5 children, on the other hand, ever outgrow a peanut allergy. Allergies to fish, shellfish, and tree nuts also tend to be more persistent, but some children outgrow these as well. It is important to regularly follow up with your pediatrician or allergist to discuss management and the possibility that the food allergy has resolved. Never try to intentionally test your child by feeding an allergen at home! If follow-up skin or blood test results are favorable, showing the child is outgrowing their allergy, your doctor may suggest a medically supervised cautious feeding (also known as a food challenge) to see if the allergy has disappeared.
If you suspect that your child has a food allergy, make sure to discuss the possibility with your pediatrician. There are various tests the pediatrician and/or an allergist can perform to give you a definitive answer.
Michael J. Welch, MD, FAAAAI, FAAP, CPI, is the Editor of Allergies and Asthma: What Every Parent Needs to Know, 2nd Edition (an invaluable resource for parents and caregivers trying to cope with the challenges of childhood asthma and allergies) published by American Academy of Pediatrics, Feb 2011, www.HealthyChildren.org. He is co-director of the Allergy and Asthma Medical Group and Research Center in San Diego, CA, and clinical professor at the University of California, San Diego School of Medicine. Dr. Welch is a fellow of the American Academy of Pediatrics and the American Academy of Allergy, Asthma & Immunology. He is past president of the San Diego Allergy Society and the California Society of Allergy, Asthma & Immunology.
This article originally appeared in the April 2011 issue of Genesee Valley Parent Magazine. Copyright 2011.