Children and food allergies

Pediatrics for Parents, Oct, 2007 by Maura Steblay

Anaphylaxis is a serious allergic reaction with effects ranging from rapid heartbeat and hives to lightheadedness or loss of consciousness. It is a parental nightmare to watch a child suffer from anaphylaxis. Most food allergies are much milder than anaphylaxis. The investment you make in determining your child's food allergies now will promote a healthy and safe future for her and piece of mind for you.

A food allergy develops when the body's immune system becomes misdirected and attacks harmless food proteins. As a result, the immune system designed to fight infection and disease creates antibodies to fight the food allergen that triggered the allergy. During an upcoming exposure to that food, whether through touching it, eating it, or inhaling its particles, the body releases chemicals, including one called a histamine, to protect itself. The result of this hypersensitivity is an allergic reaction, which may range from sneezing to eczema to anaphylaxis.

Causes

Food allergies affect nearly six million Americans. The tendency to be allergic to food in general is likely genetic. The chances a child will develop an allergy are two to five times greater if either or both of the birth parents have a history of allergies. Food allergy is more common in children than in adults; six to eight percent of infants younger than age two are allergic to some food.

While any food can cause allergies, 90% of all food allergic reactions are caused by "the big eight"--egg, fish, milk, peanut, shellfish, soy, tree nuts (walnut, pecan, etc.), and wheat. One in every three Americans modifies his diet in the belief that he or a loved one has a food allergy although oftentimes discomfort is caused by a food intolerance rather than food allergy.

Diagnosis and Identification

A RAST test (RadioAllergoSorbent Test) is a blood test measuring the level of allergen-specific antibodies. It can be ordered by your child's physician. A RAST test is not designed to pin down the cause of a reaction. It simply indicates if a reaction has produced antibodies called IgE (a protein produced by white blood cells which calls up the allergic reaction forces).

It is interesting to note allergies are part of a common trio: allergies, eczema, and asthma. A child suffering from one is more likely to exhibit signs of the other two. Many symptoms, whether allergy-caused or simply allergy-like, may disappear as the physical development of the child continues and the immunological system matures. For example sensitivity to milk, eggs, or soy tend to resolve with age, whereas allergy to peanuts and tree nuts often begins in infancy but fails to diminish with age.

Feeding Your Child with Food Allergies

How do you feed your child with a family allergy history? Remember the advice your child's doctor gave you as your child reached solid food age. When introducing a new food wait several days before introducing another first-time food to ensure no allergic reaction develops. Peanuts, tree nuts, and shell fish should ideally be introduced to children after age 36 months to five years. In general an allergy doesn't always show up on the first exposure but eighty percent of peanut allergic individuals developed symptoms on their first known exposure.

Second, take advantage of bridging foods: mixing a familiar or safe food with an unfamiliar one. Bridging varies from the above-mentioned method in that it provides a launching spot for your child. A familiar food or texture may allay some of your and your child's fears about new foods that are introduced. Again, this method will assist in your attempt to narrow the field to determine what food actually caused a problem while allowing you greater variation with meals and foods. Remember, one in every three Americans modifies his diet because he believes he has a food allergy when in fact he has a food intolerance

Another suggestion is to keep a food dairy. A food diary provides helpful and complete data on the specifics of ingestion as compared to an allergic reaction--a most useful tool in the diagnosis of possible food allergy. Foods eaten, liquids ingested, as well as the timing of any and all symptoms should be recorded. Some doctors even recommend noting brand names and all of the ingredients in processed foods whenever possible. The culprit may not be the food itself but other additives. A simpler method may be to retain the ingredients list or keep an extra container for later referral.

Preventative Action

In children, allergies can have much more serious physical and social long-term affects than they do in adults. Here is a list of considerations for children with allergies:

* Allergies may be a cause for extended school absences and poor school performance.

* Chronic allergy care can disrupt normal family activities and interrelationships.

* Nasal allergies trigger serious, recurring ear infections and chronic headaches in many young children.

* Allergy medications--especially those used to treat asthma--can be disagreeable to take and may cause side effects ranging from unpleasant to dangerous.