With food allergies very common today, parents often look at every bump, rash and stomach pain their young child experiences in a new light. The Centers for Disease Control and Prevention estimates that food allergies affect 8 percent of children — or one in 13 — in the United States. So knowing the signs of a true allergic reaction to food can be life-saving information.
What is Food Allergy?
According to Food Allergy Research and Education (FARE), a food allergy is a “serious and potentially life-threatening medical condition affecting 32 million Americans.” Research also shows that one in 13 children have a food allergy, or two kids in every classroom.
An allergic reaction happens when a person’s immune system thinks it’s being threatened after ingesting a certain food. The body’s response is to produce an antibody called immunoglobulin E (IgE), which in turn causes the allergic reaction. The most common allergens include milk, eggs, peanuts, tree nuts, wheat, soy, fish and shellfish.
Stacy Dorris, M.D., a pediatric allergist and director of the Pediatric Food Allergy Clinic at Monroe Carell Jr. Children’s Hospital at Vanderbilt, says the influx of food allergies may be the result of a too-clean society.
“It’s a working notion of the hygiene hypothesis — that we as a society have become too good at being clean, and if the immune system is idle, it can get itself in trouble,” Dorris says.
Discovering a Food Allergy
Food allergies can range from very mild to extremely severe and life-threatening. Typically, a severe allergic reaction will not be subtle. In other words, the symptoms will come on strong and quickly, usually within two minutes or up to two hours. Make sure to keep a close eye on your child as you introduce new foods.
Symptoms of an allergic reaction include:
- Hives
- Swelling on the eyelids, tongue or lips
- Respiratory distress: trouble breathing or shortness of breath
- Severe stomach pain or vomiting
If your child has two or more of these symptoms (meaning two bodily systems are involved), he is most likely having an anaphylactic reaction and will need immediate emergency care.
If you repeatedly see symptoms that cause concern, call your pediatrician — he can direct you to the right pediatric allergist for a proper diagnosis.
Getting a Diagnosis
Food allergies can mimic symptoms of other medical conditions, so you’ll need to see an allergist to confirm, diagnose and treat any possible allergy.
“The most valuable information for an allergist is a detailed food history. It’s part of your food story, and it can help us determine if there is a true allergy,” says Dorris.
Capture your child’s food story (history) in a journal. The journal should include suspected symptoms such as skin irritation, stomach problems, rashes or breathing problems. In addition, mark down the foods eaten and times/days when the symptoms occur and any new foods introduced that cause issues.
The allergist will conduct one or more diagnostic tests:
- Skin prick test (injects allergen under surface of the skin) for reactions.
- Blood test: Determines whether IgE antibodies are present.
- Oral food challenge: Ingesting small amounts of a suspected allergen. If no symptoms occur, he will continue to eat in larger doses.
- Trial elimination diet: The process of temporarily eliminating foods from the diet to see if symptoms go away.
The doctor will use the information gathered from the diagnostic testing in combination with your provided and detailed medical history to make a proper diagnosis.
Managing Your Child’s Allergy
Once your child receives a food allergy diagnosis, your next step is learning how to manage it. Honestly, it can feel like a tough job. You have to educate yourself, your family, your food allergy child, his caregivers and teachers, and friends. I know; it feels overwhelming, so putting a plan into place will help make the transition easier.
- Find the right doctor: Finding the right medical support for your family’s needs is like finding the right spouse — the most important thing is you need to feel seen, supported and heard.
- Create a plan for your home: Some families eliminate the allergen from their home for little to no risk of exposure. Some families decide to learn about and label foods. There is no right or wrong way to do it; just make a functional plan and stick to it.
- Be prepared: Going out to eat and attending functions with food will become more difficult for your family, so you will have to plan ahead. Bring a cooler of food with you if necessary. Keep safe snacks in your purse or car. Never leave home without all the necessary medicines needed. If you go out to eat, call ahead or go at “off” times so you have time to talk to the wait staff about your situation.
- Advocate for your child and educate your support system: Don’t worry about bothering people with your child’s diagnosis. Educate people in a gentle, but firm way. Anyone who cares for your child should know about his food allergies and what to do if they suspect he has come in contact with an allergen.
- Get involved in the food allergy community: It might help you and your child to have support from other people who know exactly what you’re going through. Connect with other food allergy families through Facebook groups, support groups or nonprofits like Food Allergy Research and Education (FARE).
What to Teach Your Child
As you are navigating your child’s diagnosis, remember this is new for him, too. He will need support and education as he learns how food allergies will affect his life.
Teach him to speak up and ask questions to anyone who may be handling his food. Teach him to ask about ingredients before he eats anything. While his caregivers are there to protect him, he DOES need to learn to advocate for himself at a young age.
Once your child can read, teach him how to read a food label, and get him to do it as often as he can. Make sure you double check it for him as he learns. Companies change ingredients all the time, so don’t assume a food is safe. Read and re-read ingredients every time — both of you!
Your Other Children
If you’ve got young children and you’re wondering about feeding them high allergic foods like peanuts, don’t fret. While in the past, the school of thought was to strictly avoid foods like peanuts until about age 3, new guidelines published in The Annals of Allergy, Asthma and Immunology now recommend giving children pureed peanut products as early as 4 months old, depending on your child’s history.
“Don’t avoid foods if you don’t have to,” Dorris says. “If you have a normal healthy baby, feed him everything. Of course, you’ll want to avoid choking foods like a whole peanut,” she adds. If you have a family history of food allergies or are nervous about introducing certain foods, your doctor can help.
If you find yourself facing a food allergy in your child or children, there is hope that they can potentially grow out of their allergy. Dorris says 60 – 80 percent of children outgrow a milk or egg allergy before they turn 5 – 6 years old, and 20 percent of children with a peanut allergy will outgrow it in their lifetime.
And as for the future of food allergies? As even more studies emerge and our understanding of food allergies evolve, doctors are moving toward alternate methods like oral or patch immunotherapy, notably not FDA approved yet. While it’s not a cure, it might make food allergies more manageable.