As if parents didn’t have enough to worry about, along comes another potential menace requiring attention…food allergies. Yes, food allergies have always been around, but the world today provides more ways for children to be exposed to or develop reactions to allergens in foods.
Between exposure to foods that used to be “foreign” and grown somewhere else in the world, to genetic engineering and cross breeding, to mass production in food processing facilities, new contaminants are everywhere. And it is becoming increasingly more difficult to avoid them. So what’s a parent to do?
The Bad News
Let’s start with some of the uglier information (there’s good new later). It is estimated that 3-5 million children in the US have food allergies, at least 8% under the age of six, and 2% thereafter. There are approximately 150 deaths due to allergic anaphylactic shock each year in the US and most of them are children.* And the number of children with food allergies is rising. It is believed that in just the past five years, the number of children under the age of 5 years who are allergic to peanuts alone has doubled. Further, when both one or both parents have allergies, the chance of their children also having allergies increases substantially.
What foods pose the most problems? The eight most common foods that may trigger reactions are:
- tree nuts
- shell fish
Until recently, possible allergens listed on food labels were often disguised under alternate or “technical” names. For instance, casein, hydrolysates, whey, or lactalbumin are all milk related. Egg allergy? Be on the lookout for foods that contain albumin, globulin, ovalbumin and vitellin. So it’s not enough to just scan the ingredients for the top eight offenders, you have to know their derivatives as well.
Think you’re safe if you are breastfeeding? Allergens can be passed through the breast milk. Many pediatricians recommend supplementing with formulas. Most formulas are based in either soy, milk, or rice, so it becomes a matter of trial an error if you baby seems distressed after feedings. And if you are allergic to cow’s milk, you are more likely to be allergic to soy as well. Want more? Some medicines are not allergy safe. Vaccines may be cultured in egg protein.
In a nut shell (pardon the pun), allergens are in nearly every food product on the market.
Here’s the kicker: you might think that because your baby has “successfully” been exposed to some foods that he/she isn’t allergic to them, however food allergies may be cumulative. In other words, there may be a delayed reaction while the body builds up it’s defenses. The first few times a food is introduced may result in no reaction at all. A food reaction can take days, months, or even years to appear. So when the symptoms show up, how can you determine the cause?
What reactions are you on the lookout for? Severe symptoms can affect the mouth, throat, skin gut, lungs and heart. Your doctor will likely advise you to treat such reactions immediately with an epinephrine autoinjection device or an antihistamine.
For severe anaphylaxis, look for difficulty breathing, swelling of throat or tongue, a drop in blood pressure, loss of consciousness. Fortunately, most allergic reactions fall short of that. Shorter term reactions can be swelling of the lips, face or extremities, nausea, vomiting, diarrhea, abdominal cramping, hives and skin rashes.
Uncomfortable, itchy, red eczema (a common reaction to soy) and colic are common in small babies with food allergies (both breast-fed and formula-fed) and can be signs of milder allergic reactions.
As a general rule, children are not usually given allergy tests until they are at least a year old since the results are less reliable before that. Two types of test are typically performed: a blood test (RAST), and a skin test.
In essence, they work by measuring antibodies against specific allergens. To test for everything takes a good deal of blood, so the RAST may be a bit narrower in range. Skin test are thought to be more accurate and work by placing allergens directly onto (or just under) the skin to test for a reaction.
The problem with either test type is that proving positive for an antibody may not mean a child will actually develop that allergy. However, when higher positive levels are present, measures to avoid those foods should be taken. Tests should be repeated yearly.
Often, your pediatrician will prescribe an epinephrine autoinjection device to be kept near the child at all times. All caretakers should be trained in how to use them (don’t panic – it’s really simple) because every second does count. Using them too late is a worse choice and there is little danger in using them too soon.
The Good News
Yes, there is good news. Fortunately, most children will begin to outgrow their allergies at about three years of age. The Internet provides parents with volumes of accessible information, including some sites that alert you to food recalls.
As of January 1, 2006, the US government has mandated by law (The Food Allergen Labeling and Consumer Protection Act or FALCPA), that food labels be not only very specific in their contents (simple enough for a child to understand), but indicate if these foods are produced in facilities that may be susceptible to cross-contamination. Programs are now underway to help restaurants better deal with food allergy situations. Better yet, with all the research being done today by dedicated medical organizations, it is hopeful that specific allergy shots will be available within the next decade.
The Final Note
If you have a child with food allergies, the world can sometimes seem like a frightening place. Young children have loving parents to protect them. It takes real diligence, particularly if your child has an allergy he/she doesn’t outgrow. But there is a lot a support available for parents who seek it. There are strategies and tools available for coping and protecting. Time, research, and growing public awareness are on your side.
* On a sad note, most allergic fatalities occur in the second decade of life so until medical research provides a safety net, don’t assume your older children will automatically behave responsibly about their allergies.