Posted on: July 8, 2014
A FOOD ALLERGY PRIMER FOR PARENTS
Dr. Craig Osleeb
If it seems like more and more children are developing food allergies, it’s because they are. According to data from the Centers for Disease Control and Prevention, the number of children with diagnosed food allergies has jumped 18 percent in the last 20 years, and the number of kids seeking emergency treatment for allergies has tripled. New parents are understandably concerned about this threat, and it’s crucial that they be able to recognize food allergies in their children and realize there are effective therapies.
The first thing to know is that a reaction to food isn’t always an allergy. Some children and adults will have a food intolerance: They experience stomach upset after eating certain foods. Lactose intolerance, for example, results from lacking an enzyme that helps you digest the sugar in milk, and it causes bloating, gas and diarrhea. Food allergies are the result of an immunological reaction to certain proteins and, instead of producing isolated gastrointestinal symptoms, they typically trigger tingling or itching in the mouth, swelling of the lips, face, tongue, and throat, hives, itching, coughing, and wheezing or trouble breathing. On occasion, they may also cause abdominal pain, nausea, and vomiting.
The most serious concern with allergies is that they can produce anaphylaxis, in which airways constrict and the child struggles to breathe. Blood pressure can drop, heart rate climbs, and the child may become lightheaded or even lose consciousness. To head off this possibility, you’ll want to be sure your child is checked for food allergies if he or she exhibits any symptoms, especially after drinking milk — the most common food allergy — eating eggs, or peanuts. Other sources of food allergies include tree nuts and wheat.
Diagnosing a food allergy is a two-step process. There has to be a history of symptoms after exposure, and then we confirm an allergy with testing. An allergy specialist will consider the patient’s diet and type of symptoms to make sure they’re consistent with an allergic response. Then the doctor will try to confirm the diagnosis through testing. Skin or blood tests can be used to help identify the allergy. Some doctors will use an oral food challenge in which tiny amounts of the potential allergen are given to the patient who is carefully observed for a reaction.
Once a diagnosis is made, the best option for evading severe reactions is avoidance. Read labels, control the child’s access to food, and make sure the child understands that there is no food sharing with friends. Despite everyone’s best efforts, children can still come into contact with the allergenic food, so parents, caregivers, and the child need to carry — and be comfortable using — an epinephrine shot. Self-injectable epinephrine devices provide a single dose of epinephrine, are easy to use and can ward off anaphylactic shock should the child accidentally consume the wrong food.
Food allergies can be very anxiety-provoking for parents and children. I explain to parents that this is all about risk management. We take all sorts of risks every day, such as driving a car, letting our children ride bikes, etc. As long as we take precautions like wearing seat belts while driving and helmets while bicycling, we can prevent troubles. The other good news for parents is that children often outgrow their allergies.
I recommend you visit www.foodallergy.org for helpful information on keeping your child safe. The Tools and Resources section covers topics such as managing food allergies at camp, school and when dining out.
Craig Osleeb, MD, Allergy & Immunology, Northern Westchester Hospital