Food allergies happen when our immune systems produce antibodies in reaction to a protein in food that is normally considered harmless. Food allergies are more common in people who come from families with a history of allergies, such as asthma, hayfever, or eczema. If your child has a food allergy, he will probably have an itchy or runny nose, a sore throat, itchy, watery eyes, rashes (hives) and swelling, which usually come on fairly quickly after eating the food. Food allergies are common in young children.
It is estimated that between six per cent and eight per cent of children have a food allergy (Venter et al 2008). What is my child most likely to be allergic to?
The most common food allergies in young children are to milk, eggs, peanuts and tree nuts. * Milk: Although this is not to be confused with milk intolerance. * Eggs: About two per cent of children under three are allergic to eggs. * Nuts: Just under two per cent of children are allergic to peanuts.
Nut allergies in general are on the increase (Hourihane et al 2007). What symptoms should I look out for?
It should be quite easy for you to tell if your child has an allergy. The symptoms include: * Hives (nettle rash) around your child’s mouth, nose and eyes, which can spread across his body. * Mild swelling of his lips, eyes and face.
* A runny or blocked nose, sneezing, watery eyes. * An itchy mouth and irritated throat. * Nausea, vomiting and diarrhoea. More severe reactions, involving wheezing, breathing difficulties or a drop in blood pressure may be life-threatening and are known as anaphylaxis.
Fortunately, severe reactions are rare in young children. If you suspect a child is having a severe allergic reaction, call an ambulance immediately.
When your child reacts quickly to an allergen, it’s usually easy to spot. However, delayed allergic reactions to foods are becoming more common. Your child’s body will take longer to react, because different parts of his immune system are affected. Symptoms to look out for include:
* reflux * colic * diarrhoea * constipation * eczema, which is common in young children with a milk allergy Remember that all these symptoms are common in early childhood and an allergy is only one possible explanation. How is a food allergy diagnosed?
If you think your child is allergic to a food, see your GP and ask for a referral to an allergy clinic. There are about 90 NHS allergy clinics in the UK, some of which specialise in children’s allergies (paediatric allergy), but you may not have one in your area. Your child may be seen by a general paediatrician, a dermatologist, or an adult allergy specialist instead.
Your child will have a skin prick test as a first step, and these are very helpful, even for diagnosing allergies in small babies. Your doctor may also do blood tests. Always get medical help if you’re concerned. Don’t be tempted to buy commercial testing kits, which are sold online, by mail order or in health food shops.
If your child is having a delayed allergic reaction to a food, the allergen is likely to be tracked down by a process of elimination. Your doctor will refer you to a dietician, who will work with you on a diet that cuts out various foods from your child’s meals. The dietician will review your child’s symptoms and slowly reintroduce the suspected allergen to his diet to see if the symptoms recur. Always talk to your doctor or a dietician before cutting food groups out of your child’s diet. Will my child grow out of his food allergy?
It depends on what he’s allergic to. Up to 90 per cent of children will outgrow cow’s milk and egg allergies, for example, whereas only about 10 per cent to 20 per cent outgrow nut allergies. Some children may go on to develop other allergy-related, or atopic, conditions, such as asthma or hayfever, later in life. Read our article on allergies for more information.
If your child has a food allergy, it’s essential that he is checked often by an allergy specialist, and that he is retested at intervals to see if he has outgrown his allergy. What are food intolerances?
Young children can sometimes develop an intolerance to certain foods, which is different to an allergy, because it doesn’t involve the immune system. The terms are often confused. Your child has an intolerance if he has difficulty digesting certain food. He might have the following symptoms:
* tummy pain * colic * bloating * wind * diarrhoea * vomiting The most common intolerance in babies is milk, or lactose intolerance. This usually occurs after a tummy upset and may last a few weeks.
If you suspect that your child has a food intolerance, see your GP. Never try to diagnose your child yourself, since there are other conditions that can cause similar symptoms, such as coeliac disease, a condition where the gut reacts to the gluten in grains (Bingley et al 2004).
The food that troubles your child is identified in much the same way as an allergen that causes a delayed reaction. Your doctor will refer him to a dieticians, who will put him on an exclusion diet, where suspect foods are removed from his meals then slowly reintroduced. This helps to identify which foods are causing the problem. Living with a food allergy
Once your child’s food allergy has been diagnosed, always follow your doctor’s or dieticians’ advice about avoiding trigger foods. Some children with mild allergies, for example to egg, might be able to tolerate the food in baked goods, whereas other children with severe allergies will have to avoid all traces of it.
Holidays, birthday parties, eating out and days out will need more planning than usual, but you will soon get used to providing the right food and drink for your child or advising others on how to do so.
Always remember to take your child’s medication with you on a trip out. This may be antihistamine medicine, or if your child is at risk of a severe reaction (anaphylaxis), he may also have an adrenaline pen (Epipen or Anapen) as well. Shopping for a special diet
Shopping for a special diet can be a challenge at first. But once you get to know all the products that are suitable for your child, with help from your dietician or doctor, his diet will be varied, nutritious and tasty.
There are now special “free-from” ranges in most supermarkets, and many stores provide lists of own-brand foods which are free from nuts, eggs and milk.