Children's Food Allergies
With all the media attention given to peanut allergies in children, and airplanes creating peanut-free zones, many families are concerned about including old favorites like peanut butter in their diets. After all, a peanut allergy can be life-threatening. According to the Dietitians of Canada, young children are more prone to food allergies than adults, though they tend to outgrow them in a year or two. An allergy to shellfish or peanuts, on the other hand, will probably last for life and be more severe. However, they also report that people may be restricting their diets unnecessarily; many who think they have a food allergy actually do not. Fear of an allergic reaction, especially where peanuts and babies are concerned, is fairly common.
The National Institute of Allergies and Infectious Diseases (NIAID) states that only about 3% of children have a clinically verified food allergy, (though the actual number may be higher since not everyone goes in for formal testing). In order to find out for sure, one must be diagnosed by a doctor. This statistic in no way diminishes the seriousness of allergies for those who experience their uncomfortable - even dreadful - side effects, but there may not be adequate reason to summarily ban a food product from your child's diet.
How do I know if my child has a food allergy?
What many believe to be an allergy is actually an intolerance. A true allergy involves an immune system response, such as swelling, irritation, and possibly, anaphylactic shock. Food intolerance, like the inability to digest the lactose in milk (lactose intolerance), doesn't involve the immune system. With both an intolerance and an allergy, small amounts of the offending food can sometimes be tolerated. Both are uncomfortable to varying degrees.
There are several ways in which a doctor may determine if the adverse reaction to a food is due to an allergy or even a reaction to a food at all. First, according to the NIAID, you can expect your doctor to take a detailed history determining everything from how quickly the reaction took place to how the food was prepared. The doctor may also ask you to keep a food diary and/or practice an elimination diet for a period of time (temporarily avoiding a suspected food then reintroducing it under the doctor's supervision). This, of course, cannot be done if the reaction is severe. Chrys, whose breastfed son suffered from acute gastroesophageal reflux as a 3-week-old, went on an elimination diet herself. "I was on rice and water only for a few days. No fruit, wheat, milk, cheese, citrus, etc. Once I had my system cleaned out I was able to slowly introduce foods." Now that he's older she still introduces new foods carefully, waiting a week after each food before adding anything new to his diet. "They have a chance to fully go through his system so I can see any reactions."
The doctor may administer a skin test, but these must also be avoided by people with severe reactions. In that case, a blood test can be done. Perhaps most reliable, however, is the "double-blind food challenge" done in the presence of a physician. For this test, the patient ingests several possible allergens one by one and waits for a reaction. Neither the doctor nor the patient knows when the actual suspected allergen has been ingested until the patient reacts (if you're wondering, psychological reactions to food are possible).
How do we handle a food allergy?
Avoidance of the offending food(s) - in some cases, at all costs - is the only way to treat a food allergy. This requires label reading, asking lots of questions in restaurants, and educating family, friends, caregivers and schools. Medical alert bracelets or necklaces are another option for those with life-threatening allergies. For these people, carrying a prescription syringe of epinephrine is necessary in case of accidental ingestion.
In the face of all this information, your first thought may be to simply avoid the most common allergy-causing foods, at least for the first year or two of your baby's life. In fact, this is exactly what many allergists recommend. But it's no guarantee. Doctors at UT Southwestern Medical Center at Dallas say that if someone in your family has a history of peanut allergies, or if your child has asthma, you should refrain from giving your child peanut products until age three.
Is my child at a high risk for allergies?
Some children are more likely than others to develop allergies. According to the International Food Information Counsel, your child has the following chances of developing allergies:
- 40-70% if both parents have allergies, higher if they share the same allergy
- 20-30% if one parent has allergies
- 10% if neither parent has allergies
Can allergies be prevented?
Whether or not you find that your child falls in the high-risk category, the following suggestions may prevent or delay allergies from developing: (Keep in mind that there are no guarantees.)
- Breastfeed infants for at least a year.
- Delay the introduction of solids until the age of 6 months, then introduce foods slowly, one at a time, leaving at least 4-7 days in between each different food
- Delay milk, eggs, peanuts and orange juice until one year of age.
- Avoid peanuts until age three if you have a family history of peanut allergies.
No one can say for sure whether or not your child will develop a food allergy. For many, it's a try-and-see venture, going slowly with certain foods and watching carefully to see if symptoms develop. "I chose to go ahead and give nut butters a try and started cooking with them when my daughter was 14-months-old. I know they are highly allergenic to some people, but I had no reason to believe they would be unsafe for my daughter," says Gina, mother of Chloe. "I keep Benadryl on hand, so if there were a reaction, I would've given her that and rushed her to the hospital. I knew the chances of that were small, though, and I saw no reason to ban a good protein source from her diet altogether."
For each family, the decision is a personal one. If you feel your family will do just fine without nut products and you feel safer avoiding them, then that's the right choice for you. Whether or not you choose to include nuts in your family's diet, know that offering a wide variety of healthful foods will meet everyone's nutrient needs.
- Six foods-milk, wheat, soy, eggs, peanuts and fish-cause most food allergies. For children, milk, eggs and peanuts top the list.
- Even those with a life-threatening peanut allergy rarely have a sensitivity to other legumes (lentils, for example).
- Sugar does not cause allergies.
- An allergic reaction usually takes place the second time a food is eaten.
- Lactase deficiency (lactose intolerance) is the most common food intolerance, affecting 1 out of 10 people.
- Though experts say that allergies to specific foods are not inherited, some recommend that those with a history of peanut allergy wait until a child is 3 before offering any peanut products.
Dairy and other Food Sensitivities in Breastfed Babies
The Food Allergy & Anaphylaxis Network
Help and Hope for Food Allergies
Melanie Wilson is the former editor of Vegetarian Baby & Child Online Magazine. She has a Q & A at Vegfamily.com.