Having listened to horror stories depicting children reacting to items such as nuts, shellfish, and milk, many parents find themselves fearing food allergies. As a result, parents can be reluctant to encourage their children to try new things. This may mean just slowing down the introduction of foods, but for some this means avoiding certain foods altogether. But is holding off on different types of foods the right thing to do?

The following article about food allergies in children if for general information purposes only; for specific information about your child it is best to speak to your child’s healthcare professional.

You may be aware that food allergies are on the increase, and that hospital admissions for severe allergic reactions have doubled over the last decade in countries such as the UK and USA. In Australia, admissions for anaphylaxis have increased five fold. While there is no clear understanding of why this is so, some have suggested that delayed introduction to certain foods is playing a part. Others suggest skin exposure and methods of food processing are to blame. Whatever the reason, there’s no debating that food allergies are a serious issue today.

What are food allergies?

A food allergy is an abnormal response to food, triggered by the body’s immune system. Sometimes, a person’s immune system will produce antibodies in reaction to a protein in foods which would normally be considered safe. Mast cells recognise, for example,  a peanut as an allergen, and dump IgE antibodies into the tissues as a way to rid the allergen. This is what’s known as an allergic reaction. A reaction to food can result in an itchy or runny nose, a sore throat, itchy, watery eyes, a rash (hives), skin irritations, vomiting, diarrhea and swelling, which usually appear shortly after consuming the food. Food allergies are common in infants and children, with an estimated one in twenty children between 0 and six years having a food allergy. Many children grow out of these food allergies, and just two in 100 adults suffer from food allergies.

What foods cause the most reactions?

Many types of foods can be allergens, but certain types of foods are significantly more likely to trigger an allergic reaction. According to Food Allergy Research and Education (FARE), eight foods are responsible for 90 percent of food allergies. These foods are:

• Cow’s milk
• Eggs
• Peanuts
• Shellfish
• Fish
• Tree nuts (cashews, walnuts etc)
• Wheat
• Soy.

 

Milk allergies: A milk allergy is a reaction to whey or casein, the proteins found in cow’s milk. It’s not the same as lactose intolerant, which is the inability to digest lactose. The bad news for children with milk allergies is that the chance of being allergic to other foods, such as eggs, soy and peanuts, rises. Most children with milk allergies also develop one or more other atopic diseases, such as asthma, allergic rhinitis or eczema.

Egg allergies: Egg allergies occur most often in children and, thankfully, most cases resolve by the time a child reaches adolescence. Only a small fraction of people remain allergic to eggs their entire life. Egg allergies vary, in that one person may be allergic to the yolk, while another is allergic to the white. For others, it may be both parts that don’t agree with them.

Peanut allergies: Mention peanut allergies, and panic immediately sets in. Children with peanut allergies rarely grow out of their sensitivity to peanuts, so a peanut allergy is more often than not a lifelong disorder. The thing that’s most scary about peanut allergies is that reactions tend to be quite strong, with some sufferers experiencing life-threatening anaphylaxis with accidental exposure. Anaphylaxis requires immediate medical attention, in the form of a shot of epinephrine (EpiPen).

Shellfish allergies: Shellfish allergies are another serious condition that can cause anaphylaxis, and similar to peanut allergies, shellfish allergies are usually lifelong. However, approximately 60% of people with shellfish allergies experience their first allergic reaction as adults. Prawns, crab and lobster are the most common culprits.

Fish allergies: Fish allergies are generally not that common, but an allergy to finned fish is a frequent cause of anaphylaxis. Luckily, most fish allergies don’t become present until adulthood, with 40% of sufferers having no problems with fish until later in life. An allergy to fish does not necessarily mean you are allergic to shellfish, and in fact it may be safe to eat certain varieties. An allergist will be able to help determine what varieties may be most dangerous to the individual.

Tree nut allergy: Tree nut allergy is one of the most common forms of allergy in both children and adults, and most cases tend to be lifelong. Recent studies have, however shown that 9% of children grow out of their tree nut allergies before adulthood. Tree nuts include, but are not limited to, walnut, almond, hazelnut, cashew, pistachio, and Brazil nuts. A person allergic to tree nuts should stay away from all nuts to be safe.

Wheat allergies: Wheat can be found in many foods, including some you might not suspect - for example, deli meats, soy sauce, and ketchup. This can make dealing with a wheat allergy hard. Wheat allergies are often confused with celiac disease, but these conditions differ. A wheat allergy generates an allergy-causing antibody to wheat proteins, while celiac disease causes an abnormal immune system reaction to gluten.

Soy allergies: Approximately 0.4% of children are allergic to soy, but more often than not children grow out of their allergy by age three. Allergic reactions to soy are typically mild, however severe cases have been reported. There are also many foods that may cause a milder reaction, which is referred to as an intolerance. Intolerance reactions are generally less severe than allergic reactions and, unlike allergies, intolerances are not caused by the reaction of your immune system. Even so, an intolerance can be unpleasant for young children. Common intolerances include dairy products, food additives, strawberries, citrus fruit, tomatoes, and foods containing histamines.

When to be cautious

If a family has one child with a food allergy, their brothers and sisters are at a higher risk of having food allergies too. Food allergy screening is possible, but it’s important to note that children can develop allergies at any time and a negative test should not be relied on. In the case of a positive screening test, further studies may need to be carried out. Do not presume that because you had an allergy as a child that your own children will. There is very little evidence suggesting food allergies are hereditary.

What to look for

If you suspect your child could be suffering from an allergy or intolerance to a particular food, it’s important to monitor them closely. In foods that commonly cause reactions, always pay special attention when trialing for the first time and introduce in small doses. Symptoms to food allergies will normally present themselves within 30 minutes of the food being consumed. For some children, symptoms can be severe (known as anaphylaxis), and can result in difficulty breathing, swelling of the throat or tongue, coughing, dizziness and/or unconsciousness. Deaths have occurred, although fatal reactions are extremely rare. Lesser symptoms include reflux, colic and diarrhoea.

Preventing food allergies

While there are no clear guidelines on how to prevent food allergies in young children, certain factors can help limit your child’s chance at developing an allergy. These factors include:

• Breastfeeding for a minimum six months.
• Continuing usual food habits during pregnancy and breastfeeding where safe.
• Combining solid food with continued breastfeeding.
• Not smoking during pregnancy.

Do you suspect your child may have an allergy? Reliable diagnosis is crucial in preventing a reaction, so talk to your GP today. Possible suggestions from your GP may include a skin prick allergy test or blood test. In some cases, your GP may suggest a temporary elimination diet or food challenge.