How to manage your child’s food allergies

It's difficult to determine the cause when considering food allergies in childhood.

food allergies in childhood: little girl blowing nose

Your child gets a sudden rash. Or starts wheezing. Maybe he vomits. Is there a connection? That depends. Did she eat recently? If so, it’s possible you are seeing symptoms related to food allergies in childhood.

The food your child consumes is not harmful, but the way your child’s body reacts to can be.

Lots of kids have food allergies — about 3 million in the United States alone. Allergies are tough to nail down even for adults because symptoms and causes vary so widely.

When it’s a child, identification is even harder because children aren’t able to associate what they ate with how they react. That leaves it to parents to look for clues and answers. Your job more difficult because various illnesses can cause similar symptoms. Consequently, it takes more time to figure out if this is a food reaction or something else. A primary clue indicating a food allergy is when a reaction occurs shortly after the offending food is eaten.

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What causes a food allergy? Simply, the body’s immune system has made a mistake. The immune system is supposed to protect the body from germs and diseases by making antibodies to help fight off the bacteria and viruses that make you sick. When you have a food allergy, the immune system mistakenly treats that food as something dangerous to your body. It is reacting against harmless proteins found in the food. Allergic reactions can be as minimal as skin breaking out to life-threatening loss of consciousness. Unfortunately, parents often learn the foods their children most enjoy can be the same foods their immune system is treating as “dangerous.” A child’s personal food tastes are unrelated to allergic reactions.

What are possible symptoms of a food allergy?

Skin problems

  • Hives
  • Itchy skin rashes
  • Swelling

Breathing problems

  • Sneezing
  • Throat tightness
  • Wheezing

Stomach symptoms

  • Diarrhea
  • Nausea
  • Vomiting

Circulation symptoms

  • Lightheadedness
  • Loss of consciousness
  • Pale skin

What foods most frequently cause allergies?

Most common:

  • Peanuts and nuts (such as walnuts, pistachios, pecans, cashews)
  • Seafood (shellfish such as shrimp and lobster)

Also common:

  • Cow milk
  • Eggs
  • Fish (such as tuna, salmon, cod)
  • Soy
  • Wheat

Less common:

  • Fruits
  • Grains and seeds
  • Meats
  • Vegetables

What is not a food allergy?

Adding to the complexity of figuring out whether this is a food allergy is the fact that food can cause other problems unrelated to food allergies. Examples include food poisoning, skin irritation, diarrhea and effects from certain ingredients in foods. Food poisoning can cause diarrhea or vomiting, but the cause isn’t allergy; it’s bacteria contained in spoiled or undercooked food. Too much sugar can also cause diarrhea. Acidic foods, like tomatoes and orange juice, can cause skin irritation. And overconsumption of certain ingredients such as caffeine can make a child irritable or restless.

To complicate it even more, some food-related illnesses are labeled an intolerance or sensitivity because the immune system doesn’t cause the problem as it does with a true food allergy. For example, common food intolerance is lactose intolerance where an individual has trouble digesting milk sugar (lactose). Chemicals and dyes added to food can also cause sensitivities and stomach distress. But food intolerances will not cause severe or life-threatening symptoms.

What is a life-threatening food allergy?

In some cases, food allergies can threaten your child’s life. Anaphylaxis is a serious, life-threatening allergic reaction requiring immediate medical treatment. If your child’s symptoms seem acute, get emergency medical help immediately.

Your child is at higher risk of anaphylaxis if there is a family history of allergies, asthma and/or anaphylaxis. Symptoms of anaphylaxis usually involve more than one part of the body such as the skin, mouth, eyes, lungs, heart, gut and brain. Your child may experience:

  • Dizziness and/or fainting
  • Shortness of breath, trouble breathing, wheezing
  • Skin rashes, itching and hives
  • Stomach pain, vomiting or diarrhea
  • Swelling of the lips, tongue or throat

You can’t predict how your child will react to a certain allergen from one time to the next. Both the types of symptoms and how serious they are can change. But if your child has had a life-threatening reaction to a food, it’s vital to protect them from future incidents by ensuring your child does not eat that food again. Some individuals are so sensitive that they can’t even be near the food in question.

Get help from caregivers, physicians

Work closely with your child’s provider to implement a plan that helps your child avoid this food or ingredient. If your child is school-aged or in child care, work with other caregivers to be sure they understand the importance of avoidance for your child. For instance, peanut butter is served at many child cares and schools. Children with severe peanut allergies cannot even sit next to other children eating peanut butter or they may have a severe reaction. So educating other adults that are responsible for your child’s safety is an important part of your plan for your child.

It’s important to work closely with your pediatrician or a pediatric allergist to be sure your child is protected. Your child’s provider will give you a written step-by-step plan on what to do in an emergency. The plan is called an allergy emergency care plan or anaphylaxis emergency action plan. The provider will probably prescribe an epinephrine injection (EpiPen®) in case of exposure.

Epinephrine is the medicine used to treat anaphylaxis. It comes in a device called an auto-injector. When it is pressed against the child’s outer thigh, it injects a single dose of medicine. All your family members should learn how to use it properly. You can teach people who spend time with your child how to use it too.
Your child should have this pen-like device immediately accessible at all times. If your child is too young to be responsible for it, it should be kept close to the child’s location with an adult responsible for giving the shot if necessary. If your child does receive an epinephrine shot, take him or her to the hospital so medical personnel can evaluate the allergic reaction and make sure the reaction is under control.

How can I be sure it’s a food allergy, not another food-related problem?

Some children develop food allergies as babies, while others may develop food allergies as they grow. If parents or other immediate family members have any type of allergies, it is more likely that your child could have food allergies. Allergies tend to be familial.

If you suspect a food allergy, take your child to a family medicine physician, pediatrician or allergy specialist. A simple skin test can identify whether or not you are correct by checking how your child’s body reacts to a small amount of the food or foods in question. After lightly scratching your child’s skin, the provider will put a drop of a liquid version of the food extract on the scratched spot. If the skin gets red or raised, your child is allergic to that food. A blood sample can help identify food allergies.

Does it get better?

Fortunately, many children do outgrow food allergies. Eighty to 90 percent of egg, milk, wheat and soy allergies will go away by the time a child reaches age 5. However, only 20 percent of children will outgrow a peanut allergy. And children are even less likely to outgrow nuts and seafood allergies. Children who have severe reactions to foods like peanuts, nuts and shellfish generally face a lifetime of avoiding these foods. Your pediatrician or allergist can perform tests to track your child’s food allergies. Time will tell if they are going away.

How do I help my child?

It isn’t easy, but the best solution is to have your child avoid the food(s) or drink(s) causing allergic reactions. Teach your child about his or her allergy in an age-appropriate way. As your child gets older, teach your child to read food labels and help your child understand what foods are going to make him or her feel bad. You are still going to have to help with food supervision though. Children aren’t mature enough to completely monitor and restrict their intake.

  • Learn how to read food labels and avoid cross contact. Read food labels every time you buy a product, even those you have used previously. Manufacturers can change ingredients in products at any time.
  • Wash your hands and your child’s hands with soap and water before handling food. Prepare and serve foods with clean utensils and other kitchen items and on clean surfaces. Be careful of cross contact when preparing foods.
  • Ask about ingredients in foods other people make for your child. Teach your child to ask, too, when visiting other homes or areas where food is prepared for them.
  • Educate family, friends, and everyone who is in regular contact with your child. If your child has severe food allergies, teach everyone you can how to assist your child in case of a medical emergency.

Finally, allow your child to enjoy life! Don’t let food allergies dictate happiness. As more people deal with food allergies, the food industry has created many options that are good substitutes for the allergy-causing foods. For instance, most supermarkets have lots of gluten-free and dairy-free choices now. Help your child find likeable substitutes and incorporate them into meals and snacks. Focus on what your child can have and does like, not on what your child cannot have.

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Posted In Back to School, Children's, Health Information, Healthy Living

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