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Food Allergies in Children: Detection, Management, and Prevention

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Kids are notoriously picky eaters, even without the added complication of dietary restrictions, which can make managing common food allergies in children feel a little overwhelming. The good news is you’re not alone; roughly one out of every thirteen kids, or about 8%, live with at least one food allergy. That’s common enough that your child likely isn’t the only kid in their cafeteria with no-go foods.

You might be asking yourself, “why does my child have food allergies?” It’s a question which has plagued not only parents, but also scientists. The precise origin of food allergies can be mysterious, and their severity can range from a mild annoyance to potentially life-threatening. But, armed with knowledge, a food allergy is something you and your child can manage together.

Can a parent prevent food allergies in kids?

The exact mechanism by which an allergy develops isn’t well understood, but we do know what happens once they start. Initial exposure to an allergen, either through consumption or other direct contact, triggers the production of immunoglobulin E (IgE). Once the antibody becomes established, future exposure to the same allergen sets an immune response into motion, causing an allergic reaction. Your child’s body is really trying to protect them, but it’s doing too good a job.

It’s unclear why some immune systems overreact to certain foods, but there is evidence that there might be a genetic factor. If children’s food allergies are common in your family, there’s a higher probability of your child developing an allergy as well. Likewise, if you have older children with food allergies, there’s a decent chance your younger children will follow suit.

While you can’t prevent an allergy from forming, you can be proactive about identifying and managing any allergies your child may have.

How to detect food allergies

The safest and most reliable way to find a pediatric food allergy is with the assistance of your pediatrician and allergist. Skin tests can be performed in the office and deliver results in as little as a few minutes. In a skin test, your child’s allergist will lightly poke or scrape the skin and introduce an allergen, then observe them for any reaction. Skin tests can test for multiple

allergens all at the same time, but they can also be unpleasant, especially because it’s recommended your child stop taking their allergy medications a few days ahead of the test.

Blood tests can be completed even while actively taking antihistamines or other allergy medications and there’s no risk of experiencing a negative reaction during the test. However, blood tests may need to be sent to a lab and can have a longer turnaround time. Talk with your child’s pediatrician about the best plan for them.

Both tests are looking for the same thing, IgE antibodies in the blood or skin, indicating an allergic reaction. In the meantime, be aware of the eight foods or food groups most closely associated with serious allergic reactions. They include milk, eggs, fish, crustaceans/shellfish, wheat, soy, peanuts, tree nuts, and sesame. This is why the FDA requires that food manufacturers clearly label all major food allergens used in their production.

The second most reliable, and least desirable, way to find out about a food allergy is a few minutes after your child has eaten something. The following symptoms can all be indicative of an allergic reaction in progress and may require medical intervention:

  • Vomiting or cramps
  • Hives or a toddler food allergy rash
  • Wheezing or trouble breathing
  • Repetitive coughing
  • Swelling of the tongue
  • Pale or blue coloring
  • Dizziness
  • Anaphylaxis (in severe cases)

Importantly, just because an allergy starts out mild, doesn’t mean it will stay that way. A tingly mouth today could become a restricted airway tomorrow. The best way to prevent a severe reaction is to reduce or eliminate exposure to known allergens. That means removing allergens from your child’s diet and being prepared for accidental exposure.

Managing your child’s food allergy

Like most other elements of personal and parental healthcare, the best treatment is prevention. That means checking labels and keeping allergens off of the table. If your child’s allergy extends to contact exposure, you’ll also want to familiarize yourself with the contents of non-consumable products like lotions and shampoos. While the 2004 Food Allergy Labeling and Consumer Protection Act requires clear identification of allergens in foods, the same requirements don’t extend to non-consumables like cosmetics, which commonly contain wheat or nuts.

Controlling exposure outside of the home can be a little more challenging, but still manageable.

  1. Vocalize allergies to staff when dining out. Most restaurants are happy to make adjustments to accommodate an allergy.
  2. Ask about cross contamination from shared utensils or cook spaces.
  3. Monitor for changes over time.
    • It’s possible for children to outgrow allergies to some foods like milk or eggs.
    • Other allergies, like those to tree nuts, are more likely to stick around.
  4. Be aware and on the lookout for cross reactions.
    • Kids with peanut allergies are more likely to also have tree nut allergies.
    • Likewise, kids who are allergic to shrimp, often have allergies to other shellfish.
  5. Talk to our child’s pediatrician/allergist about whether an EpiPen is appropriate.
    • Epinephrine is the first line of defense against anaphylaxis.
    • An EpiPen is an autoinjector for quick an easy delivery of epinephrine.
  6. Have a plan.
    • Talk with your child and the rest of your family and support system about what to look out for and what to do in the event of an emergency.

A new or serious baby food allergy can be an overwhelming concern for parents. But with time, learning, planning, and a lot of communication with your pediatrician the world will stop feeling like a minefield of potential dangers.

Brady Watkins, PA-C

Brady Watkins, PA-C

Brady practices pediatrics in our Bluffdale office.

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