The number of children with food allergies continues to grow. In fact, there are more children living with food allergies today than there have been in the past decade. Food allergies affect six percent of U.S. children under three years of age according to the American Academy of Allergy, Asthma & Immunology (AAAAI). It’s not surprising, then, that food allergy has become a frequent topic of discussion for parents during visits with their children’s health care providers.
Via Christi Clinic pediatric allergy and asthma specialist Chrishana Ogilvie-McDaniel, MD, shares some answers to common questions that parents have regarding food allergies in children.
1. What are the symptoms of a food allergy?
There are two general categories of allergic reactions to foods:
• Immediate reactions can occur within 10 to 15 minutes or up to two hours after the food is eaten. The severity of this type of reaction can range from mild to life-threatening. Such immediate symptoms can include itching in the mouth or throat, a red, itchy rash, runny nose, swelling of the lips, eyelids, tongue or throat, vomiting, difficulty breathing, a severe drop in blood pressure or collapse.
• Food intolerance. Chronic reactions involve more long-term symptoms. Such reactions may include moderate to severe eczema, acid reflux that does not improve with antacid medications, chronic vomiting and diarrhea or mucousy, bloody stools in infants being fed breast milk.
2. What foods most commonly cause food allergies?
Milk, eggs, wheat, soy and nuts most commonly cause food allergies in infants and young children. In older children you should also watch for allergies to fish and shellfish.
3. What is involved in allergy testing?
Your child’s visit with an allergy specialist will begin with a detailed discussion of your child’s symptoms and the identification of the potential foods that could be causing these symptoms. A physical examination will follow. If a food allergy is suspected, testing will be done. In most cases, the testing can be done the same day. The evaluation for food allergies usually begins with a skin test, in which purified drops of food allergens are pricked onto the surface of your child’s back or forearm. If there is a food allergy, a welt (hive or bump) will develop at the test site. The test is relatively painless and takes 10 to 20 minutes. If skin testing is not possible or the results are uncertain, a blood test may be needed. This test, called a RAST (radioallergosorbent test), checks for an allergy antibody to the foods in question. These antibodies are what cause allergic symptoms. The test results are available within one to two weeks. If the diagnosis is still unclear, a food challenge may be recommended. The food challenge involves your child eating small amounts of the food in question at the physician’s office. He or she will be monitored closely throughout the visit for any symptoms. The entire process can take several hours.
4. Is there a minimum age for allergy testing?
Children of any age can be tested for a food allergy. Although skin testing is not always as accurate in children under the age of 12 months, a positive reaction (testing results that indicate a food allergy) can be seen in all ages.
5. Can food allergies be prevented?
Researchers continue to study the possibility of food allergy prevention. Although there are no proven methods to prevent allergies to foods at this time, there may be ways to reduce the chance of your child becoming food allergic. For infants at high risk of developing a food allergy (those whose parents or siblings have allergies), the American Academy of Pediatrics and the American College of Allergy, Asthma, and Immunology recommend giving only breast milk for the first four to six months of life, if possible. This means that your child should not eat solid foods, such as cereals or baby food, before 4 to 6 months of age. Recommendations are still under investigation and have not been conclusively determined to prevent food allergies. Additionally, avoidance of allergenic foods during pregnancy and breastfeeding does not appear to prevent food allergies from developing.
6. Will my child eventually outgrow food allergies?
About 85 to 90 percent of children who are allergic to milk and eggs will outgrow these allergies by 5 years of age. Peanut allergy can also be outgrown, but this occurs less frequently. About one out of five peanut-allergic children under the age of 2 will outgrow this allergy by 5 years of age. Similar to nuts, seafood allergy is not frequently outgrown. If your child is diagnosed with a food allergy, strict avoidance of the food will offer the best chance of outgrowing the allergy.