By Dr. Hemapriya, mylittlemoppet_
Most of us are familiar with the idea of allergies, many of us either suffer from them personally or have a family member who does. However, compared to general allergies like dust allergy, food allergy is a whole different ballgame, and can be more dangerous as well as more difficult to manage.
The Food Allergy Awareness Week falls in May( 9–15), so we’ve decided to take a more in depth look at food allergies in kids and how to deal with them.
What is a Food Allergy?
A food allergy occurs when the body reacts to a certain food in an adverse manner. The body considers the food as harmful and the immune system generates antibodies to fight the particular food allergen. In the process, the body releases certain chemicals that can create allergic symptoms. These symptoms can vary widely in type and in severity, affecting any or all parts of the skin, respiratory, gastrointestinal or cardiovascular systems.
Signs of a Food Allergy in Kids
Broadly speaking, food allergic reactions can be classified as mild and severe. Mild reactions generally include the following:
- Hives or rashes on the skin
- Sneezing or coughing
- Nausea or vomiting
- Diarrhea
- Stomach pain
More severe allergic reactions may include:
- Swelling of the lips, tongue, or throat
- Watery, swollen eyes
- Difficulty swallowing
- Wheezing or difficulty breathing
- Dizziness or lightheadedness
- Loss of consciousness
These signs can appear anywhere within a few minutes to 2 hours of having the food. In very severe cases, the food can cause a reaction called anaphylaxis. This may start of as mild symptoms but can quickly escalate to difficulty breathing or losing consciousness and if left untreated, even death.
Food allergy is not to be confused with food intolerance, which have different symptoms. Signs of a food intolerance include gassiness, burping, indigestion and loose motions. Food intolerance has nothing to do with the immune system and is generally not dangerous.
Common Food Allergens
About 170 foods are known to cause allergies but the most common food allergens for kids are milk, eggs, peanuts, tree nuts, soy, wheat and shellfish. Kids who develop allergies to these foods may not have them throughout life. About 80% of kids outgrow milk, wheat, soy and egg allergies by the time they are 5 years old. Allergies to peanuts, tree nuts and shellfish usually last a lifetime.
Globally, food allergies affect about 2.5% of people, but in India this is believed to be lower, although there are few formal studies on the subject. An article in the 2019 edition of the Journal of Evolution of Medical and Dental Sciences claims that Indian genes have a lower risk of food allergies along with allergic rhinitis, asthma and eczema.
There is a genetic factor when it comes to kids having food allergies. If you have a food allergy, your child is 50% more likely to have the same. If your spouse also suffers from a food allergy, the child’s probability goes up to 75%. The risk increases if there are other allergies like allergic rhinitis, asthma or eczema.
7 Tips to Manage Food Allergy in Kids
1. Start Early
Earlier, the theory was that it was safer to delay common food allergens for babies, but latest studies show that the reverse is true. The earlier babies are introduced to such foods, the lower their risk of developing an allergy to them. In fact, it is recommended for women (who don’t suffer from food allergies themselves) to eat all allergenic foods during pregnancy and breastfeeding. This helps the baby get to make the baby’s body more receptive to all foods later.
2. Follow the 3-Day Rule
You can introduce solids to babies after six months of age, but it’s recommended to introduce one food at a time, following the 3-day rule. Wait for 3 days before reintroducing the food so you can identify if any food causes an allergic reaction. Ensure that food fed to babies is safe and doesn’t pose a choking hazard. For instance, instead of whole peanuts, opt for creamy peanut butter. Avoid hard foods in small pieces.
3. Read Food Labels
There is no cure for food allergies, and the only treatment is to avoid foods with allergens. Due to this, when buying packaged food, it is crucial to read the food label thoroughly. It is required by law to mention any allergy information on the label. Any allergic food may either be a part of the ingredient list, or it may be listed as a separate line “Contains traces of wheat”, for instance. Some labels may also include information about where it was processed, “Prepared in a factory that processes nuts”.
4. Avoid Cross Contamination
When it comes to avoiding food allergens, it is important to be very rigorous about keeping the child’s food completely separate from others, since even a small amount of the allergen can trigger a reaction. Have a separate set of utensils – cooking and eating- for the child. Cook the allergic child’s food first, and keep it covered so that nothing falls on it. Always wash all dishes and utensils in between cooking and wipe the countertop and stove with soapy water too. Don’t forget to wash hands with soap and water too – sanitizers don’t work for allergies.
5. Have an Emergency Plan
As soon as your child is diagnosed with a food allergy, get an emergency action plan from the doctor. You can use this Allergy and Anaphylaxis Emergency Plan from the American Academy of Pediatrics as a sample. It should include basic details about the child’s age and weight as well as what foods and/or medicines the child is allergic to. The plan should also mention what to watch out for, what the immediate course of action should be, and where any medicines are kept. This will help in case you are not around when the child has an allergic reaction and someone else has do manage it.
6. Inform the School
Our children spend a good part of their days at school, which means it is important to inform the school staff about the child’s food allergies. Children often exchange lunch boxes or have class parties, which could all prove dangerous if your child has the wrong food. Explain the plan to them and also tell them where the child’s medications are kept, so they can be accessed immediately if required.
7. Carry an Epipen
An Epipen is a pen shaped tool that is actually an epinephrine auto-injector. This is a medicine prescribed by doctors that can be used in case of any emergency, especially if your child tends to have severe reactions. Always keep at least two doses of the medication with the child. The Epipen is easy to use and older kids can even use it themselves.
A diagnosis of a food allergy can be overwhelming initially, but as you include these instructions in your daily life, it gets easier to manage. One side effect of avoiding entire food groups is missing out on important macro and micro nutrients. Talk to your doctor for substitutes, for instance there are many foods that provide calcium even if your child can’t have dairy. Your doctor may also suggest multivitamins if necessary, to fill in any gaps in nutrition.