Food Allergies

Food allergies in Children

What is a food allergy?

With a food allergy, the body reacts as though that particular food product is harmful. As a result, the body’s immune system (which fights infection and disease) creates antibodies to fight the food allergen, the substance in the food that triggers the allergy.

The next time a person comes in contact with that food by touching or eating it or inhaling its particles, the body releases chemicals, including one called histamine, to “protect” itself. These chemicals trigger allergic symptoms that can affect the respiratory system, gastrointestinal tract, skin, or cardiovascular system. These symptoms might include a runny nose; an itchy skin rash; a tingling in the tongue, lips, or throat; swelling; abdominal pain; or wheezing.

A child could be allergic to any food, but these eight common allergens account for 90% of all reactions in kids:
1. milk
2. eggs
3. peanuts
4. soy
5. wheat
6. tree nuts (such as walnuts and cashews)
7. fish
8. shellfish (such as shrimp)

In general, most kids with food allergies outgrow them. Of those who are allergic to milk, about 80% will eventually outgrow the allergy. About two-thirds with allergies to eggs and about 80% with a wheat or soy allergy will outgrow those by the time they’re 5 years old.

Other food allergies are harder to outgrow. Only about 20% of people with allergies to peanuts and about 10% of those allergic to tree nuts outgrow the allergies. Fish and shellfish allergies usually develop later in life and are even more rarely outgrown.

Food Allergy Reactions
Food allergy reactions can vary from person to person. Some can be very mild and only involve one part of the body, like hives on the skin. Others can be more severe and involve more than one part of the body. Reactions can happen within a few minutes or up to a few hours after contact with the food.

Food allergy reactions can affect any of the four following areas of the body:
• skin: itchy red bumps (hives); eczema; redness and swelling of the face or extremities; itching and swelling of the lips, tongue, or mouth (skin reactions are the most common type of reaction)
• gastrointestinal tract: abdominal pain, nausea, vomiting, or diarrhea
• respiratory tract: runny or stuffy nose, sneezing, coughing, wheezing, shortness of breath
• cardiovascular system: lightheadedness or fainting
• A serious allergic reaction with widespread effects on the body is known as anaphylaxis. This sudden, potentially life-threatening allergic reaction involves two or more of the body areas listed above. There also can be swelling of the airway, serious difficulty with breathing, a drop in blood pressure, loss of consciousness, and in some cases, even death.

If the Pediatrician suspects a food allergy, you’ll likely be referred to an allergy specialist, who will ask more questions, perform a physical exam, and probably order tests to help make a diagnosis. Although there’s no cure for food allergies, medications can treat both minor and severe symptoms. Antihistamines might be used to treat symptoms such as hives, runny nose, or abdominal pain associated with an allergic reaction.

If your child wheezes or has asthma flare-ups (also called attacks) as the result of a food allergy, the doctor will likely recommend that a bronchodilator such as albuterol (which can be inhaled from a handheld pump device) be taken right away to reduce breathing difficulties.

But remember, if your child experiences an allergy-triggered asthma attack, it’s important to consider also giving epinephrine and seek emergency medical treatment immediately in case the asthma symptoms are part of anaphylaxis. Epinephrine is often used to treat severe allergic reactions, or anaphylaxis. If your child has severe food allergies, your allergist will want you to have two epinephrine autoinjectors (commonly called EpiPens) on hand at all times in case of a life-threatening reaction. This will mean keeping epinephrine in your home, briefcase or purse, and also at relatives’ homes and your child’s day care or school.

Signs and symptoms of anaphylaxis that would require epinephrine include:
• hoarseness>
• sensation of tightness in the throat>
• difficulty breathing>
• any symptoms from two or more of the body systems, such as hives and abdominal pain, or any other combination of two or more symptoms that affect different parts of the body

If your child starts having serious allergic symptoms, give the epinephrine auto-injector right away. Seconds count during an episode of anaphylaxis. Then call 911 or take your child to the emergency room so additional treatment can be given, if needed. Also, your child needs to be under medical supervision for at least 4 hours because even if the worst seems to have passed, a second wave of serious symptoms (called a biphasic reaction) often happens.

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