Solid food is introduced to a baby between 17 weeks and 6 months of age. It is at this stage that parents do raise concerns about food allergies. This is particularly stressful if there is a family history of food allergies. Understanding what causes food allergies, what the symptoms are and how best to deal with a reaction is vital to ensure the safety of your baby.
According to the Allergy Foundation, about 2.5% of South African children below the age of 3 years suffer from food allergies. Around the world the number of children with food allergies is increasing at a rapid rate. This has been attributed to increased pollution and less exposure to the healthy microbes in our environment. Healthy microbes support our immune system and regulate the way our bodies respond to food.
What are food allergies?
Probably the easiest way to explain a food allergy is to begin with immunity. We understand that when your baby gets exposed to an illness, his or her immune system responds to fight off the infection. When a child is allergic to a certain food stuff the immune system responds as if the food is a danger to the child. Histamines and other chemicals are released in response to the “perceived danger”, and these cause various symptoms like a rash, swelling of the lips and tongue, tummy pain and so on. Food allergies are more common in the first 3 years of life and children can outgrow certain allergies.
What is the difference between a food allergy and a food intolerance?
When a child has an intolerance to a particular food stuff his or her body finds it difficult to digest the food. Food allergy is an immune response and does not relate to digestion. Children with food allergies can’t have any of the food at all without a response whereas a child with an intolerance may tolerate a little bit of the food. The confusion comes in for parents because some symptoms of intolerance and allergy may be similar. These include tummy pain, diarrhoea, indigestion or feeling hot and flushed. A food intolerance is really unpleasant because of the symptoms but it is not usually dangerous.
What foods generally cause allergies?
There are eight food products that cause 90% of all allergic reactions in children. These are:
- Tree nuts (like cashew nuts)
- Shellfish (like prawns, crab or shrimp)
Other foods which may cause allergic reactions in a very small number of people are products like sesame seeds, some fruits, grains or vegetables.
The light side of food allergies is that children will usually outgrow the allergy. 80% to 90% of children outgrow allergies to egg, milk, wheat and soy by the time they are five years old.. Seafood and nut allergies tend to persist into later life. Only 20% of children outgrow peanut allergies and the figure is probably lower for seafood and other nut allergies.
What kind of reaction would a child have if he or she is allergic?
An allergic reaction can affect different systems in the body including the respiratory system, the gastrointestinal system, the skin or the cardiovascular system. These reactions would occur every time an allergic person eats (or in some cases even handles) the food.
- Respiratory System- trouble with breathing, coughing or a tight throat. Asthma symptoms including wheezing and a runny nose may also be present.
- Gastrointestinal system- tummy pain, vomiting, diarrhoea
- Skin- red blotches, swelling and itching of the lips, mouth and tongue, itchy eyes, swollen eyes, eczema.
- Cardiovascular-a drop in blood pressure which makes the child feel dizzy and may cause the child to pass out.
In very severe reactions the child may suffer anaphylaxis. This is a potentially life-threatening reaction that affects breathing, causes a sudden drop in blood pressure and can send a body into shock. Emergency medical attention is required.
Keep in mind that an allergy to milk or soy may begin before the introduction of solids. Babies who are still too young for solids may experience symptoms like blood in the stool, poor growth, colic or persistent eczema. Your healthcare practitioner would need to exclude allergy from other causes for the symptoms which your baby is experiencing.
What can I do to prevent food allergy in my child?
A study published by The American Academy of Paediatrics in 2013 recommended that babies younger than 17 weeks should not be fed any solid foods. Introducing solid food to babies younger than 17 weeks increased the possibility of allergies. The study also recommended that exclusively breast-feeding “for as long as possible,” would help reduce the risk of allergies.
Parents are rightfully afraid of the foods which are known to cause allergies but research has shown that delaying the introduction of these foods may increase the chances of an allergy. Numerous studies have shown that when a baby is exposed to egg or peanut containing products (like peanut butter) between 4 and 11 months of age, the risk of allergy to these products is greatly lowered. These foods should not be the first foods you introduce to your baby. You will begin with foods less likely to cause allergy like cereal, vegetables and fruit.
Caution should be taken when introducing a food, which is known to cause allergy, for the first time. This is particularly important with nuts, peanuts and egg. Touching the baby’s lip or cheek with the food and then watching for swelling or redness is a good way to start. Make sure that you are at home where a responsible adult can watch the baby for at least two hours after giving the food and where there is access to medicine or healthcare if necessary.
It is also not advisable to introduce an allergy food when your baby is ill. You want to be absolutely sure that the reaction you are seeing is related to the food and not the illness.
Please note that you will not be giving a baby an actual peanut to eat as this will be a choking hazard. Instead the baby may have a product that contains peanuts like peanut butter.
How will my doctor diagnose a food allergy?
Diagnosing food allergies usually begins with fundamental questions about your baby’s medical history and the symptoms you observed. The questions will most likely involve:
- What food did you introduce to your baby?
- What symptoms did you observe in your baby?
- How long after eating the food did it take for you to notice the symptoms?
- How long did the symptoms last?
- Did you give your baby any medication for the symptoms? If so, how quickly did the symptoms settle?
There are tests which may be carried out by your doctor:
- Blood tests
- Skin prick test
- Oral food challenge.
Your doctor will recommend the best form of testing given your baby’s age and the type of reaction that occurred.
My child has been diagnosed with a food allergy. What now?
The best form of treatment for a food allergy is to avoid the food altogether. It is not an easy task and at first parents do feel overwhelmed. My recommendation is as follows:
- Ensure you have an emergency plan in place in case of a severe reaction. Your doctor will advise you on this. It will usually mean that your child has immediate access to medication in case of a reaction.
- Become a food label reader. Most of the common allergens are labelled on the back of food products that we buy from the shops.
- Consult with a dietitian. Certain food allergies make it difficult to feed the child so finding alternatives are really important to make sure your child gets adequate nutrition.
- Inform your child’s school and make sure they have a copy of the emergency plan.
- If you are breastfeeding your child, you may have to avoid the food yourself.
- Get cookbooks that help with meal preparation if you are at a loss of what to prepare.
- Inform family and friends about the allergy. Sometimes a kiss on the cheek or a hug from someone who has eaten the allergen may cause a reaction in your child.
- Be careful when eating out. Certain foods may have come into contact with an allergen in the kitchen and this may result in a severe reaction.
Eating is such an important part of most celebrations but somehow this also means that the foods that cause allergies are way too accessible and tempting. Both my children suffer from allergies. My daughter is allergic to preservatives and colourants. Any of these products cause her eczema to flare up very badly. My son on the other hand is allergic to gluten. Fortunately, neither of these allergies are likely to cause anaphylaxis but they have changed the way we as a family eat. Preparing food from scratch ourselves and teaching them to take responsibility for their own allergies was a major part of the approach. As children get older parents have less control over their food and getting them on board with management is vital. Thank goodness our society has become very aware of food allergies so taking care of children with allergies has become easier. With treatment for peanut allergies underway in America I believe that in time we will have treatments for all sorts of allergies but until then we need to be vigilant and sensitive to individuals living with food allergies.