Food allergy in children can range from rashes and swelling to even a life-threatening reaction so parents must be in tune with the condition.
ALL mums worry whether their children are eating a balanced diet.
But for certain parents, what the child eats can become an all-consuming concern, especially if they have food allergies.
A food allergy is when the body has an abnormal immunological response towards certain foods, says Dr Sanjay Woodhull, consultant paediatrician at Ramsay Sime Darby Healthcare.
It can be present in many forms but the commonest form that most parents are aware of is rashes or hives. The child may also have swelling in the eyes, ears or face, throat itchiness, coughing, vomiting and wheezing.
“The most severe spectrum is something called anaphylaxis which is very dangerous, rapid in onset, life-threatening and requires immediate treatment.”
Some children experience symptoms immediately after consuming the offending food, for example, anywhere between minutes to two hours while others may experience a late onset of symptoms, after a few hours or even a few days.
In some cases, there may be a mix of both immediate and delayed reactions.
Dr Sanjay says in the vast majority of cases (meaning 60-70 per cent of children), food allergies tend to show up within the first year of life. The most common foods which cause allergies are cow’s milk, eggs, fish and peanuts.
“Generally, in children with food allergies, their immune system becomes over-responsive towards a particular food and this results in an inflammatory cascade of events going through the body,” he says.
Where peanut allergy is concerned, it used to be a major issue in more developed countries like Europe and the United Kingdom.
It was almost unheard of in Malaysia but Dr Sanjay says that in recent years, we are starting to see more peanut allergies among children here.
He adds that if parents suspect a food allergy in their child, they must see a doctor and provide a detailed history.
If possible, they should also take pictures of the rashes or facial swelling which appears when the child consumes that particular food and show it to their doctor so he is able to get a clear picture of the situation.
What parents should not do is to blindly eliminate certain foods from their child’s diet based on a suspicion of a food allergy as this can lead to nutritional deficiencies.
Parents must also remember that over-zealously removing certain things from their child’s diet can actually make the situation worse.
New evidence shows that the longer you withhold a particular food from a child suspected to have a food allergy, the higher the chances of that child actually developing an allergy towards that food in the future.
“So, we don’t recommend avoiding foods purely on suspicion. The longer they don’t take it, the higher the chance that upon reintroduction one or two years later, they will develop an allergy to it,” he says.
Before any diet elimination parents should seek medical advice.
Dr Sanjay says that based on parental concern, the incidence of allergy in some populations may get pushed up by as high as 20-30 per cent but when these children are tested, less than two per cent actually have an allergy.
There’s a huge gap between perception and the actual number of allergic kids in a population.
When a child eats something and breaks out into rashes, it may not necessarily be linked to food and even if it is, the meal eaten by the child may contain many different ingredients and it’s not possible for parents to pinpoint the offending food.
When an allergy is suspected, doctors will usually do a skin prick or blood test which can determine which types of food the child has a sensitivity to. They will also obtain a detailed food and medical history of the child from the parents.
Dr Sanjay says the blood test or skin prick test only indicates sensitivity towards a particular food — it doesn’t confirm an allergy.
Having sensitivity towards something doesn’t mean a child will break out in rashes or experience other food allergy symptoms each time he consumes a certain food.
For example, a significant number of children with a positive result on the skin prick test for egg and fish can still easily consume both types of food.
Their bodies are sensitised to it but they don’t exhibit symptoms.
Even in children with a confirmed allergy such as an egg allergy, for example, they sometimes don’t exhibit symptoms if they eat a muffin which contains egg as opposed to scrambled eggs because the protein in the egg gets broken down during the baking process.
As a result, diagnosing a food allergy critically lies in getting the patient’s history.
“Taking a good history would be the most important thing when diagnosing a food allergy.”
What doctors usually do after the skin prick test or blood test and after obtaining a detailed history is something called an “oral challenge”, where the child is fed the offending food and his reaction monitored.
Children with food allergies need to be educated on their condition and parents must help them manage the problem.
Dr Sanjay explains that by the time children are two to three years old, some tend to outgrow food allergies.
By age three, for example, most children outgrow their cow’s milk allergy.
Egg allergies stop becoming an issue once the child is 3-7 years old while peanut allergy takes a longer time to diminish, usually persisting until adolescence, the teenage years or sometimes until adulthood.
While children with a family history of allergies are more likely to face the problem, studies are also showing that exclusive breastfeeding and early weaning can help delay or prevent the onset of food allergies.
Dr Sanjay says children who are started on solids earlier — at around four to five months of age (instead of six months) — are less likely to develop allergies as they are exposed to foods such as eggs, fish and peanuts at an earlier age.
WHEN IT’S NOT
OFTEN, certain foods that children eat trigger illnesses which parents may mistakenly confuse as allergies.
The following conditions are not food allergies:
* Food poisoning – usually caused by bacteria in undercooked or spoilt food.
* Drug effects – certain ingredients such as caffeine in carbonated drinks can make children shaky or restless.
* Skin irritation – can be caused by acids found in foods such as orange juice or tomato products.
* Diarrhea – can occur in young children even because of too much sugar, such as from fruit juices.
A FOOD allergy will manifest in symptoms that affect the body in various ways. These include:
Hives (red spots that look like mosquito bites)
Itchy skin rashes (eczema, also called atopic dermatitis)
Loss of consciousness.
COMMON ALLERGY TRIGGERS
BESIDES food, there are other things in and around the home and even outside which can trigger allergies in children.
tree pollen, plant pollen, insect bites or stings
pet or animal hair or fur, dust mites, mold.
cigarette smoke, perfume, car exhaust fumes.
Source: Children & Allergies - acaai.org
HOW can you tell when your child is describing a food allergy?
Some children (particularly very young ones whose communication skills are lacking) may not be able to tell you what’s happening when they experience a food allergy but there are certain phrases or actions which may point to the problem and help parents to take action.
* Putting their hands in their mouths or pulling or scratching at their tongues in response to a reaction.
* Change in voice (for example become hoarse or squeaky), and they may slur their words.
* A child might also use these phrases to describe a reaction:
“This food is too spicy.”
“My tongue is hot (or burning).”
“It feels like something’s poking my tongue.”
“My tongue (or mouth) is tingling (or burning).”
“My tongue (or mouth) itches.”
“It (my tongue) feels like there is hair on it.”
“My mouth feels funny.”
“There’s a frog in my throat.”
“There’s something stuck in my throat.”
“My tongue feels full (or heavy).”
“My lips feel tight.”
“It feels like there are bugs in there.” (to describe itchy ears)
“It (my throat) feels thick.”
“It feels like a bump is on the back of my tongue (throat).”