Below is practical, sensible, and expert information for parents on childhood food allergies.
By Dr. Elana Lavine, BSc MD FRCPC (Pediatrics, Allergy and Clinical Immunology) Dip(ABP)
1. What are food allergies?
While there are lots of ways that a particular food might not “agree” with your body, not all of them are allergies. Examples of NON-allergies would include lactose intolerance (you can’t digest the milk sugar, called lactose), or dark chocolate or aged cheese triggering migraines in people who tend to get them, or spicy foods worsening “heartburn” in people who tend to get that.
Food allergies are a particular way that your immune system can respond to a food. One type of reaction happens quickly after you eat a food, or have close contact with it in some situations, and can include hives, swelling, eye or nose symptoms, trouble speaking, swallowing, or breathing, vomiting, and possibly trouble with your heart’s function and blood pressure.
Other types of allergic reactions may involves your stomach and gastrointestinal system and may behave a bit differently. It’s important to speak to your doctor before you diagnose yourself or your child with a food allergy. You can see how this last type of allergic reaction could be confused with, say, lactose intolerance or something else.
2. Are food allergies on the rise?
Yup, it sure seems they are. There are several studies trying to measure how many people, especially children, have food allergies, and they tend to show that more and more kids are allergic in the population. (Don’t ask me why! There really isn’t a simple answer. We are all waiting for some insight on this question…)
3. Is there anything a parent can do to prevent their children from developing food allergies?
Don’t we all wish there was an easy fix! In short, we don’t think mothers should drive themselves crazy during pregnancy or while breastfeeding their babies because we can’t figure out what to tell them to do. You are still best off breastfeeding your baby for at least 4 months and that seems to reduce the incidence, or at least delay, your baby developing eczema (atopic dermatitis) and wheezing while they are little.
If you can’t breastfeed, you may be better off using what’s called an “extensively hydrolyzed” formula, meaning the cows milk proteins in the formula are broken down in a major way and that seems to be helpful in preventing eczema in some babies. (However, lots of babies don’t like the taste of these formulas so sometimes it’s a struggle to get them to drink them!)
Ask your doctor about which formulas qualify as “extensively hydrolyzed” because it is very confusing – all that stuff at the grocery store that uses words like “gentle” or suggests that they are easily digested is NOT the same as an extensively hydrolyzed one.
Also, we don’t think there is any value in delaying your baby’s start on healthy solid foods, so all babies should be starting to eat that stuff between 4 and 6 months, depending on their developmental progress (can they sit up to eat? will they allow a spoon in their mouth?) and parent’s preference.
A few months ago my son (16 month old) had 2 reactions of hives on his face and mild swelling that we felt could have been linked to peanut butter and was finally seen by an allergist yesterday who did a scratch test to confirm a peanut allergy. Unfortunately as a working Mom I had let my husband go without me assuming there would be more work up than just one appointment but he was sent on his way with a prescription for an epipen and told to remove peanuts from the house. I obviously want more info but my first question is a peanut allergy always severe and treated always as an anaphalaxis reaction or are there degrees? I just need to know how vigilent we need to be. Also, with only a scratch test for peanut, cashew and sesame and the prescription am I wrong in expecting more of a workup and education from our allergist? Thanks
Thanks for your questions. Although this blog is not intended to provide direct medical advice to patients/parents, hopefully I can give you some general suggestions that will be helpful.
1. If you feel as if you did not get sufficient information out of the consultation with the allergist, I strongly recommend that you book another appointment to discuss any outstanding concerns.
2. Peanut allergies (or any allergies for that matter) are unpredictable. This means that the next reaction can be anything from mild symptoms to a life-threatening anaphylactic reaction. It is for this reason that an epipen (and a person trained to administer it) should always be available no matter where your son is and at all times. This is often daunting and overwhelming at first, but over time, most families get accustomed to it.
3. Regarding further work-up. Again, if anything is not clear to you from the consultation with the allergist, I cannot recommend more strongly that you book a follow-up visit to get all of your questions and concerns addressed.
4. Finally, ask your allergist if you can be put in touch with another family that had to go through this process. It is often very helpful to talk with someone about how they worked through this challenge