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Understanding Children’s Food Allergies

By Natalia Padgen

The number of children with food allergies is on the rise and with more coverage in the media, plus claims and advice from unauthorised sources, it is important to be informed on the matter.

According to ASCIA, (The Australian Society of Clinical Immunology and Allergy), studies have shown that food allergy affects between 2.3 and 3% of children aged 0-6 years.

A higher proportion of children suffer from adverse reactions such as food intolerances and sensitivities.

Knowing the difference between the two, what symptoms to watch out for, the high risk foods to be wary of and even how to potentially prevent them, is a smart path to take for all parents.

For those who do have children living with allergies, understanding how to effectively manage the condition is key to ensuring that they lead happy, healthy lives with minimised symptoms.

What is a food allergy?
A food allergy occurs when the body identifies a usually harmless food as a dangerous invader.

The immune system then releases antibodies to eliminate the invader.

Immediate reactions can occur within minutes of ingesting the food and in some cases, they can be life threatening.

An extreme allergic reaction can cause anaphylactic shock, which constricts the airways.

When this is the body’s response, the food must always be avoided and the child must be issued with an adrenaline autoinjector (EpiPen, or Anapen).

Other severe allergic reactions include:
- Difficulty breathing
- Swelling or tightness of the throat
- Swelling of the tongue
- Wheezing or coughing
- Difficulty talking
- Dizziness or loss or consciousness
- Becoming pale and floppy or limp in younger children

Less obvious symptoms include:
- Infantile colic
- Chronic diarrhoea
- Reflux
- Eczema
- Hives
- Cramping
- Vomiting
- Failure to thrive in infants

What is a food intolerance or sensitivity?
Symptoms of an intolerance or sensitivity do not involve the immune system so are not classed as an allergy.

Reactions can occur to food from one hour to days following consumption and can be much harder to detect.

If untreated, symptoms can present as illnesses affecting various parts of the body and include:
- Asthma
- Colic
- Crohn’s disease or colitis
- Constipation
- Diarrhoea
- Vomiting
- Irritable bowel syndrome
- Obesity or excess weight
- Ear infections
- Eczema
- Rashes
- Frequent infections
- Bronchial infections
- Runny nose
- Attention-deficit disorder
- Anxiety
- Hyperactivity
- Bed-wetting
- Spitting up in infants

What are the most common food allergies?
The most common foods that are the root of children’s food allergies include:
- Cow’s milk
- Soy
- Eggs
- Peanuts & tree nuts
- Sesame seeds
- Wheat
- Fish
- Shellfish

Severity in reaction can vary depending on the acuteness of the allergy, the amount eaten and the form that the food was consumed in.

While cooked foods are sometimes better tolerated, liquids may be absorbed faster, increasing the level of reaction.

Factors that may increase the severity of reaction include the presence of asthma and exercise near the time of consumption.

When do allergies develop and how do I test for them?
Allergies can develop at any age but most commonly in children under five.

Even babies can have allergies.

Before conducting medical allergy testing you can try to isolate the problem food at home.

Try keeping a food diary to identify patterns between food consumption and symptoms.

In consultation with your physician, you may also try an elimination diet.

This entails ridding the body of the suspected food, flushing the body with lots of water, reintroducing the suspected food after a 2-4 week period along with lots of nourishing food to strengthen the immune system and monitoring the results.

If at this point the allergy still cannot be identified, medical testing may be required.

The two most common tests for allergies are skin testing or RAST (radioallergosorbent test), a blood test to check for antibodies against certain allergens.

Allergy testing can be conducted at almost any age and according to the American Academy of Paediatrics age is no barrier to skin testing; positive results can be obtained at any age. It is thought that skin testing is not as accurate in children under 12 months.

It is important to note that tests can sometimes produce false positives. If this is a concern, a food challenge can be conducted under medical supervision to confirm the results.

Can anything be done to avoid allergies?
There are few studies on allergy prevention and even fewer specific to food.

There have been limited findings in studies related to allergy prevention.

Experts recommend that mothers:
When pregnant:
- Do not smoke
- Avoid exposure to tobacco smoke in the home

There is no evidence suggests that a restricted diet during pregnancy or breastfeeding reduces the risk of developing food allergy.

With children:
- Breastfeed children for at least the first 4-6 months. If not possible, use a hydrolysed formula (unless a cow’s milk allergy is already established)
- Should seek medical advice before introducing foods to which they suspect their children are allergic

How do I manage my child’s allergy?
Managing your child’s allergy effectively will ensure that it has minimal impact on their day to day lives and that reactions are avoided or treated.

Take the following steps:
1) Identify and Avoid
- Once you have identified the food, where possible, ensure that it is not available to your child.
- Learn to read product labels as basic food ingredients are often contained within processed items.
- Make your family, friends and school aware of the allergy and associated requirements.
- Obtain medic alert bracelets for your children.
2) Recognise and React
- Recognise the early symptoms of an allergic reaction.
- Know what the treatment is for your child’s allergic reaction and how to administer it.
3) Future Plans
- Have an action plan in case of accidental exposure.
- If an adrenaline autoinjector has been prescribed, it is essential to have an ASCIA action plan. These must be completed by a doctor and can be found on the ASCIA website.

Children’s food allergy can be a serious matter.

While it is something to be aware of, when managed effectively children can lead happy, healthy lives with reduced risk of reaction.

Research is being conducted into the area of immunotherapy to develop allergy vaccines to switch off the allergy once it has developed.

While results are promising, the research is not ready for clinical use.

In the meantime, parents must be diligent to ensure their children’s safety and draw on support from paediatricians and organisations such as ASCIA.