Caring for a child with food allergies requires education, according to Dr. Lourdes de Asis, Section Chief of Allergy and Immunology at Montefiore Nyack Hospital. Food allergies affects up to 2 million people in the U.S., approximately 8% of whom are children.
Many children outgrow food allergies—an estimated 26% of egg, milk, wheat and soy allergies go away by age 5 years.
Children are much less likely to outgrow allergies to peanuts, tree nuts or seafood. New treatments on the horizon show promise for treating food allergies, especially peanut allergies, Dr. de Asis says. The treatments use a method called immunotherapy, in which children are exposed to incrementally increasing doses of peanut protein, to develop tolerance to peanuts so they no longer suffer allergic reactions.
Symptoms of food allergies can include:
- Skin reactions including hives; eczema; redness and swelling of the face or extremities; itching and swelling of the lips, tongue, or mouth
- Abdominal pain, nausea, vomiting, or diarrhea
- Runny or stuffy nose, sneezing, coughing, wheezing, shortness of breath
- Lightheadedness or fainting
If you think your child may have food allergies, talk to their doctor. You are likely to be referred to an allergy specialist, who will order tests to help make a diagnosis. Your child may have a skin test, which involves placing liquid extracts of food allergens on your child’s forearm or back, pricking the skin and waiting to see if a localized allergic skin reaction occurs. The doctor also may do blood tests to look for IgE antibodies to specific foods. IgE, short for “immunoglobulin E,” is the antibody that triggers food allergy symptoms.
To see if a child has outgrown a food allergy, the doctor may do a food challenge. In most cases, this test is only done after the child has been avoiding the allergic food for at least three years. The child is given gradually increasing amounts of the food while the doctor and nurses monitors the child closely for symptoms. The test is done in a medical facility such as the allergist’s office or hospital.
If your child is diagnosed with a food allergy, you’ll need to get educated about which foods contain that ingredient, and learn to read food labels very carefully, Dr. de Asis says. Always ask about ingredients when eating at restaurants, or before eating foods cooked by family or friends. “I’ve seen cases where someone cooks a meal with peanuts, and then simply picks out the nuts and serves it to a child allergic to peanuts. That child can’t eat any food that has touched peanuts—it can still cause an allergic reaction. Picking out the nuts isn’t enough,” she says.
You or your child will always need to carry an auto-injectable epinephrine device (EpiPen or AUVI-Q) to treat emergency reactions and have a food allergy and anaphylaxis action plan (anaphylaxis is a severe, potentially life-threatening allergic reaction). Teach family members and other people who care for your child how to use the device and give them copies of the action plan. Talk to the school nurse about your child’s allergy. Provide them with the action plan, which includes a list of the allergens your child needs to avoid; a list of symptoms that require emergency treatment with an epinephrine auto-injector, instructions on calling 911 to transport student to the hospital; and a list of emergency contacts.
Consider having your child wear a medical alert bracelet describing their allergy. If a reaction occurs, your child needs to be taken to the emergency room, even if symptoms subside.
“There’s no reason for parents of a child with food allergies to be afraid,” Dr. de Asis says. “You just need to be aware and take precautions.”
A copy of the food allergy and anaphylaxis action plan is available at foodallergy.org/FAAP.