Food allergies: There is no validated test for intolerences

Andrea Mara reports on a disturbing increase in food allergies among children and talks to a leading expert in the field who warns there is no validated test for intolerences.

Sarah Ryan was hugely relieved when her son Donnchadh was diagnosed with cow's milk allergy at 15 months old.

CHILDHOOD allergies are on the rise around the world, and Ireland is no exception. 

Up to 6% of children here now have food allergies, causing symptoms such as hives, swelling, wheezing or anaphylaxis. 

So how are food allergies diagnosed - the most common types are eggs, nuts and dairy, and why are they on the increase?

The increase isn’t fully understood. One explanation is the hygiene hypothesis, which says that lack of early childhood exposure to infectious agents increases susceptibility to allergic diseases.

Whatever the cause, allergist and UCC professor of paediatrics and child health Jonathan Hourihane, says cutting out food groups is not the answer.

“Our attempts to try to mitigate [allergies] by avoiding foods appears to have been the wrong way to do it. We should have been eating the foods all along, maybe starting earlier,” he says.

Wexford mother-of-two Sarah Ryan has first-hand experience. Her son Donnchadh was diagnosed with a cow’s milk allergy, as well as wheat and soya intolerance, when he was 15 months old.

“Donnchadh was a very upset baby and the first year was a constant struggle,” says Sarah. 

She got tremendous support from her local GP and was referred to a number of specialists, but found the consultations disheartening.

“It was frustrating. Each time we were told he’ll grow out of the symptoms in six weeks or three months. 

"We were told to stop solids, restart solids, reintroduce dairy, record crying in minutes, and then ‘he’ll need firm boundaries as a teenager — he’s playing you’. The list went on and my heart sank further each time.

“Then the universe aligned in our favour in March 2015 when we were referred to the Allergy clinic in Tallaght Hospital.”

Donnchadh was diagnosed with cow’s milk allergy, and although there was no overnight change, the relief was immense. 

“There was a name to it. There was no longer the assumption that we were neurotic parents who were just having a hard time adjusting to two kids,” says Sarah.

Diagnosis is done through taking a family history, then doing a skin prick test and/or a blood test — an allergist will always take the story first.

“Having the test done before you have the story taken down means you end up with false positives. The story tells us more than the tests,” says Professor Hourihane.

He is also very clear that children should be seen by a trained allergist, pointing out that “there’s no validated test for intolerances.” 

Indeed, for Donnchadh, soya and wheat showed up negative on his allergy test. The intolerance was diagnosed via symptoms.

While getting a diagnosis takes a huge weight off the shoulders of anxious parents, it is only the beginning of a new journey navigating the complex world of food exclusion.

“At first it was overwhelming,” says Sarah. 

“But now we have tried and trusted recipes that the whole family can enjoy. Our diet is time-consuming to make but batch cooking helps. 

"Both children are involved so it makes it more fun and also educational.”

Challenging though it may be, shopping and cooking for her own family is something that’s very much within Sarah’s control. Where it gets more complicated for parents is eating out and visiting friends.

“Donnchadh is naturally curious now at 27 months and checks if he can have a food before consuming,” says Ryan. 

“And Orlaith, his four-year-old sister, is brilliant at scanning for possible dangers if we go to a friend’s house or play centre she’ll shout ‘He’s dairy free and can’t have that thanks!’.”

Galway woman Anne Walsh also has first-hand experience parenting a child with allergies. 

Ten years ago, her third child, a toddler at the time, suffered a near-fatal allergic reaction to peanuts. 

Anne felt there was very little support for families managing allergies, so started her business, Allergy Lifestyle, selling adrenaline pen cases, inhaler cases, and allergy wristbands. 

Recently, she secured investment on RTÉ’s Dragons’ Den programme.

“If your child has been diagnosed with anaphylaxis or severe allergies it can feel overwhelming initially,” she says.

“But with good communication and planning, allergic children can be safely accommodated and enjoy a healthy and active school life. 

"Carry prescribed medicines on you at all times and ensure whoever is responsible for your child is aware of their allergies and knows what to do with an emergency.”

Sarah also has a message for parents of newly diagnosed children: “You are doing a great job even though you will question that most days, and you’re the best advocate for your child. 

"Be strong and if something doesn’t feel right health-wise, push forward and keep looking for answers.”

Online info

Useful websites for parents whose children have food allergies:

* Irish Food Allergy Network ( www.IFAN.ie ) — the Irish health professionals’ website, which is due to have parenting support added.

* Anaphylaxis Campaign ( www.Anaphylaxis.org.uk ) is a British website giving support for those with allergies

* Food Allergy Research & Education ( www.foodallergy.org ) in the US provides lots of information on allergens, symptoms, diagnosis and treatment

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