Experts are usually quick to link particular foods to a severe allergic reaction in a child. But it can be more difficult to identify the cause of mild symptoms, says Sharon Ní Chonchúir,
Food allergies are on the rise. If you’re a parent, you’ll know this because of frequent reminders not to pack nuts in your children’s lunchboxes.
According to the Irish Food Allergy Network, 4% of children in Ireland now have an allergy to some, food such as eggs, cow’s milk, and nuts, and this percentage is on the rise.
However, determining whether your child has a food allergy isn’t straightforward. A severe allergic reaction is unmistakable, but mercifully rare, while milder reactions can be vague or sporadic. In some cases, they may even indicate an intolerance or other digestive problem.
This can be confusing. How can parents tell if their child has an allergy? And what should they do if they think they might?
A food allergy “occurs when the immune system forms antibodies against food proteins, similar to the way it does to fight bacteria and viruses,” says paediatric dietitian Ruth Charles, founder of the Irish Food Allergy Network. “It overreacts to something — in this case, a food — that it normally would ignore.”
These foods are called allergens and when the immune system is exposed to them, it releases histamine. Histamine is what then causes allergy symptoms.
Mild symptoms include an itchy tongue or itchy mouth roof. “Small children will often report that their mouth feels ‘funny’ or ‘fizzy’,” says Charles.
Other mild symptoms include itchy eyes, itchy skin, an itchy nose, small crops of hives or rash on the skin, mild sneezing fits, localised swelling, and abdominal pain or nausea.
If the allergy is more severe, the eyes and lips can swell. The eyes can become watery, red, and itchy. Outbreaks of hives or rash will also be larger and more pronounced.
There can even be delayed allergic reactions. These include eczema, poor weight gain, chronic diarrhoea, and constipation.
If an allergy is especially severe, the symptoms are much more serious. They can vary from difficulty talking and swallowing to anaphylaxis, where the person starts wheezing and struggles to breathe.
Other warning signs of anaphylaxis include a swelling of the mouth, tongue and throat, a tight chest, dizziness, confusion, and a drop in blood pressure. If any of these symptoms occur medical help is urgently needed, as the situation can become fatal.
Luckily for parents and their allergic children, such life-threatening reactions are uncommon. Yet parents can still worry, especially when it comes to weaning a baby if there is a history of food allergies in the family, or if the baby already has other allergy-related conditions such as eczema.
Charles is reassuring.
“Recent, robust studies, from allergy teams in the UK, have shown that once a child is developmentally ready (has doubled their birth weight, has head control, and is giving clear signals that they are hungry), solid foods should be introduced. This is typically any time from 16 weeks of age. It is not recommended to withhold foods to prevent allergy,” she says.
“For example, there is no benefit to delaying the introduction of peanut. It should be introduced into the diets of healthy infants, and those with mild eczema, at six months, along with other foods, including milk, eggs, fish, and other nuts.”
More caution is required with children who have a history of moderate to severe eczema, or children who have first-degree relatives who have allergies. “It’s vital that their skin is treated, to restore and maintain its barrier function, before solids are started,” says Charles.
If symptoms appear while weaning, parents should stop feeding their child the food in question and speak to their GP.
Don’t ‘diagnose’ the allergy by yourself. It could be counterproductive, advises Charles. “Removing foods from the diet can lead to allergies developing rather than allergy prevention,” she says. “It also carries a potential risk to the nutritional status, growth, and development of a child and should only be done for a good reason.”
Furthermore, a GP will follow professional guidelines when managing the allergy. “Any food that is removed from the diet is done so for a defined time and with a reintroduction timeline and safe plan in mind,” says Charles. “It’s all about assessing and managing the risk.”
How an allergy is managed depends on its severity. Mild allergies may need little to no treatment, apart from cool packs and lotions to soothe skin symptoms. It’s quite common for these allergies to disappear during childhood.
More serious allergies may require the use of antihistamines, steroids, and immunotherapy.
Those with the most serious allergies will have to carry an EpiPen at all times, in case they ever come into contact with the food in question.
The key thing is for children and their parents to learn to avoid the triggering allergen. Other adults in the child’s life should also be informed about the allergy so keep the child’s relatives, teachers, and childminders in the loop, too.
“We’ve got lots of advice on how to manage allergies on our site, www.ifan.ie,” says Charles.
“It’s got everything you need to know if your child has been diagnosed with a food allergy.”