Written by Leslie Penkunas

bon appetit?

Knowledge is power in the battle against food allergies

It’s like the Boogeyman. Scary, perhaps even life-threatening, but not- for us at least- real. We all think, ‘ Nah, the Jone’s have it (them), but we’re safe here’. And then, from behind the cheerios, it attacks- your child’s first food allergy!

Food allergies 101

When the immune system incorrectly identifies a specific food as harmful to the body, an allergy develops. The immune system produces antibodies to this “dangerous” food intruder. The next time that food is ingested (or in severe cases, touched or breathed in), the immune system releases massive amounts of chemicals, including histamine, to “protect” the body.

The resulting allergic symptoms can range from mild—like hives, a runny nose, or diarrhea—to more severe, involving the respiratory or cardiovascular systems, or the gastrointestinal tract. A severe reaction involving two or more body systems is called anaphylaxis, which additionally can cause swelling of the airway, serious breathing difficulty, a drop in blood pressure, loss of consciousness, and, in some cases, even death. Hence our fear.

 

On the rise

One out of every 26 children has one or more food allergies, according to a report issued in Oct. 2008 by the Center for Disease Control. Overall, food allergies have increased by 18 percent in the past decade. Why?

“There’s the hygiene hypothesis,” says Lawrence Montelibano, M.D., an allergist and immunologist with Ochsner Baptist Medical Center and Ochsner Children’s Health Center. “We’re geared to fight infections. That’s what our bodies did pre-immunizations.” With antibiotics and immunizations now removing the risk of so many potential diseases, “infant bodies are looking for something else to fight,” which can become the food they eat.

Parents are also more aware of food allergies and thus more likely to report their concerns to a pediatrician, which could contribute to the increase in cases. And then there’s our ever-expanding diet. “A greater variety of food is more readily available to us now—like kiwi and papaya,” says Dr. Montelibano, “so we’re hearing about more allergies to exotic foods.”

Before you think, phew, I just won’t feed my little one those imported fruits, you should know that the most common allergies in children remain the more commonplace foods: milk, egg, peanut, wheat and soy.

Predicting and diagnosing

So you’re wondering, is there any way to know if my baby will develop a food allergy? Family history is a good indicator; according to Dr. Montelibano, that history isn’t limited just to food allergies. “Most of the data is for allergies in general—food, sinus, and asthma,” he says. “If an infant has one parent or sibling with any allergic disease, he’s at a higher risk.”

Some symptoms of food allergies in young infants include chronic problems like loose stools (sometimes containing blood), vomiting and refusing food, as well as hives and eczema. A failure to thrive—the lack of appropriate weight gain in an infant—is also an indicator of a possible food allergy.

Addie Imseis, of the Westbank, saw her son Ben’s allergies to milk protein and soy develop over the course of several months. “He had what I would consider ‘normal spitting up’ for the first three months of life. The vomiting got worse the older he got.  We knew that reflux symptoms usually peak between four to six months old and got worse before getting better. We just got to the worse part and never got better.” She adds that he also had slow weight gain, which became pronounced around seven months.

Because Ben was breast fed, Addie eliminated milk from her diet. That helped, but not entirely. She eventually tried the elimination diet for herself, eating only meats and rice, and took him off all baby food. As she reintroduced foods, she found that both milk and soy triggered his symptoms. She permanently removed both from her diet, while continuing to breastfeed, and his symptoms, including slow weight gain, resolved themselves.

“Many people suggested that I just switch to the hypoallergenic formula,” says Addie. “I didn’t sign up for parenting only if it would be easy.  Plus, how could I expect my child to adhere to a special diet if his mom couldn’t?”

It’s an allergy. now what?

Addie’s decision to continue breastfeeding, rather than switch Ben to an hypoallergenic formula—which breaks proteins down into particles that are less likely to trigger an allergic reaction—is one embraced by pediatricians and allergists alike.

Dr. Pamela Richard, FAAP, a pediatrician with Ochsner Children’s Health Center in Covington, says, “Rarely do moms have to switch from breast feeding to formula. There are so many great benefits to breastfeeding, I hate to have them switch.”

Because there are no medications to treat or cure food allergies, avoidance is essential. Parents must read labels carefully. The Food Allergen Labeling and Consumer Protection Act, enacted in 2006, has made things easier by requiring food manufacturers to list on the top of their food labels—in plain English—the most common food allergens: eggs, milk, wheat, soy, peanuts, tree nuts, fish, and certain shellfish (crab, shrimp, and lobster). Parents must also be vigilant about checking with restaurants as well as their children’s daycare centers or schools to make sure they won’t come into contact with a food allergen.

“At restaurants, we go directly to the manager or the food manager and have them go over the menu with us so we know what’s safe to order,” says Lisa Flood of Covington, whose oldest son, Ryan, now 10, has a life-threatening peanut allergy. Her efforts to keep him safe at school include having her pediatrician’s office make in-service visits to teach teachers and staff how to use the Epi-Pen, the auto-injector of epinephrine used to stop an anaphylaxis allergy attack. And, she says, Ryan, who sits at a special peanut-free table in his school’s lunch room, “doesn’t eat anything I haven’t approved.”

Preventative efforts

While there is no concrete study showing that food allergies can be stopped in their tracks, there are some protections we can take. “The best evidence is the use of breast milk,” says Dr. Montelibano. “Breast feeding exclusively for the first four to six months helps prevent or decrease eczema and wheezing, up to about five or six years of age.”

Adds Dr. Richard, “If an infant is breastfed, foods are processed by the mom, not the baby.”

Delaying the introduction of solids to your infant’s diet until he’s four to six months old is another important measure. “When a baby is young, his gut is immature,” explains Dr. Montelibano. “If you introduce foods too early, he might not be able to break them down properly and could develop allergies.”

When it does come time to start an infant on solids, introduce the new foods one at a time. “It’s hard to predict who is going to have an allergic reaction to foods,” Dr. Montelibano says. “Slowly introduce foods to your child so you can see if he’s allergic to them.”

By taking simple preventative measures, and staying on top of our babies’ introductions to new foods, we can help lessen our fear of food allergies in our children.

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