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Food Fights...Not Again!

February 2006

Tired of wrestling with your child's food allergies?
Here's some advice on keeping them under control:

By Laura Wise-Blau

When most parents arrange a play date, they hope their child has fun. When I make a play date, I hope my child doesn't end up in the emergency room. As a parent of a food-allergic child, every day is a trial. Birthday party? I'll need to make substitute cupcakes, send a replacement for the ice cream, and hope there's no candy in the goody bags. School? Better make sure the teacher has plenty of alternate snacks, knows how to follow the emergency plan, and is a good sport. Restaurants, movies, festivals, holidays, vacations? Lots of planning and a good cooler.

It isn't fun. A study by the Food Allergy & Anaphylaxis Network (FAAN) found families living with a food-allergic child suffer more emotional stress than those with children who have epilepsy or asthma.

Sadly, I'm not alone. "There has been a tremendous rise in food allergies," says Roger Friedman, M.D., clinical professor of allergy, immunology and pediatrics at Children's Hospital and The Ohio State University Medical Center in Columbus. "When I started 20 years ago, it was unusual to see a patient with an allergy to peanuts. Now I see one or two per week. Twenty years ago, it was unusual to find a child with a peanut allergy at school. Now, it's typical to have one peanut-allergic student per class."
Researchers aren't sure why the incidence of food allergies has spiked. "We've been trying to figure this out without much luck," Friedman says.

Food Allergy Basics

Food allergens differentiate themselves by their reaction from the immune system. "When someone has an allergic reaction, the allergic, or IgE, antibody recognizes the food as an invader, causing a chemical reaction," Friedman explains. "When you ingest an allergen, your mast cells open up and spill out the histamine, causing itching, hives, sneezing, coughing, wheezing or intestinal symptoms like diarrhea, upset stomach or vomiting." Rarely, the reaction can be anaphylaxis; an intense response from the body's systems that may cause constriction of airways, an extreme drop in blood pressure and, if not treated with a shot of epinephrine (chemical adrenaline), death.

Ninety percent of allergic reactions come from peanuts, tree nuts, fish, shellfish, eggs, milk, soy and wheat. Other food allergens include corn and other vegetables, plus various fruits, grains, and animal products.

According to the American Academy of Allergy, Asthma and Immunology (AAAAI), about 6 to 8 percent of children younger than 3 years old have food allergies. Those who have allergies to milk, egg and soy will most likely stop having reactions by age 10; those with allergies to peanuts, nuts and seafood can expect lifelong reactions.

5 Steps to Manage Food Allergies
Though it may seem daunting, it is possible to maintain a fairly normal and healthy lifestyle for your food-allergic child by following these important steps.

  1. Practice avoidance: "Strict avoidance of offending allergens is key," Friedman says. That means no amount, even trace, of the offending allergen is acceptable. Most food allergy sufferers find they can stay healthy without medication through careful food management.

  2. Read labels: Take time in the store to scrutinize food labels. Learn alternate names for your allergen. For example, a product containing dairy products may list them as milk, but also casein, whey, hydrolysates, lactose, lactalbumin or a host of other names.

  3. Have a plan: Have an action plan, Friedman advises. Know when to give an antihistamine or epinephrine, and when to call the doctor. Put this plan in writing and update it when needed. FAAN's Web site offers downloadable plans to share with schools, camps and others.

  4. Create advocates: Parents, teachers, caregivers and, to a certain extent, the child must work together to prevent reactions. Everyone must also be prepared to act should an inadvertent ingestion occur. Contact restaurants, hotels and resorts in advance of your visit and ask to speak to the kitchen staff. Often you'll find they are more than willing to prepare foods that meet your needs.

  5. When in doubt, don't eat it. If you are unsure whether the food will cause a reaction, turn it down. Unless you can get complete assurance the food is allergy-free, it is not safe.

The Good News

"There is some exciting news. In the future, we will have better treatments," Friedman notes. "Immunotherapy will someday be possible, maybe as soon as two to five years from now. There are studies and trials working on medicines to desensitize allergy sufferers. Anti-IgE therapy will turn off the whole allergy system for those with allergic asthma, rhinitis and other food allergies."

In the meantime, parents should have faith: "The encouraging part is that the number of food allergy fatalities is very, very small, especially when you compare the numbers to our overall population," Friedman says. "Yes, it can be dangerous, but it can be managed."

From About Health, reprinted with permission by McMurry.

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Page last updated 7/29/2012

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