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| |    Diagnosing and Treating Food Allergies by Robert Needlman, M.D., F.A.A.P. reviewed by Laura Jana, M.D., F.A.A.P. Reprinted from Scholastic Parent and Child magazine On average, 1 child in 20 has a food allergy. Although more than 150 different foods can cause allergies, just eight food types are responsible for 90 percent of allergic reactions: dairy, soy, wheat, eggs, fish, shellfish, nuts, and peanuts (which are actually legumes). A variety of symptoms Food allergies cause a range of symptoms, including hives, eczema, and anaphylaxis. Hives (also called urticaria) are raised, reddish, itchy blotches that come and go. They are uncomfortable but not dangerous. More serious--and thankfully, rare--allergic rashes include blistering or skin peeling. The role of food allergies in eczema and asthma is controversial, but I believe that food allergies can make these conditions worse. Anaphylaxis is a severe, life-threatening allergic reaction in which a person may gasp, have difficulty swallowing, feel dizzy, or pass out. In addition to foods, bee and wasp stings are common triggers for anaphylaxis. Children who have experienced an anaphylactic reaction should never be far from a syringe preloaded with epinephrine, the best emergency treatment. Epinephrine, which is also called adrenaline, is a hormone that our bodies make all the time, and that goes up in times of stress. One of its effects is to temporarily counteract the effects of anaphylaxis. It can be life saving, so if you think your child is at risk for anaphylaxis, you should certainly ask a physician about epinephrine. It's also good to note that not all food intolerance is an allergy. For example, many children can't digest cow's milk very well, so a big glass of it will make them gassy or cause diarrhea or constipation. However, these same children might handle smaller amounts without a problem. But in true allergies, even a tiny amount of the food is enough to trigger the immune system's overreaction, resulting in the allergic symptoms. Sometimes simply being near the allergen is enough. So how do you know if your child truly has a food allergy? If you consistently notice hives, itching, or other allergic symptoms after your child eats a particular food, but not at other times, chances are she's allergic. An allergist can do skin tests or blood tests to confirm the diagnosis. Treating a food allergy Without question, the most effective treatment is to avoid the offending food. This is easier for some foods (nuts, shellfish, fish, and soy) than for others (dairy, wheat, eggs, and peanuts). As the grocery shopper in the home, you have to read every label, stay away from most commercially baked breads and cookies, find substitutes for milk, and so on. This can be especially difficult in school. However, it's probably not necessary--or wise--to ban allergic foods from a child's classroom except in rare severe cases. The goal with food allergies, as with all chronic medical conditions, is for the child to be able to lead as much of a normal life as possible. If the child's allergy becomes the reason why no one in the class is allowed to have birthday cake or peanut butter and jelly sandwiches, it will not help the child feel normal and accepted! It is better to train your child to avoid the foods she's allergic to, and to work with her teacher to accomplish this, without drawing too much attention to herself. Keep in mind, though, that no matter how careful you and your child are, one of you is bound to slip up. When that happens, you can treat mild symptoms using an antihistamine, such as diphenhydramine (one trade name is Benadryl), which you can get over the counter. With this, as with all medications, be sure to read the precautions, give only the recommended dosage, and store the medication where children can't get at it (a locked cabinet is the safest). If any questions arise, talk with your physician or pharmacist. Also remember that medication can treat the symptoms, but it can't cure the underlying food allergy itself. Experts continue to learn about prevention, however. For example, breastfeeding for at least four to six weeks reduces the risk of food allergies, as does delaying introduction of highly allergic foods (like wheat and eggs) until age one, and even until age three for peanuts and shellfish. These precautions are especially worthwhile if your family has a history of food allergies. If all this seems like a lot to worry about, don't despair--there is light at the end of the tunnel. Children often outgrow their food allergies; in fact, only about one in 100 adults has them. Helpful websites
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