Food Allergies In Children You Should Know Of
- Nearly 5% of children under the age of five years suffer from food allergies.
- It does not take large quantities of food to cause a severe reaction in allergic individuals.
- Many food intolerances are often mistaken for food allergies.
- The most common cause of food allergies in children are eggs, milk, and peanuts.
- Currently, there is no cure available for food allergies.
- When your toddler shows signs of such allergies, taking them to a doctor and telling them all about the symptoms can help in finding the type of allergies and find better treatment options.
Starting to feed a baby solid foods is an exciting milestone for parents and an essential one for the toddler. However, this milestone comes with lots of questions and concerns regarding what to eat and what to avoid, especially when it comes to food allergies in children.
Common questions such as what are food allergies, what foods are most likely to cause allergies in babies, and how do you avoid them, might be the parent’s topmost concern.
Studies have shown that introducing a variety of foods together might be a safe and efficient practice as it may help the immune system have a lower risk of developing food allergies. However, more studies are needed in this area. Checking with your doctor about what’s best for your baby is the best way to tackle this issue.
Let’s understand all about food allergies, foods that cause allergies, and common allergens in our surroundings that can increase your toddler's risk of allergies.
- Nearly 5% of children under the age of five years suffer from food allergies.
- From 1997 to 2007, the prevalence of reported food allergies increased by 18% among children under the age of 18 years.
- Children with food allergies are 2-4 times more likely to have other related conditions such as asthma and other allergies, compared with children without food allergies.
- Eight types of food account for over 90% of allergic reactions in affected individuals.
What are food allergies?
We all know what an allergy is. A food allergy can be defined as an abnormal immunological reaction to proteins present in our foods. These proteins cause an adverse clinical reaction in our body. Even a tiny amount of the allergy-causing food can trigger signs and symptoms of the allergic reaction.
Food allergies have been recognized as a major pediatric health problem in western countries due to the severity of the reactions in children. The dramatic increase in these cases over the past decades has led to rising concerns around the issue.
At present, food anaphylaxis is the leading single cause of anaphylactic reactions treated. Food allergies are more common in the pediatric age. Acknowledging this condition at a young age can help in seeking treatment options and finding better food alternatives.
What are the symptoms of food allergies?
Food allergies in toddlers can be difficult to jot down due to their fussy eating habits. It can be confusing to understand if your child is avoiding certain foods because they simply don't like them, or because there is something unexplainable going on in their bodies that they are unable to communicate.
According to the National Institute of Allergy and Infectious Disease, it does not take large quantities of food to cause a severe reaction in allergic individuals. In fact, as little as 1/44,000 of a peanut kernel can cause an allergic reaction in those with severe allergy issues. Allergic symptoms may begin within minutes to an hour after ingesting the food.
Watching out for symptoms of allergy after introducing new foods to your toddler is important.
Here are some symptoms that you need to look out for:
- Trouble breathing
- Throat tightness or itchiness
- Belly pain
- Abdominal cramps
- Itchy, watery, or swollen eyes
- Red spots
- A drop in blood pressure
- Lightheadedness or loss of consciousness (passing out)
Many food intolerances are often mistaken for food allergies. The symptoms of a food allergy may resemble other problems or medical conditions. It is always best to consult your child’s doctor for a proper diagnosis before arriving at any conclusion or self-medication.
Foods capable of causing allergic reactions in people are termed food allergens. Technically, a variety of foods can cause an allergic reaction. However, approximately 90% of all food allergies in children are caused by the following eight foods:
- Tree nuts
The most common food allergies in children are caused by eggs, milk, and peanuts. Wheat, soy, and tree nuts are also included in this list. Peanuts, tree nuts, fish, and shellfish are most commonly known to cause severe allergic reactions.
Although most children ‘outgrow’ their allergies, allergies to peanuts, tree nuts, fish, and shellfish may be lifelong. Now that we’ve answered the question ‘what are the most common allergies in kids?’, let us look at the different types of food allergies in children!
Types of food allergies
True food allergies can be divided into two main types. They are as follows:
1. Immunoglobulin E (IgE) mediated
In this type of food allergy, your body’s immune system produces IgE antibodies in significant amounts, which in turn react with certain food. Antibodies are a type of blood protein used by your immune system to recognize and fight infection. An IgE-mediated allergic reaction usually occurs within several hours of eating the food allergen and can include mild to severe symptoms, including anaphylaxis.
IgE-mediated food allergies are the most common in toddlers and children.
Sometimes allergy symptoms are mild but other times they can be severe. Taking all allergic symptoms seriously is important. Mild and severe symptoms can lead to a serious allergic reaction called anaphylaxis. This reaction usually affects more than one part of the body and can get worse quickly. Anaphylaxis should be treated immediately to provide the best chance for improvement and prevent serious, potentially life-threatening complications.
The symptoms of an anaphylactic reaction usually occur shortly after having ingested the allergen. In some individuals, there may be a delay of two to three hours before the appearance of symptoms.
- Cross-Reactivity: Having an IgE-mediated allergy to one food can mean your child is allergic to similar foods. For example, if your child is allergic to shrimp, there is a possibility they may be allergic to other fish. The reaction between different foods is called cross-reactivity. This happens when proteins in one food are similar to the proteins in another food.
- Oral allergy syndrome: Some individuals who have allergies to pollens, such as ragweed and grasses, may also be allergic to certain other foods. Proteins in the pollen are like the proteins in some fruits and vegetables. So, if your child is allergic to ragweed, they may have an allergic reaction to melons and bananas. That’s because the protein in ragweed is similar to the proteins in melons and bananas. This is known as an oral allergy syndrome or pollen food allergy syndrome.
2. Non-IgE mediated
In a non-IgE food allergy, your immune system does not make IgE antibodies, but other parts of the immune system are engaged in mounting a response against the perceived threat. A non-IgE mediated allergic reaction often involves the skin or digestive symptoms, or a combination of those symptoms, including vomiting and diarrhea, and can occur up to 3 days after eating the food allergen.
Most symptoms caused by non-IgE mediated food allergies involve the digestive tract or the gut. Symptoms of this sort may include vomiting, diarrhea, and abdominal pain. The symptoms can take longer to develop and may last longer than IgE-mediated allergy symptoms. Sometimes, a reaction to a food allergen occurs up to 3 days after eating the food allergen.
When an allergic reaction occurs with this type of allergy, epinephrine is usually not needed. In general, the best way to treat these allergies is to stay away from the food that causes the reaction. Below are examples of conditions related to non-IgE-mediated food allergies.
- Eosinophilic Esophagitis (EoE): It is an inflammation of the esophagus. With EoE, swallowing food can be hard and painful. Symptoms in infants and toddlers are irritability, problems with eating, and poor weight gain. The symptoms can occur days or even weeks after eating a food allergen.
- Food Protein-Induced Enterocolitis Syndrome (FPIES): It is also a food allergy occurring mostly in infants. Symptoms usually don’t appear for two or more hours. Symptoms include vomiting, which starts about 2 hours or later after eating the food causing the condition. Once the infant stops eating the food causing the allergy, the symptoms go away.
- Allergic Proctocolitis: It is an allergy to cow's milk or soy proteins found in formula or breast milk. This condition inflames the lower part of the intestine. Infants may also develop green stools, diarrhea, vomiting, anemia, and fussiness. Symptoms resolve once the allergic foods are removed from the diet.
What is food sensitivity?
If your child is allergic to a specific food, their immune system reacts to that food as though it were a harmful substance. Food sensitivities or food intolerance usually result from the digestive system’s inability to properly digest food.
Food triggers an intolerance in your digestive tract. This is where your body is unable to efficiently break down certain foods. For example,
- Lactose intolerance is when your body can’t break down lactose (a sugar found in dairy products)
- Gluten intolerance is when your body can't break down gluten (a protein found in wheat, rye, barley, and oats)
Reasons to develop a food sensitivity or intolerance include:
- Unavailability of the necessary enzymes needed to digest a certain food
- Reactions to food additives or preservatives (sulfites, MSG, or artificial colors)
- Pharmacological factors, like sensitivity to other chemicals.
- Sensitivity to the natural sugars found in certain foods like onions, or Brussels sprouts.
Symptoms of food sensitivity might vary. However, the symptoms of intolerance are gut-related. These can include:
- Gas and bloating
Diagnosing food-related allergies
Diagnosing food allergies in toddlers is crucial to protect them in the future. Here are ways your doctor might look into to know more about your child's condition.
- Detailed medical history: A series of questions will be asked, These will include questions about what your child eats and drinks and how long after eating or drinking symptoms occur. This will help your doctor determine if food insensitivity is the cause of your child’s problem.
- Diagnostic tests: These might include blood tests, upper endoscopy, or colonoscopy.
- Elimination diet: In this method, your child is made to stop eating possible problem-causing foods for a while. Then, they are added back into your child’s diet one by one to find out which ones are causing reactions.
- Percutaneous skin testing: Doctors place a small amount of the allergen on your child’s skin and then prick the skin so that the substance seeps under the surface.
- Patch testing: Doctors place a small amount of the suspected allergen directly on the surface of your child’s skin.
- Breath testing: A test that involves drinking a liquid and periodically blowing into a device to help your child’s clinician diagnose lactose intolerance, fructose intolerance, and small intestinal bacterial overgrowth.
Treatment of food-related allergies
Currently, there is no cure available for food allergies. It is very important to consult a doctor for your toddler’s food-related allergies. Depending on the severity of your food allergy, your healthcare professional may prescribe medications like:
- Epinephrine: Can help reverse symptoms of a serious allergic reaction (anaphylaxis)
- Antihistamines: Can help reduce itching and congestion from less severe allergic reactions.
- Corticosteroids: Can reduce swelling from more severe allergic reactions.
The doctor can also give you an allergy action plan, which helps you to prepare for, recognize, and treat an allergic reaction efficiently. Sharing this plan with important people who need to know about it such as relatives, babysitters, neighbors, and caretakers is important. Wherever your child is, caregivers should always know where the emergency allergy drugs are. Consider having your child wear a medical alert bracelet as it can be helpful.
Taking good care of toddlers can be challenging for parents. Paying attention to your toddler’s food and eating habits can help you spot any food allergies or sensitivities. When your toddler shows signs of such allergies, taking them to a doctor and telling them all about the symptoms can help in finding the type of allergies and finding better treatment options.
With the help of a doctor, determine which foods should be avoided for your toddler. You can also consult a registered dietitian who can help you find food alternatives and avoid foods your toddler is allergic to while ensuring their nutritional needs are met.
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- Radlović N, et al. Srp Arh Celok Lek. 2016 Jan-Feb;144(1-2):99-103.
- Berni C, et al. Current Opinion in Pediatrics, 20(5), 584–589.