Food Allergies in Children

Christina L. Willis, A.P.N./C.P.N.P. Pediatric Nurse Practitioner at Dreyer Medical Clinic – West Aurora

Food allergies in children are becoming more common today than ever before.  As many as 25-30% of households having at least one family member with a food allergy, and approximately 6% of children three years of age and younger are allergic to at least one food.  Causes of food allergies can be genetic, environmental, or from exposure to certain foods.  A child with a family history of food allergy is more likely to develop an allergy themselves.  In infants, their diet, as well as when they are introduced to certain foods can also play a role in developing food allergies.  Exposure to common allergic foods, in addition to genetic and environmental risk, can contribute to the development of allergy.  The most common food allergies among children include egg, wheat, peanut, soy, and milk.

Certain allergies tend to be age-related.  Allergy to milk, wheat, and egg is more common in children under age 3 and are most commonly outgrown.  On the other hand, allergies to tree nuts, fish, shellfish, and seeds are usually not outgrown.  Children with a food allergy who are older than 3 years are less likely to outgrow their allergy, but avoiding allergic foods at an early age may encourage future tolerance, especially with milk, egg, and soy. 

Anaphylaxis and possible death are serious complications from ingestion of allergic foods.  Symptoms of anaphylaxis include:

• itching of the mouth and throat
• swelling of the face, lips, tongue, or throat
• change in voice
• breathing difficulties, including coughing and wheezing
• nausea and vomiting
• hives (more than a few)
• flushing

If these symptoms occur, 9-1-1 should be called immediately.  Peanuts, tree nuts, and shellfish are the foods most often involved in causing food-induced anaphylaxis.

There are a few effective ways to officially diagnose a food allergy.  Skin prick testing is one of the oldest allergy tests and is the most common screening tool for allergies.  Since the reliability of the results depends on many factors, this test should be performed in an allergist’s office.  Though skin prick testing may be the first choice, blood tests for specific allergies can also be performed in individuals who are taking certain medications or have skin conditions that may affect results.

There are several things to remember when a child has been diagnosed with a food allergy.  Breast milk can carry the allergic component of a food, so if breastfeeding is continued, the mother needs to avoid the allergic food as well.  An EpiPen® (epinephrine self-injectable device) should be carried with the child at all times in case of severe allergic reaction.  Complete avoidance of the allergic foods is the best and only proven therapy once food allergy is diagnosed.  Becoming familiar with the allergic foods and components of those foods is extremely important.

There are many support groups and other ways to get information about recipes, action plans for accidental exposures, and school policies through websites.  The Food Allergy and Anaphylaxis Network is one of the most reliable websites and can be found at www.foodallergy.org.  Recipes and ordering specialty foods can be found at www.foodyoucaneat.com.  It may be helpful for children with multiple food allergies to see a dietician, to make sure they are meeting nutritional needs for their age.