The latest on children and allergies
Doctors used to recommend waiting until age 1 or even much later to introduce solid foods that are common allergens, especially with children at risk for allergies. But the American Academy of Pediatrics (AAP) has changed its tune, because studies show that these delays probably don't help keep allergies from developing.It's still a wise idea, though, to introduce new foods gradually, waiting several days after each new menu item to make sure your baby doesn't react to it. And if you believe that your baby is likely to have food allergies -- for example, if allergies run in your family -- check with his doctor to determine the best strategy for introducing allergenic foods like eggs, milk, peanuts, wheat, soy, tree nuts, fish, and shellfish.
That being said, Check out the following for questions you might have on allergies:
Could my baby have a food allergy?
It's possible, although a suspected food allergy often turns out to be something else. Approximately 6 percent of young children and 3 to 4 percent of adults in the United States have a food allergy.By understanding how allergies work, you may be able to recognize the early signs, just in case. It's also important to know what to do if your baby ever has an allergic reaction.
What happens if my baby has an allergic reaction to a food?
If your baby is allergic to a food, her body treats the food like an invader and launches an immune-system attack.Sometimes the body makes an antibody called IgE, a protein that can detect the food. If the food is eaten again, the antibody tells your baby's immune system to release substances such as histamine to fight the "invader."
These substances cause allergy symptoms, which could be mild or severe.
Symptoms — like hives, swelling, or trouble breathing — usually show up within minutes to two hours after eating a specific food. If your baby has a severe allergic reaction, it can be life threatening.
In some cases, though, food allergy symptoms — like eczema or gastrointestinal problems like vomiting or diarrhea — are chronic, or ongoing. (Eczema is dry, scaly patches of skin that show up on a baby's face, arms, or legs, but usually not the diaper area.)
Remember that your baby can have a reaction to a food even if she's eaten it before without any problem. So if she inherited the tendency to be allergic to eggs, she might not have a reaction the first few times she eats them — but eventually she'll show symptoms.
Keep in mind that her early exposures to the ingredient may have been when it was combined with something else — for instance, the eggs, milk, or ground nuts in a cookie.
What foods might my baby be allergic to?
It's possible to be allergic to any food, but these eight food groups are responsible for 90 percent of food allergies: eggs, milk, peanuts, wheat, soy, tree nuts (like walnuts, Brazil nuts, and cashews), fish (such as tuna, salmon, and cod), and shellfish (like lobster, shrimp, and crab).What should I do if I think my baby's having an allergic reaction to a food?
If your baby ever seems to be having trouble breathing, has swelling of the face or lips, or develops severe vomiting or diarrhea after eating, call 911 or your local emergency number right away.Severe allergic reactions are nothing to fool around with. Your baby's airway can close up within minutes, so don't call the doctor to get advice or drive her to the emergency room. You need paramedics on the scene as soon as possible.
If your baby consistently has symptoms within two hours of eating a certain food, talk with her doctor. He may refer you to a pediatric allergist for testing.
An allergist should be able to tell you which food or foods are causing the problem and whether the symptoms are part of an immune reaction (indicating an allergy) or are a sign that your baby's unable to digest the food (indicating a food intolerance).
Once your baby has had an allergic reaction to a food, you'll want to be prepared in case it happens again. Even if her first reaction was mild, the next might be severe. Your baby's doctor can provide you with an action plan, including instructions on how to manage an allergic reaction.
The doctor may recommend that you carry an epinephrine auto-injector, which he can prescribe and show you how to use in case of a reaction. These devices look like magic markers and automatically administer the right dose of epinephrine to stop an allergic reaction.
Auto-injectors are usually first prescribed for young children, but if your baby has had an allergic reaction to a food, the doctor may recommend one for her now.
Make sure anyone who takes care of your baby — babysitters, relatives, daycare workers — knows about her allergy and what she shouldn't eat. Point out the kinds of foods that could hide the substance and ask caregivers to double-check ingredients. Also make certain that her caregivers know exactly what to do if she ever has an allergic reaction.
Are allergies inherited?
Your baby may inherit the tendency to have allergies but not necessarily a specific allergy.For example, if you have hay fever, pet allergies, or a food allergy, your child has a 50 percent chance of having some sort of allergy, too, although maybe not the same one you have. That probability jumps to 75 percent when both parents have allergies.
Will my baby outgrow her food allergy?
She might. Many children outgrow allergies to soy and wheat by the time they head to school. And about 20 percent of children outgrow their peanut allergy. Allergies to peanuts, tree nuts, fish, and shellfish are more likely to be lifelong than other food allergies.Some recent studies suggest that milk and egg allergies may take longer to go away these days than before, with fewer than half of children in one study outgrowing milk or egg allergies by age 8 to 10.
But Scott Sicherer, associate professor of pediatrics at the Jaffe Food Allergy Institute at Mount Sinai School of Medicine in New York and author of Understanding and Managing Your Child's Food Allergies, points out that these new studies are from a referral center for food allergies and may represent children with more severe allergies.
What's a food intolerance and how is it different from a food allergy?
Adverse reactions to foods are reported by about 20 percent of the U.S. population, but most of those reactions aren't allergic in nature. The most common type of adverse food reaction is a food intolerance.A food intolerance doesn't involve the immune system. If your baby has a food intolerance, it may mean she has trouble digesting a particular food. You may notice that every time she eats or drinks that food she's plagued with digestive symptoms such as gas, bloating, or diarrhea.
The most common one is lactose intolerance.People who are lactose intolerant lack the enzyme necessary to digest the sugar in cow's milk and other dairy products. It's not recommended that babies under the age of 1 drink cow's milk anyway, but lactose may be present in other foods your baby ingests, including formula.
What should I do if I think my baby might have a food allergy?
Talk with her doctor. He might suggest a food diary to help identify the cause or a change in infant formula, and he might refer you to an allergist or pediatric gastroenterologist.An allergist will ask detailed questions about your baby's symptoms. He may do an allergy skin test or a blood test to determine whether the symptoms are caused by an immune reaction.
If the skin test produces a hive or the blood test shows that your baby has IgE antibodies to the food, there's a chance she's allergic to that specific food. If the tests are negative, your baby's symptoms are less likely to be due to a food allergy, although they may be caused by a food intolerance.
At that point, you may be referred to a gastroenterologist to pinpoint the cause of the intolerance or to investigate other explanations for your baby's symptoms.
Is there anything I can do to prevent or delay a food allergy?
This is the million-dollar question. In the past, the American Academy of Pediatrics (AAP) suggested delaying the introduction of certain foods in children who seem likely to have allergies because their parents have allergies. But practices in other cultures – and recent research – suggest that it might not be the best course of action.In a clinical report published in January 2008, the AAP says there's no solid evidence that waiting to introduce allergenic foods will protect a child from developing an allergy. If you think the odds are good that your baby has a food allergy, talk with her doctor about the best strategy.
One thing most experts do agree on is that breastfeeding offers some protection against allergies. Consider breastfeeding your baby as long as you can, especially if you have a family history of allergies.
Another thing you can do is introduce your baby to new foods gradually. Feed her one new food at a time, waiting several days between introductions of new items. That way you'll be able to tell which food she's reacting to if she does have an allergic reaction.
Can food allergies be treated?
There are no medications that cure or prevent allergic reactions to foods, and the allergy shots used for hay fever don't work for food allergies. The key to preventing an allergic reaction is strict avoidance of the food.Avoiding a particular food is trickier than it sounds. Foods show up in unlikely places, and even a little bit may be enough to trigger a severe reaction. Most people who have a severe reaction have eaten a food they thought was safe.
You'll have to become vigilant about reading food labels, knowing which ingredients to avoid, and asking about ingredients in restaurant dishes or food at friends' homes.
The Food Allergen Labeling and Consumer Protection Act (FALCPA) — which went into effect on January 1, 2006 — is proving helpful. This law requires food manufacturers to list these top food allergens on product labels: eggs, milk, wheat, soy, peanuts, tree nuts, fish, and crustacean shellfish (crab, shrimp, and lobster but not mollusks like clams, oysters, or squid). Nuts, fish, and shellfish must be named specifically.
All the allergens must be listed in plain language. For example, the label has to say "egg" instead of "albumin" or "egg" in parentheses after "albumin."
Websites for such organizations as the Food Allergy Network can also help you identify and steer clear of hidden dangers. If you're unsure about a product's ingredients, call the manufacturer.
The proteins that cause the allergy may be passed on in your breast milk. So you may need to give up the offending food yourself if you're nursing a baby with a food allergy,
And if you're formula-feeding a baby who seems to be allergic to cow's milk, you may need to change formulas. Some babies who are allergic to cow's milk are also allergic to soy, though, so it's important to discuss the situation with your child's doctor before making any kind of change.
If your baby has been diagnosed with a food allergy, you'll want to learn all you can about it — including exactly which foods to avoid, how to read labels, and how to recognize the early signs of an allergic reaction.
Sites for information on these articles:
Food Allergy Network
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