Managing Food Allergies
Food allergy is a term that encompasses many clinical situations. Food allergy, defined as an adverse reaction to a food, is commonly based on patient self report. Physician diagnosed is a more reliable estimate, and is generally established in only a third of self reports. Sensitization to a food, that is the detection of allergy antibodies to a food does not always correlate with clinical symptoms when the food is consumed. It’s important to know what causes food allergies.
With the above in mind, parent’s self reports of food allergy in their infants and children occurs in 12% of the population and adults self reports of food allergy occurs in 13% of the population. Physician diagnosis in children puts the prevalence at around 3% while that in adults in unknown.
- The foods most associated with food allergy in children are eggs, cow milk and peanuts. Foods most associated with food allergy in adults are fruits, tree nuts and fish and shrimp.
- As children grow older, many of them, but not all, no longer exhibit the same clinical reactions to eggs. Fewer children may exhibit the same natural course to peanuts.
- In infants, cow milk and soy symptoms may not be hives and/or asthma, but may be colic or blood in the stools.
Dietary maneuvers that may assist in the management of allergy to food in infancy include:
- Exclusive breast feeding for 4-6 months
- Delaying the introduction of solid foods
- Delaying the introduction of highly allergenic foods
Children and adults with established diagnosis of food allergies require special precaution:
- Avoiding the allergenic food remains the mainstay of preventing food allergy reactions. Care givers of children with food allergy and adults with food allergy should be informed on how to manage an allergic reaction, including the administration of epinephrine (adrenaline).
- Because fatal and near fatal food allergy reactions often occur outside the home and sometimes in a school setting, parents need to make sure the school has a written emergency action plan providing instructions on preventing, recognizing and managing food allergies in the school and during other school related activities such as sporting events and school trips.