Understanding Food Allergy

Did you know that up to one third of all parents report some kind of bad reaction to food in their kids? The prevalence of food allergies has increased from 3.4% in 1997 to 6.2% in 2016. The peak prevalence of food allergy is around 6-8% at one year of age and then falls to 3-4% in later childhood. Cow’s milk, soy, fruits (especially citrus and berries), vegetables (especially tomatoes), hen’s eggs, fish, wheat, and nuts are some of the most common. My youngest son has a cow’s milk allergy, my sister was allergic to peanuts, and my cousin is allergic to fish. It’s everywhere, and it’s not always easy to understand.

 

The Language:

 

A food allergy is not the same thing as a food intolerance. Food allergy happens when the immune system overreacts to the proteins on a food. In a “classic” food allergy reaction the immune system dumps out a whole bunch of antibody called Immunoglobulin E (IgE). IgE then causes a cascade of allergic reaction symptoms (think hives, runny nose, scratchy throat, wheezing, vomiting, and/or diarrhea) within minutes to hours.

 

Food intolerance may have similar digestive symptoms as food allergy, but a food intolerance does not involve the immune system. A food intolerance is often related to the amount of food eaten, and the body’s inability to digest it well; it is not life threatening. A food allergy, on the other hand, is often unpredictable, and has the potential to cause serious reactions even with very small exposures.

 

The History:

 

There are several theories as to why food allergies are on the rise. Remember the statistics above? That’s like 1 in 13 kids, or 2 kids in every public school classroom, with a food allergy. That was not the case when I was in school. Some say it is because we have avoided the allergenic foods, or are “too clean.” Others say it’s related to nutrient deficiencies and poor gut health. The bottom line? We don’t know why.

 

The Plan:

 

The most important strategy in the management of food allergies is to avoid eating those foods. This is a lot easier said than done. A study from last summer found that one-third of products examined contained undeclared allergen, while 57% of products with advisory labeling did not contain any of the declared allergens.

So, the point I’m trying to make is, it’s also very important to understand how to treat an allergic reaction.

 

Here’s what the family should do:

 

Tell everyone

Whether it’s the school, daycare, church, friends and family, camp, whatever. Just make sure everyone is aware of your child’s allergy.

 

Tell your child

Make sure your child knows what foods are safe, what foods to avoid, and how to read food labels. Also make sure your child knows the symptoms of an allergic reaction and how/when to notify an adult if an allergic reaction happens.

 

Medication

Provide properly labeled medication, instructions, and documentation. Replace expired medications!

 

Make a plan

Work with the school team to develop a plan that accommodates you child’s needs throughout the school. This includes in the classroom and cafeteria, in after-care programs, during school-sponsored activities, and on the school bus, as well as a Food Allergy Action Plan.

 

Here’s what KidMed can do:

 

A serious food allergy reaction, or anaphylaxis, is very unpredictable. One exposure may cause a mild reaction while another exposure may be much more serious. Epinephrine is the best treatment for such a reaction. Use your child’s autoinjector (EpiPen, AuviQ, etc.) immediately, even if it is expired. Then, go to the nearest KidMed or pediatric ER.

 

I want to be clear: your child needs evaluation at KidMed or a pediatric ER after epinephrine autoinjector to ensure symptoms do not worsen. It is not because the epinephrine injection is dangerous, so PLEASE DO NOT HESITATE to use it. Epinephrine should be given even if KidMed or the pediatric ER is close, or EMS is on the way.

 

Please also know that antihistamines (Benadryl, Zyrtec, Claritin, etc.) and/or asthma inhalers (albuterol, etc.) are not enough. These medicines treat some of the symptoms of severe food allergy, but they do not treat everything. And they definitely do not work fast enough in rapidly developing anaphylaxis.

 

At KidMed, we immediately assess your child with a severe food allergy reaction. He is hooked up to a monitor so we can see his heart rate, respiratory rate, blood pressure, and oxygen level. We can give epinephrine, albuterol, oral steroids, oxygen, IV fluids and medications as necessary. Then, we wait and watch. The pediatric experts at KidMed closely monitor your child as long as needed to ensure he is safe and taken care of. Our goal is to resolve the serious food allergy reaction, and send you home. But, we can also easily and safely arrange for transport to a pediatric ER if it is necessary.

 

I know this is a lot of information, on a pretty scary topic. But the pediatric experts at KidMed are here to help if/when you need us.

 

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