In Australia, as with the rest of the world, food allergies are becoming increasingly more common in our kids. And no one really knows why.
Dr Sam sifts through the facts to discuss what all parents really need to know about food allergies.
Food allergy can develop at any age, but is most common in babies under one, affecting one in ten. Most childhood allergies are 'outgrown', only affecting about one in twenty by age five, and only 2% of adults.
So what is an allergy?
An allergy arises when the body's immune system reacts to a substance – an 'allergen' - in the environment that would otherwise be harmless. Common examples include medications, insect bites, foods, or pollens.
An allergic reaction, is when the person goes on to develop symptoms following the allergen exposure. These symptoms can range from mild to severe, with anaphylaxis being the most extreme form.
- MILD - Hives, welts, fine rash, itchy eyes, swelling of face or lips, abdominal pain or vomiting.
- SEVERE/ANAPHYLACTIC - Difficulty breathing, tongue swelling, throat tightness, wheeze or cough, dizziness, drowsiness, or collapse.
Most allergies are mild, and only some are severe. And whilst we need to be wary as parents, it's important to remember that death is in fact rare, and can be easily avoided with careful allergen avoidance, and immediate emergency treatments - usually an adrenaline shot.
When it comes to kids, we are often relying on what we observe - as kids are not that great at telling stories! If concerned, I always encourage parents to keep a diary and even take some photos.
At times food allergy can be sinister and vague, especially so in kids. And this makes diagnosis even harder. It may simply present as infantile colic, reflux, eczema, or even struggles with growth.
What are the most common foods?
Nine foods are responsible for over 90% of allergic reactions: cow's milk, egg, peanut, sesame, soy, tree nuts, wheat and shellfish.
But it's important to remember that almost any food can result in an allergy.
Most kids with cow's milk, egg, soy, or wheat will 'outgrow' their allergy. However, about three in four kids with the peanut, sesame, shellfish, or treenut allergies will be stuck with theirs for life.
Is it always an allergy?
In general practice the term allergy gets thrown around a lot.
In reality, many suffer simple reactions to food, that whilst uncomfortable, are really very harmless. The most common examples I come across are bloating or loose poos after a big whack of cow's milk or wheat (pasta/pizza/bread), or even headaches after chocolate and alcohol. Now, these reactions can be debilitating for some, but they do not fall under an allergy, and certainly won't be life threatening.
My usual advice is - if a food makes you feel uncomfortable, then don't eat it!
Why are allergies to foods becoming more common in Australia?
The simple answer is: we just don't know.
Current research indicates that a fear of allergies to foods such as peanuts has led to parents delaying when they introduce these to babies. Despite their best intentions, this has infact compounded the issue. This is certainly a focus of advice for new parents in my general practice, ALL foods must be introduced EARLY in a baby's diet.
There is also the hygiene hypothesis. Freaked out germophobe Generation X and Y parents are over protecting their kids. By avoiding the rough and tumble of playgrounds, parks, and daycares, our kids just aren't exposed to enough bugs, thereby avoiding important immune system boosts.
So how do we know when it is a food allergy?
This is a job for your GP, and the trusted allergy specialist they refer you to- the immunologist!
A good doctor will sift through the history - what are the symptoms, timeframes, and what has been eaten in the minutes, hours, and days before.
Blood tests and skin prick tests are useful to confirm or exclude potential triggers, however, positive results do NOT guarantee an allergy is present ('false-positives'). Elimination diets can help the monitoring of symptoms.
But ultimately, the immunologist may need to conduct a supervised challenge test in order to fully establish a link of any specific food to an allergic reaction - often done around the time of school entry.
My child has a food allergy, what should I do?
The first thing to do is avoid that food! There is currently no cure for food allergy, with strict avoidance being the mainstay of management.
The next, follow the advice of your allergist.
Whilst most kids outgrow their allergy, we have no way of predicting who will and who won't. Therefore it's imperative that you stay in contact with your medical team. Your immunologist may conduct periodic supervised food challenges in order to assess where things are at.
Your doctor should provide you with an action plan and adrenaline autoinjector if necessary. Make sure everyone knows the plan, what symptoms to look out for, and how to use the autoinjector - this includes all close friends, family, and school staff.
Lastly, foster responsibility in your kids. Teach them how to ask for help, how to read food labels, and most importantly - which foods to avoid!
Can food allergy run in the family?
This is interesting. Most kids with food allergy do NOT have a parent with allergy. But, their siblings ARE at more risk, although still low. The screening of siblings is, unfortunately difficult and rought with issues, so best discussed with your immunologist.
But my homeopath assures me they can cure my child's allergy?
There are several completely useless waste of money tests that less reliable health practitioners may recommend.
These include cytotoxic food testing, iridology, allergy elimination techniques, hair analysis, Vega testing, or IgG food antibody testing.
These tests are simply unreliable, have no scientific validity, and have no useful role for diagnosing food allergy whatsoever!
Please spend your time and money consulting a good evidenced based medical team.