It is Food Allergy Awareness Week and did you know that approximately 1 in 13 children have true food allergies. In other words, these children have an antibody response to a food which then triggers a cascade of symptoms. While any food is capable of causing an allergic reaction there are 8 foods that cause 90 percent of food allergies and these are: milk, soy, egg, peanut, tree nuts, fish, shellfish and wheat.
Our body’s immune system is efficient in trying to fight off bacteria and viruses but at times it seems to “get confused” and will develop antibodies (immunoglobulin E to be exact-IGE) to a protein in food. This may occur the first time you are exposed to the food or at any time in life.
The immune reaction is a complicated series of events beginning with a histamine response which then triggers other chemicals in the body as well which then cause the symptoms of an allergic reaction. These symptoms may be as mild as sneezing or itchy areas on the skin to severe symptoms with swelling of face, lips or tongue, difficulty swallowing, difficulty breathing with wheezing and shortness of breath, and nausea and vomiting. Any symptom warrants attention. A severe reaction is called anaphylaxis and is a life threatening event.
While some children may not yet be verbal when they are first exposed to a food, they may show signs of an allergic reaction by coughing, vomiting, pulling at their tongue or grabbing their neck. A parent needs to be aware that these may be symptoms of a food allergy.
The most accurate way to diagnose a food allergy is by history. There are also blood tests and skin tests that may help to identify a food allergy. In some cases an allergist may recommend a food challenge under a doctor’s supervision.
Any child with the diagnosis of a food allergy needs to have an epinephrine pen available for an emergency. If a child is accidentally exposed to a food that they are allergic to, the “epi” pen is injected to prevent an anaphylactic reaction. Parent’s and caregivers need to be instructed on how to use the epinephrine injector. I typically prescribe enough epinephrine pens in order that the parents both have one, the school has one, there is one in the house and if the child is old enough that they carry one as well. The importance of the immediacy of having the epinephrine available cannot be emphasized enough.
There is a new product available called Auvi-Q which is the first epinephrine auto-injector that talks you through the injection process. It’s very helpful for children, parents or caregivers. You can find out more information at www.auvi-q.com.
Food allergies continue to be studied and there are currently some trials being done in which children are being desensitized to the food they they are allergic to. I have several patients involved in studies who are undergoing peanut and milk de-sensitization, and are having success. Exciting breakthroughs for sure.