Food Allergies in Children: Causes, Symptoms, and Management

Food allergies have become one of the most common health issues in children in recent years, especially when solid foods are first introduced into their diet. The symptoms can appear suddenly and unexpectedly, varying from mild to severe, and in some cases, they can even be life-threatening. An important distinction to know is between food allergies and oral allergy syndrome, both of which require different approaches to treatment and management. Fortunately, early detection of food allergies can protect your child from long-term health and psychological complications.

What is a Food Allergy?

A food allergy occurs when the immune system reacts abnormally to a particular food, treating it as a harmful substance. The immune system releases chemicals like histamine, which cause allergy symptoms that can affect the skin, digestive system, respiratory system, or even the cardiovascular system.

Causes of Food Allergies:

The exact cause of food allergies is not fully understood, but it is believed to result from a combination of genetic and environmental factors. A family history of allergies increases the likelihood that a child will develop food allergies. Additionally, environmental factors such as early exposure to allergens can contribute to the development of allergies. Excessive hygiene and sanitization may reduce the exposure to beneficial bacteria, making the immune system more likely to overreact to harmless allergens.

Certain chemicals found in food can trigger allergy symptoms in children, such as rashes, wheezing, nasal congestion, stomach cramps, vomiting, and diarrhea.

Common Foods that Cause Allergies:

While nearly any food can cause an allergic reaction, the following eight foods account for about 90% of food allergies:

• Milk

• Eggs

• Peanuts

• Soy

• Fish (such as salmon, cod, and tuna)

• Shellfish

• Wheat

• Nuts (such as tree nuts)

Symptoms of Food Allergies:

Food allergies can cause a wide range of symptoms, which vary in severity from child to child. Some of the mild to moderate symptoms include:

• Sneezing or wheezing

• Stomach cramps or abdominal pain

• Nausea or vomiting

• Diarrhea

Anaphylaxis:

Anaphylaxis is a severe and potentially life-threatening allergic reaction that requires immediate medical attention. Symptoms include:

• Pale or blue-colored skin

• Swelling of the neck, itching, or tightness in the throat

• Difficulty breathing

• Dizziness or a drop in blood pressure

• Partial or complete loss of consciousness

• Seizures

Most food allergy reactions occur within minutes to an hour or two after consuming the food, although in rare cases, they may happen 4 to 6 hours later or even more.

Oral Allergy Syndrome: A Different Condition

Oral allergy syndrome is not the same as a food allergy, though it involves an allergic reaction to food. It occurs when the immune system reacts to pollen proteins found in certain raw fruits, vegetables, or poorly cooked foods, rather than the food itself.

Symptoms of Oral Allergy Syndrome:

• Red patches on the skin (hives)

• Itchy skin or eczema (atopic dermatitis)

• Runny or congested nose

• Swelling in the mouth, tongue, or throat

Common Foods That Trigger Oral Allergy Syndrome:

• Milk (cow's milk)

• Eggs

• Peanuts

• Nuts

• Wheat

• Soy

• Fish

• Shellfish

Symptoms typically appear within minutes to 2 hours after eating these foods and can include:

• Redness or sudden rashes, especially around the mouth, cheeks, or chest

• Swelling of lips, eyelids, or tongue

• Intense itching or unexplained crying after eating certain foods

• Vomiting, diarrhea, or stomach cramps right after eating

• Sudden coughing, wheezing, or shortness of breath

• Runny nose or unusual sneezing

• Fatigue or drowsiness, or in severe cases, loss of consciousness

Anaphylactic Shock: A Medical Emergency

Anaphylactic shock is a third, serious, and emergency-level allergic reaction. Symptoms include:

• Severe difficulty breathing

• Rapid heartbeat

• Low blood pressure

• Blue or pale skin

• Loss of consciousness

Immediate medical intervention is required in such cases.

Practical Steps for Managing Food Allergies:

1. Gradual Introduction of Foods:
   When introducing solid foods to your baby (typically around 6 months of age), it’s advised to introduce one new food every 3 days, and monitor any reactions to it. This approach helps in identifying any potential allergens.

2. Observe After New Meals:
   Introduce new foods during the day rather than at night, so that you can notice any reactions quickly. Avoid giving more than one new food at a time to make it easier to pinpoint any allergies.

3. Keep a Food Journal:
   Maintain a detailed record of your child's daily meals, including the timing and any symptoms that appear afterward. This can help doctors diagnose food allergies accurately.

4. Be Prepared for Emergencies:
   If your child shows signs of a food allergy, no matter how mild, consult a pediatrician immediately. The doctor may recommend allergy tests (such as skin tests or blood tests) to pinpoint the exact cause.

5. Check Food Labels Carefully:
   If your child is diagnosed with an allergy, always read food labels carefully before giving them any product. Some foods may contain traces of allergens even if they are not listed as primary ingredients.

6. Understanding Cross-Contamination:
   Some children with food allergies may react to foods that are genetically related to the allergen they are allergic to. For example, a child allergic to peanuts may also be allergic to tree nuts. Always consult with an allergist about cross-reactions.

7. Educate Those Around Your Child:
   Make sure all caregivers, teachers, and others who interact with your child are aware of their food allergies and know what to do in case of an allergic reaction.

8. Carry Epinephrine Auto-Injectors:
   In the case of severe allergies, doctors often prescribe an epinephrine auto-injector (EpiPen). Keep this device with you at all times, and ensure that caregivers know how to use it in case of an emergency.

9. Regular Follow-Up:
   Some allergies may subside as the child grows, while others may persist. Regular follow-ups with an allergist or pediatrician are important to monitor the child's progress, especially as they approach school age or adolescence.

10. Teach Self-Awareness:
    As your child grows, it is essential to teach them about their food allergies. Encourage them to identify safe foods and refuse food from strangers. Make sure they inform adults immediately if they experience any unusual symptoms after eating.

By staying informed, introducing foods cautiously, and being prepared for emergencies, you can ensure that your child’s food allergies are managed effectively, leading to a safer and healthier environment for them.