Approximately 15 million Americans have food allergies, whether it’s dairy, soy, egg, wheat, shellfish, or nuts. Food Allergy Awareness Week, which runs May 13-19, aims to shed light on this health issue by educating everyone about what they should know and keep in mind when they are around individuals with food allergies—especially children. One in 13 kids has food allergies, which is equivalent to nearly two kids per class in the United States.
In an effort to help with this educational effort, we spoke to Susan Schuval, M.D., chief of the Division of Pediatric Allergy/Immunology at Stony Brook Children’s Hospital and associate professor of clinical pediatrics at Stony Brook School of Medicine on Long Island. Read on for her insights into what parents should know about children’s food allergies and precautionary measures to take around others who may be in their children’s classes.
What do parents need to know about children with food allergies?
Food allergies occur in 5-8 percent of children and may range from mild reactions such as hives to severe systemic reactions such as anaphylaxis. Although anyone can develop a food allergy at any age, food allergies are more common in young children, and may be outgrown over time. Milk, soy, egg, and wheat allergies are most commonly seen in young children, while adults are more likely to be allergic to fish, shellfish, peanuts, and tree nuts. In the past, strict avoidance of the offending foods was recommended to patients with food allergies. However, the success of recent clinical trials of food oral immunotherapy (OIT) has suggested that OIT may be an effective future treatment for food allergies. This involves inducing tolerance of allergenic foods via very slow introduction, starting at very low doses, and then gradually increasing over time, under the close care of an allergist. Though, OIT is currently not approved by the U.S. Food and Drug Administration. Recent studies have also shown that earlier introduction of allergenic foods such as peanuts may prevent food allergies in high-risk infants. The National Institute of Allergy and Infectious Diseases has recommended earlier introduction of peanuts to infants, with evaluation by an allergist suggested for high-risk infants (those with eczema and peanut allergy).
How can you determine what food allergies your child has?
Evaluation by an allergist is helpful in the diagnosis of food allergy. Children diagnosed with food allergies should see the allergist regularly for patient education, and to review use of the epinephrine auto-injector, a medication that may be lifesaving in children experiencing severe allergic reactions to foods. Yearly re-testing is often recommended, as many children will outgrow their food allergies. Milk, egg, soy, and wheat allergies are commonly outgrown, while peanut allergies are outgrown in 20 percent of children and tree nut allergies in 10 percent of children over time.
What can parents do to be more sensitive to a child with food allergies who may be in their child’s class?
Some classrooms or schools may be “peanut-free” or “tree nut-free,” or may offer a “peanut-free table.” Parents may be asked to send in lunches or snacks without peanuts or tree nuts, and should be cognizant of these requests. Also, children without food allergies may bully children with food allergies, so teachers and parents should be aware of any such activities.
How can parents better support their child who has food allergies?
Food Allergy Research and Education (FARE) offers numerous resources for food-allergic patients such as tips on home food preparation, dining out in restaurants, and dealing with food allergies at school. It also provides resources such as food allergy support groups for parents who may feel overwhelmed by their child’s food allergies. Family and patient education about avoiding food allergen cross-contamination and accidental food exposures is provided by the allergist. Meals should be customized for children with food allergies, and involving the child in grocery shopping and menu preparation may be helpful. Nutritionist evaluation may be needed in a child with multiple food allergies to ensure a healthy diet.
What are some resources parents of children with food allergies can use to help them?
Regularly scheduled visits with the allergist are important in monitoring a child’s food allergies and providing ongoing patient education. Online resources include FARE; the American Academy of Allergy, Asthma, and Immunology; and the American College of Allergy, Asthma, and Immunology.
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