The approach to food allergies in children is undergoing a revolutionary change of late. First, let’s define the problem:
- 6% of children <2 yrs
- 9%<5 yrs
- 8% ages 6-10 yrs
- 6 million children overall
- 40% of affected children have severe allergy
- 30% of affected children are allergic to multiple foods
The most common allergic foods in infants and toddlers are milk, eggs and peanuts. In older children we also see symptoms from shellfish, soy, wheat, and other fish.
Food allergies cause symptoms in a variety of organ systems:
- Skin–hives, itching, eczema
- Respiratory–cough, congestion, wheezing, throat closing
- GI-nausea, vomiting, diarrhea
- Cardiac–dizziness, fainting, collapse
Also note that most of these symptoms–or adverse reactions that are similar–may be mimicked by unrelated conditions like food poisoning, lactose intolerance or idiosyncratic/specific food reactions. So not everything that occurs in relation to eating/food is”allergy.”
As recently as 2000, guidelines from the American Academy of Pediatrics recommended that parents delay the introduction of high incidence allergy foods until 1-3 years of age. Since then, we’ve seen an almost 50% increase in the incidence of food allergies.
Now, thanks to the LEAP (Learning Early About Peanut allergy) study, that’s all changing. Early introduction of peanut seems to be protective. As little as 2 gm daily of peanut butter(about 2 tsp) was often effective. The EAT (Early Allergy Treatment) study found similar results with other common allergy foods. It appears these small doses of allergy-type foods may decrease the incidence of the condition by as much as 86%. So now the medical community is “doing a 180”–going in completely the opposite direction from the previous recommendations. Early introduction of common allergy causing foods is becoming the way to go for at risk children/families.
Those at greatest risk include children with confirmed allergic siblings or parents or those who have severe eczema or asthma. Please contact me if you are concerned about food allergies in your child. We can explore and design a food introduction/desensitization program, or consult an allergist to guide us in that effort.
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