Understanding and Managing Food Allergies

There are currently no cures for food allergies. Management is based on avoiding the food and being prepared to treat an allergic reaction should the food be eaten accidentally. Anti-histamines can help mild symptoms such as itching and hives, but an epinephrine injection is necessary for severe symptoms or breathing difficulties (eg, throat swelling, wheezing). If epinephrine needs to be given, the child should be immediately taken for emergency medical care, or if necessary, 911 should be called.

If your pediatrician believes there is any risk that your child could have a severe allergic reaction to food, your pediatrician will recommend that you—and your child, when old enough to use it by himself—always carry an epinephrine autoinjector device in case of accidental ingestion of the food. You must review with your doctor how and when to use this medication. The devices are easy to use and the medication is safe, but it is important to be familiar with the prescribed device so that there are no delays in providing emergency treatment. A child at risk for anaphylaxis should also wear medical identification.

Understanding and Managing Food Allergies

There’s only one sure way to prevent food allergy symptoms, and that’s to avoid the problem of food altogether, in all forms, at all times. Sometimes this is easier said than done. Product labels must be read carefully each time to ensure the allergic food is not an ingredient. Read the label each time because ingredients may change. This is extremely important for patients with severe food allergies. At home, avoid cross-contact with safe foods with an allergen. For example, a knife used in peanut butter and then in jelly may leave peanut residue in the jelly jar that could cause a reaction when the jelly is used another day.

Similarly, be careful when preparing foods and using cutting boards, mixing spoons, and heating surfaces. In restaurants, have a cautious conversation with the waiter to be sure that the allergen is not an ingredient or contaminant of your child’s meal, although this may not be guaranteed. For schools, bringing safe foods from home may avoid problems with cafeteria meals, although many schools can provide safe foods with proper preparation. Strict no-sharing policies must be followed to prevent accidental ingestions. Also, avoid using food products in craft and science projects to steer clear of accidental exposures.

Understanding and Managing Food Allergies

It’s a relatively simple to keep a problem food away from a very young child who eats meals and snacks under the watchful eye of parents or caregivers. However, it is more difficult with an older child with less supervision while eating. Not only your child but also his friends and their parents should understand how serious the condition is and how important it is to avoid the allergen in any form. Above all, children should be warned never to share or taste another child’s food.

Understanding and managing food allergies

Be sure to provide full information about your child’s food allergies to school and camp personnel and childcare providers. Update information regularly at the start of each school year and as new facts become available. In this regard, it is important to report accurate information, ie, definite food allergies, not minor food sensitivities.

Most people who are allergic to food are only allergic to a few popular foods. Immunoglobulin E, which is an antibody, links to food proteins and wrongly sees them as threats. This causes a chain reaction of chemicals, including histamine, to be released. Histamine makes allergy symptoms worse by making areas swell up and turn red by making blood vessels open up more.

Understanding and managing food allergies

It also affects the nerves in your skin, making the inside of your nose feel itchy and sometimes burning. Anaphylaxis is a severe allergic reaction that can be deadly. It is caused by a rush of histamine and other chemicals released by the immune system into the bloodstream. Food allergies can be caused by or not caused by IgE. Some people are allergic to certain foods because their bodies make immunoglobulin E (IgE), which is a type of antibody.

Several hours after eating the problematic food, the body starts to react with different symptoms, such as anaphylaxis. Some allergy signs that are not caused by immunoglobulin E antibodies are stomach pain or skin irritation. Diarrhea and throwing up are two of the most common signs, though they may not show up until three days after eating the bad food.

Food Allergies Myths and Misconceptions

Understanding and Managing Food Allergies
  1. Food Allergies affect behavior. No convincing research results are showing that a true food allergy causes problems such as attention-deficit/hyperactivity disorder or autism. Some studies show that chemical preservatives or dyes, presumably through a pharmacologic rather than allergic mechanism, might contribute to these problems, but the evidence is weak and not widely accepted by experts.
  2. Sugar allergy causes behavioral problems. Parents may blame high-sugar foods for unusual behavior. However, the results of several carefully controlled studies of preschool and school-aged children showed sugar or artificial sweeteners had no effect on behavior.
  3. Each allergic reaction gets worse. It is not automatically the case that each subsequent exposure to the food will result in a worse allergic reaction. The severity of a subsequent reaction is not easily predicted and can be worse, the same, or milder than previous reactions.
  4. Peanut-allergic children should avoid all kinds of nuts. Peanut is a legume and not of the tree nuts family. Many children with peanut allergies can tolerate tree nuts, and vice versa. However, some children can be allergic to multiple different foods, including peanuts and certain tree nuts. Make sure you are clear about what the situation is with your child.

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