Your Child's Food Allergies
By Wesley Burks, MD and Dennis Clements, MD, PhD.
allergy occurs in 4 to 6 percent of young children and 3 to 4 percent
of adults. It can be a major cause of life-threatening allergic
egg, and peanuts are the most common foods that cause food allergy,
followed by wheat, soy, fish, shellfish, and tree nuts such as walnuts
and pecans. Other foods may cause allergic reactions but much less
to peanuts, which cause the most reactions, can range from simple
hives to severe systemic reactions. Almost 1 percent of young children
in the United States are thought to be allergic to peanuts. In the
last 15 years the number of children who have peanut allergy has
doubled for reasons that are not entirely clear.
for Food Allergies
The diagnosis of peanut and other food allergies is made by taking
a careful clinical history from the patient and family. Generally,
allergic reactions happen within seconds to minutes after eating
the food. The symptoms are reproducible, which means that each time
the food is eaten the same general symptoms occur.
foods need to be eaten -- not just inhaled or touched -- to cause
any serious allergic reactions. Often the physician making the diagnosis
will then look for the allergic protein to the food (called IgE)
using skin scratch testing or blood testing.
negative test is a good sign that the child is not allergic to the
food, while a positive test only indicates the child may be allergic
to that food.
of Food Allergies
After the diagnosis, the treatment for food allergy is elimination
of the food from the diet. This sounds easier than it really is
for the patient and family. Compliance with an elimination diet
is time-consuming, inconvenient, and requires a great deal of education
and commitment on the part of the patient and all caregivers.
Food Allergy and Anaphylaxis Network, a non-profit patient advocacy
group, is an invaluable resource for parents as well as physicians
in this endeavor. Even with good educational information, about
half of food-allergic patients have accidental ingestions and subsequent
allergic reactions after diagnosis.
or difficult-to-read food labels may result in accidental ingestion
of the food. The United States Food and Drug Administration requires
food manufacturers to declare all food ingredients on food labels.
However, some of the wording does not clearly indicate the presence
of a food allergen. For instance, natural flavorings
may contain several individual ingredients including whey, or vegetable
proteins may include soybean.
Food Allergen Labeling and Consumer Protection Act (FALCPA), which
takes effect January 1, 2006, will address some of the limitations
of current food labeling practices. FALCPA requires food manufacturers
to plainly state the presence of the eight major food allergens:
milk, egg, wheat, soybean, peanut, tree nuts, fish, and shellfish.
Because accidental food ingestions can not always be avoided, patients
and their caregivers must be equipped to manage acute food-induced
reactions. Individualized treatment plans should be prepared in
advance and medications readily available. These medications may
include antihistamines (Benadryl, for example) and injectable epinephrine
food allergies to milk, egg, wheat, and soybean are generally expected
to be outgrown by about school age, while other food allergies --
like peanut, tree nuts, fish, and shellfish -- are likely to be
with a person for life.
number of research studies are ongoing at Duke and nationally that
will likely change the treatment of peanut and other food allergies
in the next several years.
novel forms of treatment for food allergy hold promise for the safe
and effective treatment of food-allergic individuals and the prevention
of food allergy in the future. It is likely that some type of allergy
immunotherapy (or vaccine) for food allergy will be
available relatively soon. Then perhaps these food allergy worries
can be a fear of the past.
Burks, MD, is Professor and Chief of the Division of Pediatric Allergy
and Immunology at Duke. Dennis Clements, MD, PhD, is the chief medical
officer of Duke Children's Hospital. For more information, visit
information presented on this site is intended solely as a general
educational aid, and is neither medical nor healthcare advice for
any individual problem, nor a substitute for medical or other professional
advice and services from a qualified healthcare provider familiar
with your unique circumstances. Always seek the advice of your physician
or other qualified healthcare professional regarding any medical
condition and before starting any new treatment.