When your body wages war against food

The rise in food allergies has made finding food to share with a group of children much more complicated. Even if your children don’t have food allergies, they likely play with kids who do. So, we all need to know what to do and when to call for help. To borrow from the sports world, the best defense is a good offense.

I learned this lesson this past October when my daughter asked to bring to school Dunkin’ Hines triple chocolate brownies. Her best friend has severe allergies to egg whites – the life-threatening kind. My daughter did not want to leave her friend out. Turns out brownies cook just as well with only the egg yolk. Who would have thought? I imagined something more complicated – involving special stores and cooking techniques. One batch of egg white-less brownies later, everyone was happy and no calls were made to 911.

Most digestive complaints are unpleasant but not due to food allergies: gas, bloating, stomachache, even vomiting or diarrhea. An allergy is when your body actually attacks the food – it develops such a huge immune reaction that antibodies and other chemicals released to attack the food actually harms our bodies and can be life threatening. Allergic symptoms include eczema, tingling in the mouth, swelling of the mouth or throat, trouble breathing, hives, vomited, abdominal pain, diarrhea, or even shock – a sudden drop in blood pressure leading to loss of consciousness and possibly death. This last reaction is called anaphylaxis and it accounts for 30,000 trips to Emergency Rooms each year with 150-200 deaths a year. These allergic reactions require immediate antihistamines and epinephrine to avoid a catastrophe.

Food allergies are getting easier to manage thanks to improved awareness and better FDA requirements for food labeling. Unfortunately, it’s not so simple because not all ingredients can be identified in all foods. And, many foods contain traces of allergenic foods due to the cooking process. For example, nut-free cookies and granola bars may be cooked on cookie sheets that were used to cook nut-containing products. That trace amount of nut is enough to cause a severe allergic reaction.

The major allergic foods in the United States are milk, fish, eggs, wheat, tree nuts, peanuts, soybeans and crustaceans (shrimp, crabs). While kids will out grown most food allergies, allergies to tree nuts, fish and shrimp are usually for life. Early introduction of foods during infancy and relatives with food allergies increase a child’s chance of developing a food allergy. And, as our world becomes more clean and germ-free, our immune systems actually start reacting to other stimuli that they used to ignore when busy battling infections. Attending daycare and coming from a large family helps to decrease a child’s chance of developing food allergies. Just goes to show how delicate the immune system is – too much exposure at the wrong time increases food allergies but increased immune stimulation in general seems protective.

The AAP recommends that high risk infants not be introduced solid foods until 6 months of life, dairy at 1 year of age, eggs at 2 years of age, and peanuts/nuts/fish at 3 years of age. Breast feeding for the first 6 months of life is helpful as well has having nursing mom’s not eat highly allergenic foods, such as with milk products and peanuts, is also beneficial in warding off food allergies.

There are a number of excellent resources to get more information: The food allergy and anaphylaxis Network, www.foodallergy.org; American Academy of Allergy, Asthma and Immunology, www.aaaai.org, and the American Academy of Pediatrics, www.aap.org.

So, don’t sweat too much if your children are slow to eat “adult food” – it will happen when their palates and immune systems are ready.

© 2005 Pediatrics Now.
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