Baby reaction to food allergy
Baby Food Allergies: Identifying and Preventing Them
Written by Gina Shaw
In this Article
- Start Gradually to Identify Any Food Allergies
- Babies and Allergies: The Top 8 Allergenic Foods
- Food Allergy Symptoms to Watch for in Your Baby
- Severe Food Allergy Symptoms: When to Call 911
- Dealing With Mild Food Allergies in Baby
- The Family Food-Allergy Connection
- Protecting Baby Against Food Allergies: Easy Does It
Starting to feed a baby solid foods is an exciting milestone for parents. However, it comes with a lot of questions and concerns, especially about food allergies. What foods are most likely to cause allergies in babies? How do you avoid them?
Emerging research has shown that introducing multiple foods together is safe, and may help the immune system have a lower risk of developing food allergies, but more studies are needed. Check with your doctor for what’s best for your baby.
Start Gradually to Identify Any Food Allergies
It’s most important to introduce a baby to new foods gradually, one at a time, in case of food allergies. If not, a parent may have trouble tying an allergy to a specific new food. For example, if you give your baby three new foods over the course of a day and they develop an allergic reaction, you won’t know which of the foods provoked it.
The type of food or the order in which food is introduced is not much of a concern, as long as the foods you are offering are healthy and well-balanced for the baby. Each time you offer a new food, you should wait three to five days before adding another new item to the menu. Don’t eliminate the other foods your baby is eating during that time; you already know these are safe because the child has not had any food reactions up until now. Just don’t add anything else new.
Babies and Allergies: The Top 8 Allergenic Foods
With any new food, you’ll want to be on the lookout for any allergic reactions. There are more than 160 allergenic foods; certain foods may be more allergenic than others. The following eight foods and food groups are known to possibly cause problems with allergic reactions possibly up to 90% of the time.
- Cow's milk
- Tree nuts (such as walnuts or almonds)
New nutrition guidelines from the American Academy of Pediatrics say it's okay to introduce these allergy-causing foods when your baby is ready to eat solids. There is no evidence that waiting until the baby is older prevents food allergy. If you believe your baby has an allergic reaction to a food, such as diarrhea, rash, or vomiting, talk with your child's doctor about the best choices for the diet.
Within a few months of starting solid foods, your baby's daily diet should include a variety of foods, such as breast milk, formula, or both; meats; cereal; vegetables; fruits; eggs; and fish.
Food Allergy Symptoms to Watch for in Your Baby
Food allergy symptoms usually appear very soon after the food is eaten -- within a few minutes to a couple of hours. If you’re introducing a new food to your baby, keep an eye out for these symptoms:
- Hives or welts
- Flushed skin or rash
- Face, tongue, or lip swelling
- Vomiting and/or diarrhea
- Coughing or wheezing
- Difficulty breathing
- Loss of consciousness
Severe Food Allergy Symptoms: When to Call 911
Severe allergic reactions can be fatal very quickly. If your baby is having trouble breathing/wheezing, has swelling on their face/lips, or develops severe vomiting or diarrhea after eating, immediately call 911. You can inform your pediatrician at a later time.
Dealing With Mild Food Allergies in Baby
If you see mild symptoms, such as hives or a rash, contact your pediatrician for further evaluation. The doctor might refer you to an allergist (allergy specialist doctor), who will ask more questions and do a physical exam. The allergies may order diagnostic tests such as:
- A skin test. This test involves placing liquid extracts of food allergens on your child's forearm or back, pricking the skin, and waiting to see if reddish raised spots form within 15 minutes. A positive test to a food only shows that your child might be sensitive to that food.
- Blood tests to check the blood for IgE antibodies to specific foods
Remember, just because a baby’s initial allergic reaction to a new food may be mild, it may get worse upon following exposures. Talk to your pediatrician about any food allergy symptoms in your baby.
Some allergies go away with time. Egg and milk allergies often go away as children get older, but peanut, tree nut, and shellfish allergies tend to persist. That said, research shows that in the case of peanut allergies, peanut immunotherapy drops administered under the tongue are safe and effective as treatment for peanut allergy, even in children as young as 1. They were also found to help significantly desensitize the patients to peanuts.
The Family Food-Allergy Connection
If there is a family food allergies, your baby has an increased risk of also developing allergies, although it is not a certainty. If you have the allergies, the odds are 50-50 for them to have them as well.
It’s best to introduce the 8 allergens gradually, at one-to-two week intervals over time so that you can recognize if an allergy develops.
Protecting Baby Against Food Allergies: Easy Does It
In a reversal of earlier policy, the American Academy of Pediatrics is now recommending that potential allergens be introduced to your infant earlier rather than later. In doing so, the move may actually help prevent them from developing allergies to those foods.
Breastfeeding you baby for 4-6 months is the best way to prevent a milk allergy. Remember that breast milk or formula is higher in nutrition. When you begin to introduce whole milk, you should do so under a doctor’s supervision. Yogurt and soft cheeses are fine, because the proteins in these dairy products are broken down and less likely to cause tummy trouble.
The AAP now advises that, in the case of infants who are at high risk of allergies, peanuts should be introduced between 4-6 months. Infants at highest risk of developing peanut allergies are those with eczema or egg allergies or both. It was originally believed that introducing your baby to the foods when they are older might make any reactions more manageable.
Other potential allergens such as tree nuts and fish should be introduced over a period of time as you introduce your baby to solid foods, between 6 and 9 months
You should wait until at least age 1 (some experts say age 2) to introduce honey, which can cause a potentially serious disease called infant botulism. Ask your pediatrician for guidance.
Food Allergies in Children | Johns Hopkins Medicine
What is food allergy?
A food allergy is an abnormal response of the body to a certain food. It is important to know that this is different than a food intolerance, which does not affect the immune system, although some of the same symptoms may be present.
What causes food allergy?
Before having a food allergy reaction, a sensitive child must have been exposed to the food at least once before, or could also be sensitized through breast milk. It is the second time your child eats the food that the allergic symptoms happen. At that time, when IgE antibodies react with the food, histamines are released, which can cause your child to experience hives, asthma, itching in the mouth, trouble breathing, stomach pains, vomiting, and/or diarrhea.
What is the difference between food allergy and food intolerance?
Food allergy causes an immune system response, causing symptoms in your child that range from uncomfortable to life-threatening. Food intolerance does not affect the immune system, although some symptoms may be the same as in food allergy.
What foods most often cause food allergy?
Approximately 90 percent of all food allergies are caused by the following eight foods:
Eggs, milk, and peanuts are the most common causes of food allergies in children, with wheat, soy, and tree nuts also included. Peanuts, tree nuts, fish, and shellfish commonly cause the most severe reactions. Nearly 5 percent of children under the age of five years have food allergies. From 1997 to 2007, the prevalence of reported food allergy increased 18 percent among children under age 18 years. Although most children "outgrow" their allergies, allergy to peanuts, tree nuts, fish, and shellfish may be lifelong.
What are the symptoms of food allergy?
Allergic symptoms may begin within minutes to an hour after ingesting the food. The following are the most common symptoms of food allergy. However, each child may experience symptoms differently. Symptoms may include:
Itching or swelling of the lips, tongue, or mouth
Itching or tightness in the throat
Lowered blood pressure
According to the National Institute of Allergy and Infectious Disease, it does not take much of the food to cause a severe reaction in highly allergic people. In fact, as little as 1/44,000 of a peanut kernel can cause an allergic reaction for severely allergic individuals.
The symptoms of food allergy may resemble other problems or medical conditions. Always consult your child's doctor for a diagnosis.
Treatment for food allergy
There is no medication to prevent food allergy. The goal of treatment is to avoid the foods that cause the symptoms. After seeing your child's doctor and finding foods to which your child is allergic, it is very important to avoid these foods and other similar foods in that food group. If you are breastfeeding your child, it is important to avoid foods in your diet to which your child is allergic. Small amounts of the food allergen may be transmitted to your child through your breast milk and cause a reaction.
It is also important to give vitamins and minerals to your child if he or she is unable to eat certain foods. Discuss this with your child's doctor.
For children who have had a severe food reaction, your child's health care provider may prescribe an emergency kit that contains epinephrine, which helps stop the symptoms of severe reactions. Consult your child's doctor for further information.
Some children, under the direction of his or her health care provider, may be given certain foods again after three to six months to see if he or she has outgrown the allergy. Many allergies may be short-term in children and the food may be tolerated after the age of 3 or 4.
Milk and soy allergy
Allergies to milk and soy are usually seen in infants and young children. Often, these symptoms are unlike the symptoms of other allergies, but, rather, may include the following:
Often, your child's doctor will change your baby's formula to a soy formula or breast milk if it is thought he or she is allergic to milk. If your child has problems with soy formula, your child's health care provider might change him or her to an easily digested hypoallergenic formula.
The symptoms of a milk or soy allergy may resemble other problems or medical conditions. Always consult your child's doctor for a diagnosis.
Prevention of food allergies
The development of food allergies cannot be prevented, but can often be delayed in infants by following these recommendations:
If possible, breastfeed your infant for the first six months.
Do not give solid foods until your child is 6 months of age or older.
Avoid cow's milk, wheat, eggs, peanuts, and fish during your child's first year of life.
Dining out with food allergies
If your child has one or more food allergies, dining out can be a challenge. However, it is possible to have a healthy and satisfying dining-out experience; it just takes some preparation and persistence on your part.
The American Dietetics Association offers these tips for dealing with food allergies when your family is eating away from home:
Know what ingredients are in the foods at the restaurant where you plan to eat. When possible, obtain a menu from the restaurant ahead of time and review the menu items.
Let your server know from the beginning about your child's food allergy. He or she should know how each dish is prepared and what ingredients are used. Ask about preparation and ingredients before you order. If your server does not know this information or seems unsure of it, ask to speak to the manager or the chef.
Avoid buffet-style or family-style service, as there may be cross-contamination of foods from using the same utensils for different dishes.
Avoid fried foods, as the same oil may be used to fry several different foods.
Another strategy for dining out with food allergies is to give your server or the manager a food allergy card. A food allergy card contains information about the specific items your child is allergic to, along with additional information, such as a reminder to make sure all utensils and equipment used to prepare your meal is thoroughly cleaned prior to use. You can easily print these cards yourself using a computer and printer. If your child is eating out with friends and you are not going to be present, give your child a food allergy card (or make sure the adult in charge has one) to give to the server.
Alternately, there are several types of allergy cards available on the internet that can be customized with your child's personal information. One example is the Food Allergy Buddy Dining Card, promoted by the National Restaurant Association.
The Food Allergy Initiative, in conjunction with the National Restaurant Association and the Food Allergy and Anaphylaxis Network, has developed the Food Allergy Training Program for Restaurants and Food Services. This training program was developed to help restaurants and other food service outlets to ensure their customers, including those with food allergies, will receive a safe meal prepared to customer specifications.
Food allergies in children - symptoms, treatments, diet its individual components.What are its causes, what are the risk factors, and what food to choose in case of an allergic reaction - read in this material.
Food allergy symptoms
The causes of food intolerance are related to the fact that the immune system "incorrectly" recognizes them as potentially dangerous, and produces protective antibodies in excess. Excessively violent reaction leads to the fact that the child develops an allergy to certain types of food. 1.3
Symptoms of food allergy in children are different. But most often, food allergies manifest themselves on the part of the skin - itching, a feeling of tightness and dryness. Local swelling may occur on the skin, a rash (urticaria), redness, blisters may appear. In second place in terms of frequency of manifestation - reactions from the respiratory system. Runny nose, nasal congestion, sore throat, cough of varying intensity. Also, reactions from the organs of the gastrointestinal tract can indicate food allergies. A very young child begins to be disturbed by colic, dyspepsia, stool disorders from diarrhea to constipation. Older children complain of nausea, vomiting, abdominal pain, a feeling of scratching in the throat, behind the sternum.
Do not forget about the general symptoms of food allergies: the child becomes lethargic, capricious, sleeps poorly, does worse in school (or psycho-emotional development), is prone to daytime sleepiness. 2.3
Causes of food allergies
Newborns and young children, if predisposed, may suffer from allergies due to their physiological characteristics. The fact is that a child is born with an immature gastrointestinal tract, the intestinal walls are permeable to many substances, the enzyme system is still imperfect. Therefore, it is difficult for the body to cope with the digestion of proteins. The body seems to be in a state of constant "combat readiness" and the ingestion of even a small amount of allergens leads to a response from the immune system and the development of a violent allergic reaction. 1.2
In older children, many internal and external conditions become risk factors. For example, heredity - after all, if one of the child's parents suffered from an allergic disease, then with a high degree of probability the child will also be given a tendency to it. Unfavorable environmental factors influence - polluted atmosphere, car exhausts, lack of green plants in cities. Very often, a violation of the immune system in the form of an allergic reaction occurs in children with a labile, mobile psyche, with sharp transitions from friendliness and calmness to crying and back. Finally, bad habits, both in children and mothers during pregnancy, become an important factor. This is incorrectly introduced complementary foods and early introduction of potentially allergenic foods into the child's diet: citrus fruits, nuts, chocolate, berries, honey, and, of course, the habit of children to eat only something tasty (usually unhealthy; chocolate, carbonated drinks, fast food ) 2,3,4
List of products that provoke allergies
Due to the extreme individuality of the immune system, it is almost impossible to predict its reaction. However, there is a rough list of foods classified into groups depending on their allergenicity - that is, the ability to cause a sharp reaction from the immune system and allergy symptoms. It is important to remember that it is not necessary that any product from the first column will cause a reaction. Like any low allergenic product, in some cases, it can cause an overreaction to it. 2,3,4
Examples of the most typical exoallergens
|Highly allergenic products||Foods of average allergenicity||Low Allergy Products|
|all citrus fruits, strawberries, strawberries, raspberries, blackberries, pineapples.||peaches, cranberries, lingonberries, cherries, blueberries, black currants.||pears, gooseberries, dried apricots, plums, white currants, apples and pears.|
|carrots, tomatoes, bell peppers, radishes.||potatoes, beets, peppers, peas, corn.||broccoli, green peas, zucchini, squash, white and cauliflower, cucumbers, pumpkin.|
|eggs, sausages and sausages, chicken, sea fish.||beef, rabbit, pork.||lamb.|
|whole cow's milk, cheeses, yoghurts with additives.||fermented milk products.|
|wheat, rye.||buckwheat, oats, rice, peas, beans.||barley, millet.|
|coffee, cocoa, chocolate, nuts, honey.||xylitol, fructose|
|mushrooms, carbonated drinks, packaged juices.||vegetable oil.|
The diagnosis of this allergy, as well as the search for the causes that caused it, requires a careful and serious approach on the part of parents. The younger the child, the easier it is to find foods that cause illness. For this, two conditions must be met.
The first thing is to put a child or mother on a hypoallergenic diet if she is breastfeeding - a detailed nutrition plan will be helped by an allergist together with a pediatrician. Please note that during an exacerbation, the diet will be extremely strict, the so-called elimination diet - aimed at removing the allergen and reaction products to it with the complete elimination of potential and cross allergens. The duration of such a diet is determined by the doctor. When the exacerbation fades, the diet gradually expands due to safe foods. 3.4
And the second is to start keeping a special food diary in which to record everything that was eaten and drunk by the child during the day, as well as what was prepared and how. At the first sign of an allergic reaction, suspicious foods should be eliminated one at a time (or from the mother's diet if the baby is breastfed). After elimination, within a few days, it is worth observing the reaction, if the manifestations of allergies decrease, then the product is really not suitable for the child - it should be avoided. If the child is very small, then the diary is kept according to the opposite principle: all foods that are introduced as complementary foods are recorded in it. The name of the product, the quantity, the time of eating and the reactions of the body are recorded over the next few days (the attending physician will determine the specific timing of observation). Next, the doctor will need to check and confirm the preliminary diagnosis by conducting special tests and analyzes.
Emergency measures for food allergies
First, you need to assess the severity of the manifestations of food allergies.
For any symptoms, the first step is to avoid contact with a specific familiar allergen or any suspicious food or drink.
If the symptoms of allergy are mild - itching, redness of the skin, then you can give the child an antihistamine, which was previously recommended by the doctor for such cases. In addition, you must also call the local pediatrician and carefully monitor the condition of the child.
In case of obvious or possible signs of deterioration, call an ambulance. Signs that you should pay close attention to and immediately dial 03 include spreading rash and redness, increased itching, fever, drowsiness and lethargy, vomiting and nausea, refusal to drink water, difficulty breathing, loss of consciousness and pallor .
For general symptoms, in which it is difficult to understand whether they are associated with allergies or not, and which may indicate a developing serious condition, an ambulance should be called immediately if the child has any difficulty or changes in breathing, shortness of breath, cough, croup, vote. If pains in the abdomen began, extensive swelling, redness, itchy skin areas appeared. There is dizziness, fainting, as well as changes in the pulse - slowing or increased heart rate. 1,3,4
How to treat a food allergy in a child
Treatment depends on the stage of the allergic reaction process. With an exacerbation, antihistamines are prescribed that block histamine receptors, hormonal drugs. For skin manifestations of allergies, local preparations are used: creams, powders, etc. Respiratory reactions are treated with inhalation drugs and physiotherapy.
Food allergy in children - Family Clinic Aleksandrovskaya
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Currently, more and more often, children with various manifestations of allergic diseases appear at the pediatrician's appointment. Food allergy, that is, a pathological reaction of the child's body to certain foods, is becoming one of the leading factors in the development of allergic diseases and a deterioration in the quality of life of both the child and the whole family. In the truest sense of the word, food allergy is not an independent diagnosis, but in each case of an allergic disease indicates the cause of its occurrence.
How common is food allergy? There is no single answer to this question. According to scientific studies, up to 3% of the world's population have some form of food allergy. Moreover, a direct dependence on age was noted, that is, the younger the child, the more often a perverted reaction to food occurs, so at an early age up to 20% of children have various manifestations of food allergies. In addition, the risk of allergic diseases in children directly depends on the health of the parents. If a mother or father in the family has certain diseases associated with food allergies, then the probability of developing such a disease in a child approaches 50%. If both parents have manifestations of food allergies, then the risk of pathology in a child increases to 70% or more.
How does food allergy manifest in a child?
1. Primarily by the development of allergic skin lesions:
- atopic dermatitis of varying severity, from slight dryness of the skin of the cheeks to the development of eczema: common weeping skin surfaces, accompanied by intense itching and sleep disturbance. Among children with atopic dermatitis, the incidence of food allergies reaches 30% - 40%.
- urticaria - an acute allergic reaction in the form of common urticaria bright elements, the skin as if burned with nettle leaves. The condition of the child is significantly disturbed, there may be an increase in body temperature, severe itching.
- swelling of the soft tissues of the face, hands, feet with the development of Quincke's edema, a formidable complication of which can be swelling of the vocal cords, bronchospasm and a rapid increase in respiratory failure.
2. In addition to skin lesions, the pathology of the digestive tract is often among the clinical manifestations: nausea, vomiting, loose stools, abdominal pain that occurs after the use of a product that is an allergen for a child.
Which foods are most often responsible for the development of allergic diseases?
1. In the first place are cow's milk proteins, they most often cause allergic diseases in infants, in the future, most babies develop tolerance, that is, immunity to these allergens, and the child recovers by school age. It is important to know that the allergic properties of cow's milk proteins do not decrease during processing (boiling, pasteurization). This problem is more significant for children who are bottle-fed. A large number of allergens enter the child's body, with still unformed enzyme systems and an immature digestive tract, penetrating into the bloodstream and causing a significant response from the baby's immune system. Yes, and a child who is breastfed is not immune from the appearance of allergic diseases in the event that cow's milk protein enters mother's milk. In addition to cow's milk, the milk of any mammal, including goat, can act as an allergen.
2. The next significant allergen is the chicken egg, mainly due to proteins, although the yolk allergen can also cause an allergic reaction. A chicken egg contains about 13 different proteins, many of them are destroyed, which means they lose their allergenic properties during intensive heat treatment, this explains the fact that if they are allergic to chicken egg proteins, many people are able to eat small amounts of this product undergone significant heat treatment.
3. Soy - causes serious allergic reactions when eating foods containing it. Therefore, changing the milk formula in a child of the first year of life to a formula based on soy does not reduce the manifestations of atopic dermatitis, but can lead to an aggravation of the situation and a deterioration in the child's condition.
4. Peanuts - is part of many products, being a "hidden" allergen. During heat treatment, the allergenic properties of the product only increase, causing the development of severe reactions.
5. Nuts - almost any kind of nuts cause the development of cross-allergic reactions.
6. Grain proteins - mainly proteins of wheat (gliadin), rye, oats and barley act as an allergen. Manifestations of allergic diseases appear in children older than 6 months, with the introduction of complementary foods. It is worth noting the fact that in most cases, by the age of 4-5, immunity to wheat gliadin develops and the child's condition improves.
7. Fish and seafood - certain fish proteins cause severe allergic manifestations when they are eaten, and they are not destroyed by heat treatment, but turn into vapor and become significant inhalant allergens, leading to serious reactions from the respiratory system. Protein allergens are similar in structure in the main fish species, so cross-allergy is very common. With age, immunity to fish proteins does not develop, so many adults continue to suffer from allergic diseases associated with its use. A very small amount of a fish or seafood allergen is enough to develop severe systemic allergic reactions, up to the development of anaphylaxis.
8. And a number of products, which include chocolate, honey, citrus fruits, coffee, cocoa, which contribute to the occurrence of allergic diseases due to the release of histamine from target cells, which triggers the inflammatory process. Such products also include a variety of canned food, fermented cheeses, sauerkraut, tomatoes.
9. In addition, it is not the product itself that can cause an allergic reaction, but substances added to it by the food industry to preserve its consumer qualities: various dyes, preservatives, nitrites, glutamates (coding E with different numbers on the product packaging).
Diagnosis of food allergy is a rather laborious process, there is no single criterion by which one can speak with a high degree of certainty about the presence or absence of signs of food allergy in a particular person. When making a diagnosis, a pediatrician will rely on the data of the clinical picture, the relationship of exacerbations of the disease with a particular food product, the data of an allergological examination of a child with food allergens. The decisive stage is often the improvement in the condition of the child or his complete recovery after the appointment of a diet that provides for the complete exclusion of foods that act as an allergen in the baby.
Principles of dietary management for children with food allergies:
1. In a child of the first year of life, it is recommended to make every effort to maintain breastfeeding. With an allergy to cow's milk proteins, cow's milk, beef, and veal are excluded from the mother's diet. Given that allergic reactions are rarely caused by only one allergen, it is also recommended to exclude other products that have highly allergenic properties. Allowed: pasta, vegetables and fruits, mostly light in color, vegetable soups, turkey, rabbit, lean pork, buckwheat, corn, rice, oatmeal.
2. With mixed or artificial feeding: the child is transferred to a formula based on highly hydrolyzed protein. If within 2 weeks there is no improvement in the child's condition, then an amino acid mixture is introduced. Such nutrition is prescribed for at least 6 months, or until the child reaches the age of one year. Then, after determining the titer of specific antibodies, they try to introduce a fermented milk product containing cow's milk protein.
3. Introduction of complementary foods: complementary foods in a healthy child are introduced no later than 6 months of age, the same terms are established if the child has manifestations of food allergies. The first food can be vegetable puree or dairy-free porridge. When introducing a new product, it should be remembered that its composition should be one-component, in a small amount, no more than a teaspoon, it is necessary to introduce the product into the diet in the first half of the day in order to track changes in the child's condition. With good tolerance, the amount of the product is gradually increased and adjusted to the required age within 10-14 days.
4. In children older than one year: the composition of the diet is based on the therapeutic diet No. 5, given the fact that very often food allergies are accompanied by pathology of the digestive system. The principles of mechanical, thermal sparing of the gastrointestinal tract are used. They try to use cooking on the vara, boiled or baked. All the same significant allergens described above are excluded from the diet. If, as a result of the diet, it becomes clear that the child's diet is poor and there is a deficiency of essential nutrients, then special mixtures are introduced into the diet containing the entire necessary set of basic ingredients, including minerals and vitamins.
5. Drug therapy is used quite rarely, and includes the appointment of antihistamines for a short period.
Thus, it becomes clear that the problem of food allergy can be solved by following the principles of the elimination diet. And the more responsible the parents approach the diet of their baby, the more carefully they follow the recommendations of the pediatrician in this matter, the more chances a small child has to grow up to be a strong and healthy person.