Can babies outgrow food allergies
Food allergy vs. food intolerance: What is the difference and can I prevent them?
What is an allergy?
An allergy happens when a person’s immune system treats a substance (allergen) like an inappropriate invader. The body will try to protect itself by releasing a chemical into the body called histamine. This chemical is what causes the symptoms that are unpleasant or even dangerous. The reaction can start very suddenly, even after being exposed to a small amount of the allergen.
Allergens can get into the body in different ways. They can be:
- inhaled (such as dust or pollen),
- ingested as food (some common ones are nuts, eggs or shellfish),
- ingested as medication (such as penicillin),
- injected by an insect sting (like a bee or wasp venom), or
- absorbed through the skin (such as poison ivy).
What foods are common allergens?
Any food can trigger an allergic reaction, but the most common are:
- peanuts
- tree nuts
- eggs
- shellfish
- fish
- milk
- soy
- wheat
Are there any foods I should avoid while breastfeeding to prevent my child from getting allergies?
You don’t need to avoid milk, egg, peanut or other foods while breastfeeding. There is no evidence that avoiding certain foods will prevent allergy in your child.
Is there a particular formula I should use to prevent allergies?
If breastfeeding is not an option or if you choose not to breastfeed, use a store-bought iron-fortified infant formula for the first 9 to 12 months. The formula should be cow’s milk-based. There is no evidence that soy-based or hydrolyzed formula will prevent your child from developing an allergy.
Should I wait to offer common food allergens to my baby for the first time?
- Don't delay. In infants at low risk for food allergy, common food allergens can also be introduced at around 6 months of age to try to prevent an allergy.
- For children considered at high risk of developing an allergy (e.g., they have a parent or sibling with an allergic condition, or they have other allergies, such as eczema), consider introducing common food allergens at around 6 months of age, but not before 4 months.
- When introducing foods that are common food allergens, try offering no more than 1 per day. Wait 2 days before you introduce another. This makes it easier to identify a food that may have caused a reaction.
- Once you offer these foods to your child, it’s important to continue to offer them on a regular basis.
- If you have concerns, speak to your health care provider.
How will I know if my child has a food allergy?
Most often, your child will have to eat a food more than once before you know they are allergic. For example, the first time your child is exposed to nuts, there will probably be no reaction. If they develop an allergy to nuts, the next exposure could be more serious.
What are the signs of an allergic reaction to food?
An allergic reaction can affect many different body parts. Symptoms can include:
- itchy mouth and throat when eating certain foods,
- hives (raised red, itchy bumps on the skin),
- stomach trouble (diarrhea, cramps, nausea, vomiting),
- swelling of the face or tongue, or
- trouble breathing.
What is anaphylaxis?
Allergic reactions can be very serious, even life-threatening. In rare cases, a child may have a rapid and severe reaction to an allergen. This is called anaphylactic shock or anaphylaxis. It can happen within minutes or up to 2 hours after being exposed to an allergen.
What are the symptoms of anaphylaxis?
A severe allergic reaction can cause:
- difficulty breathing,
- swelling of the face, throat, lips, and tongue (in cases of food allergies),
- rapid drop in blood pressure,
- dizziness,
- unconsciousness,
- hives,
- tightness of the throat,
- hoarse voice,
- lightheadedness.
If any of these happen to your child, go the nearest emergency department or call 911 immediately.
Do children outgrow food allergies?
Many children outgrow food allergies, especially if the allergy started before age 3. Allergies to milk, for example, will usually go away.
However, some allergies, like those to nuts and fish, probably won’t go away.
What is food intolerance?
Food intolerance is different from an allergy. It is not caused by an immune reaction. Food intolerance will cause discomfort, but it’s not dangerous to your child.
How can I tell if my child has food intolerance?
Your child may experience bloating, loose stools, gas or other symptoms after eating a specific food. Even though this reaction is not dangerous, if it causes your child discomfort you might want to avoid those foods in the future.
What is lactose intolerance?
Lactose intolerance happens when the body doesn’t produce enough of the enzyme lactase to fully break down the sugar (lactose) found in most dairy products. It is rare in young children and usually only develops after 3 years of age. While some young children adjust to the lack of this enzyme, some will have problems for life.
If your child is lactose intolerant, you can give them the calcium they need by offering lactose-free or lactose-reduced milk.
While none of these items will provide enough calcium on their own, it’s also healthy to offer:
- fortified soy milk,
- yogurt,
- canned salmon and sardines with edible bones,
- oranges or fortified orange juice,
- broccoli,
- almonds, and
- pinto beans.
Many of these foods do not provide enough vitamin D. Talk to your doctor about whether a supplement of vitamin D would be right for your child.
When should I call the doctor?
It is hard to diagnose food allergies. If your child has a reaction to a food, you will need to see your doctor. Your doctor will refer you to an allergist for the right testing.
If a serious allergy is confirmed, your doctor may prescribe a medication (e.g. EpiPen or Allerject), a needle that will protect your child right away if they are exposed to the allergen.
More information from the CPS
Additional resources
Reviewed by the following CPS committees
- Allergy Section
- Community Paediatrics Committee
- Nutrition and Gastroenterology Committee
Last updated: March 2021
Likelihood of Child Outgrowing Food Allergy Depends of Type, Severity of Allergy
-
By
Shawn Bishop
July 26, 2013
Dear Mayo Clinic:
Is it possible for children to outgrow food allergies?
Answer:
Some children may outgrow their food allergies.
But the likelihood of that happening depends in large part on the type of food a child is allergic to, as well the severity of the allergy.
In people who have a food allergy, the body's immune system mistakenly identifies a specific food or part of a food as something harmful. When that happens, the immune system releases into the body immunoglobulin E, or IgE, antibodies. The next time the IgE antibodies sense that food, they cause a variety of chemicals, including histamine, to be released into the bloodstream.
Those chemicals trigger the symptoms of the food allergy, such as hives, skin or throat swelling, gastrointestinal problems, or breathing problems. In some people, a food allergy may lead to a life-threatening reaction known as anaphylaxis. Symptoms of anaphylaxis can include the above symptoms as well as severe tightening of the airways (causing breathing problems), rapid pulse, drop in blood pressure, and/or loss of consciousness. Without emergency medical treatment including epinephrine, anaphylaxis may result in death.
Food allergies affect about 6 to 8 percent of children under age 5, and about 3 to 4 percent of adults. Food allergies often are confused with a much more common reaction known as food intolerance. While bothersome, a food intolerance often is less serious. Usually, its symptoms come on gradually and are limited to digestive problems. Testing generally is not available for food intolerance. A severe form of food intolerance called food protein-induced enterocolitis syndrome, or FPIES, should be evaluated by an allergist or gastrointestinal specialist. Most children outgrow FPIES.
It is possible to have an allergic reaction to almost any type of food. But some foods lead to allergies more frequently than others. Of the common food allergies, milk, egg, soy and wheat allergies are the ones children most often outgrow by the time they are in their late teens.
About 60 to 80 percent of young children with a milk or egg allergy are able to have those foods without a reaction by the time they reach age 16.
Recent studies suggest that children with egg or milk allergies who can eat those foods in a baked form, such as a muffin, without an allergic reaction are very likely to be able to tolerate plain egg or plain milk in the future.
Some other food allergies are much less likely to be outgrown. These foods are also common allergens and include peanuts, tree nuts, finned fish and crustacea. They tend to cause a more severe food allergy reaction. Only about 20 percent of children who have a peanut allergy outgrow it. An even lower number of those with tree nut allergies — 14 percent — will lose that allergy. And only 4 to 5 percent of children with a fish or crustacean (shellfish) allergy will go on to be able to eat those foods without a reaction later in life.
In many cases a blood test or an allergy skin test, combined with a thorough assessment of a child's health history, can help determine how likely it is for that child to outgrow his or her food allergy.
If it seems a child has outgrown a food allergy, a test called a food challenge may be recommended.
It involves giving the child small amounts of the food in a controlled setting. A very small amount is given first. It is then doubled every 15 to 30 minutes until the child eats one serving size. This test is not recommended for children who are at high risk of anaphylaxis.
If your child has a food allergy, it is a good idea to work with a doctor who specializes in childhood allergies. An allergist can help you monitor and manage a food allergy over time as your child grows.
— Nancy Ott, M.D., Pediatric Allergy and Immunology, Mayo Clinic, Rochester, Minn.
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Can a child "outgrow" a food allergy?
Food allergy is most often the first manifestation of an allergy in a child, and this problem is most relevant at an early age. However, with an allergic reaction to food - a seemingly not very significant pathology - the so-called "atopic march" can begin - when a child develops allergic diseases one after another (atopic dermatitis, allergic rhinitis, asthma). Therefore, it is obvious that this problem deserves serious consideration. How the disease will develop depends on many factors, which include hereditary predisposition to allergic diseases and the influence of environmental factors, including nutrition. However, a very important factor is the early diagnosis and adequate treatment of the first manifestations of allergy and the selection of a diet, which in most cases can improve the prognosis of the formation of tolerance or, at least, achieve a mild course of food allergy manifestations.
Nevertheless, there is still such a myth: “nothing needs to be done about the early skin manifestations of allergy, the child will outgrow the food allergy”
Perhaps it was once so. Perhaps, in cases of mild food allergies, sometimes this happens even now. We do not see such children, since children with already neglected conditions often come to us. And unfortunately, we have to observe the mistakes of doctors and parents of the child in the early stages of the formation of pathology and see how simple cases turn into complex ones due to incorrect tactics in this initially simple pathology. Unfortunately, the facts do not indicate that children "outgrow" the early manifestations of food allergies, but the opposite - there is an increase in the frequency of severe, difficult to treat forms of food allergies, multiple food allergies to a number of different products.
Mechanisms for the development of severe manifestations are known. First, because children with even mild food allergies and reactions to one food (for example, cow's milk proteins) have intestinal barrier disorders, these children easily develop allergies to other foods and multiple (or, as it is also called, "polyvalent") food allergy.
Second, if a child does not receive topical treatment for skin manifestations of food allergies, the lack of adequate skin care and treatment of allergic inflammation leads to a violation of the skin barrier and this, as scientific studies have shown, dramatically increases the risk of sensitization to environmental allergens - allergens of house dust, plant pollen, animal hair. And this is the risk of allergic rhinitis and bronchial asthma. Therefore, the sooner adequate treatment is started even with the first mild manifestations of food allergy, the better the prognosis of the disease and the less likely that the child will “leave” on the “atopic march”. It has now been shown that restoring the integrity of the skin through adequate therapy of atopic dermatitis, as well as the active use of specially designed moisturizers for dry atopic skin, reduces the risk of sensitization not only to environmental allergens, but also to food allergens. And the recommendations of a pediatrician for a child with atopic dermatitis such as "do not worry, he will outgrow" indicate a lack of awareness of the doctor.
Therefore, the sooner and more correctly the treatment of early manifestations of food allergies is carried out, the more likely it is that the child's immune system will cope with them and the child will be able to "outgrow" them.
author of the article: Makarova S.G.
Food allergies in young children
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Contents
How food allergies develop in babies
Food allergies in a child is a problem that can make significant adjustments to everyday life. This problem, according to the American Academy of Allergy, Asthma and Immunology (AAAAI), affects up to 6% of children under the age of 2 years.
And at the age of 3 years, food allergies, according to WHO, already suffer up to 8% of children.
However, among children under 5 years of age, the incidence of allergies is decreasing and is about 5%. This is due to the fact that some types of children's food allergies disappear on their own over time.
For example, up to 90% of children outgrow cow's milk and egg allergy. On the other hand, only 10-20% of children get rid of peanut allergy as they grow older. Food reactions to nuts, fish, or seafood are also likely to persist into adulthood.
To find out if the child has outgrown the allergy, you will have to periodically undergo appropriate testing.
But, even if the baby outgrows one allergy, in the future the disease can "return" with such allergic conditions as asthma or hay fever. This phenomenon is called allergic or atopic march.
In addition, according to scientists, some factors may increase the likelihood of developing allergic reactions.
For example, one of the hypotheses is hygiene, based on the fact that a significant increase in the number of allergic diseases is observed in developed countries, where hygiene is better and there are relatively fewer infections.
The use of antibiotics in infancy may also be associated with an increased risk of subsequent development of allergies. This assumption is based on the notion that antibiotics deplete the normal gastrointestinal bacterial flora that would normally suppress the Th3 response.
Along with this, scientists believe that some factors may, on the contrary, reduce the risk of developing allergies in a child .
Thus, according to research results, food allergies in children occurs less frequently if the baby remains exclusively breastfed for at least the first six months of his life.
The intake of probiotics by breastfeeding mothers or babies can also help reduce the risk of developing allergies as an addition to infant formula.
In addition, early gradual exposure to allergens such as peanuts is also the prevention of further allergies to them.
But new foods should be introduced into the baby's diet in turn: one at a time and with an interval of two or three days, or even less often. In this case, any reaction should be recorded, and, if necessary, reported to the doctor.
You also need to know that food reactions, as a rule, do not appear at the first acquaintance with the allergen. In most cases, the reaction is preceded by a sensitization process - it is formed by the preliminary exposure to the allergen. It occurs directly or through breast milk.
Causes of Food Allergies in Children
Whether a child develops a food allergy to a particular food depends on many factors.
First, a baby is more likely to have this problem if the family has a family history or other allergic conditions such as asthma, hay fever or eczema.
The tendency to develop allergies to food and inhalant allergens is mainly genetically determined. The chance of developing a food allergy in a child whose parents do not have a history of allergies is 20%. If one of the parents has an allergy, the chances increase to 30-50%. If both parents suffer from allergies, then with a probability of 60% - 80% the child will also have this problem.
The connection between food allergies and eczema is also quite strong.
Atopic children are genetically predisposed to produce immunoglobulin E (IgE) antibodies to various food and inhalant allergens to which they are exposed. Further influence of IgE, which is fixed on mast cells, leads to the release of chemical mediators that cause both an immediate reaction and a delayed reaction.
Atopic dermatitis (AD), IgE-mediated food allergy, asthma, and allergic rhinitis are often associated. They may coexist, or as one condition improves, the other may evolve into the already mentioned “allergic march.
”
Babies who develop severe eczema before three months of age are more likely to have food allergies. Simply put, the earlier a baby has eczema, and the greater their birth weight, the more likely it is that the baby will develop a food allergy.
Approximately 90% of all food allergies are caused by the following eight foods:
milk
eggs
wheat
soy
Tree nuts
Peanuts
Fish
Shellfish.
A common food allergy in infants and young children is a reaction to milk, eggs, peanuts and nuts such as hazelnuts, walnuts and almonds.
According to statistics, 1.6-7% of children are allergic to cow's milk, and about 2% of children under three years old are allergic to eggs and peanuts.
Peanuts, tree nuts, fish and shellfish cause the most serious reactions.
Due to an allergy to cow's milk protein, infants may develop allergy to formula fed or supplemented.
Also, formula-fed babies may develop an allergy to soy.
Symptoms of food allergies in young children
Most food allergies are of the immediate type. In this case, food allergy in child appears immediately - most often within 15 minutes after eating, or within 2 hours.
The main symptoms of an immediate food allergy are:
urticaria (most commonly around the mouth, nose and eyes, but this rash can spread all over the body)
mild swelling of the lips, eyes and face
runny or stuffy nose, sneezing, watery eyes
itchy mouth and throat irritation
nausea, vomiting and diarrhoea.
If a child has a severe reaction, wheezing, breathing problems, swelling of the throat and tongue, and a sudden drop in blood pressure may occur. Such a severe reaction is called anaphylaxis, and its extreme, severe manifestation, is anaphylactic shock . This is a particularly life-threatening condition that is most commonly caused by foods such as peanuts, nuts, fish, and seafood.
At the first sign of anaphylaxis, you should immediately seek medical help and inject epinephrine.
However, sometimes an allergy does not make itself felt immediately, but after a delay
Therefore, the problem is more difficult to notice. But this type of reaction is becoming more common. First of all, a delayed reaction is typical for products such as milk and soy. Such an allergy has several other manifestations.
The main signs of delayed food allergies, or not indirect IgE, are in the child:
· Reflux
· Colic
· Diariya
· Constipation
· Blood or mucus in feces
· Bad set of weight and bad sets of weight and bad short stature
moderate to severe eczema, which is common in children with milk allergy.
Can a child's food allergy be cured
The answer to this question is ambiguous. On the one hand, today there are no official cures for food allergies for children.
On the other hand, as mentioned at the beginning, a child may very likely outgrow an allergy to certain foods.
Until then, abstaining from the allergen and periodically undergoing special tests to diagnose food allergies will be the best option.
Children with mild allergies, for example to eggs, can sometimes eat foods containing baked eggs. If your child has a severe allergy to, for example, nuts, they may need to be avoided in any form or amount. More precisely, this can be determined by a molecular allergy test.
In milder cases of allergy, children are prescribed antihistamine drops to relieve general allergy symptoms.
Antihistamines may be used to treat symptoms of an allergic reaction such as hives, runny nose, or stomach pain. Topical ointments may be effective in treating skin manifestations. But when a child has a severe reaction in the form of anaphylaxis, such symptomatic treatment does not work. Therefore, it is necessary to inject adrenaline.
The latter is available as auto-injectors.
In any case, consultation with an allergist is indispensable. Moreover, sometimes another problem can be hidden behind the symptoms of an allergy. For example, it may be intolerance to milk proteins or lactose milk sugar. Usually, food intolerance in children is manifested by indigestion and can last for several weeks.
sources of information:
1. https://www.hopkinsmedicine.org/health/conditions-and-diseases/food-allergies-in-children?amp=true
2. https://www.nhs.uk/conditions/pregnancy-and-baby/food-allergies-in-babies-and-young-children/
3. https://www.ncbi.nlm. nih.gov/pmc/articles/PMC2805592/
4. https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Food-Allergies-in-Children.aspx
5. https:/ /pubmed.ncbi.nlm.nih.gov/27276868/
6. https://www.webmd.com/parenting/baby/introducing-new-foods
7. https://www.babycentre.
