Food alergies in babies
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:
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Milk
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Eggs
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Wheat
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Soy
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Tree nuts
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Peanuts
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Fish
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Shellfish
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:
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Vomiting
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Diarrhea
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Cramps
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Hives
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Swelling
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Eczema
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Itching or swelling of the lips, tongue, or mouth
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Itching or tightness in the throat
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Difficulty breathing
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Wheezing
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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:
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If possible, breastfeed your infant for the first six months.
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Do not give solid foods until your child is 6 months of age or older.
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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:
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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.
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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.
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Avoid buffet-style or family-style service, as there may be cross-contamination of foods from using the same utensils for different dishes.
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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.
Babies and Food Allergies | Children’s Hospital Los Angeles
Categories:
Health and Safety Tips
Experts agree: Feeding infants peanuts, eggs and other common allergens makes them less likely to develop sensitivities to these foods.
By Stephanie Cajigal
A lot has changed when it comes to caring for babies, including how to feed them. It used to be that parents were told to wait until their child was 3 to give him or her foods many people are allergic to, like peanuts. Not anymore.
Experts now recommend feeding babies common allergens before they turn 1 to reduce their chances of developing allergies to these foods.
Jill Madison, MS, RD, a Clinical Dietitian at Children’s Hospital Los Angeles, and Jonathan Tam, MD, Medical Director of the Gores Family Allergy Center at Children’s Hospital Los Angeles, offer these tips for feeding your little one.
Feed solids at around 4 months
Your baby is likely ready to start eating food when he or she has good head control, can sit up unassisted, and shows interest in foods, Madison says. At the baby’s 4-month checkup, your pediatrician will tell you whether it’s time to introduce solids. This means giving your baby a single-item food, like steamed carrots, not a combination of foods, like steamed carrots blended with potatoes.
“Historically, we started with purees. Now we know you can give a baby a whole food as long as it’s soft enough to chew, like a slice of ripe peach,” Madison says. To prevent choking, make sure that chunks of food are not round and hard, and can be mashed with a fork.
The first foods babies typically eat are single-grain cereals, vegetables, fruits and meat. Once your baby has gotten comfortable with these foods, you can start feeding him or her common allergens, introducing them one by one.
Safely introduce allergens
The most common allergens are eggs, milk, wheat, soy, sesame, tree nuts, peanuts, fish and shellfish. It’s a good idea to feed these foods to your baby before he or she turns 1, with the exception of milk in liquid form. That’s because cow’s milk has more calcium than breast milk and could interfere with the way your baby absorbs iron. Give your baby cottage cheese, yogurt or other forms of dairy, but wait until 12 months to give a cup of milk, Madison says.
As for nuts, babies can choke on these when they’re whole, so opt instead for nut butters that are creamy and smooth as opposed to chunky. You can make the nut butter less sticky by mixing it with water or breast milk or even blending it with apple sauce, Madison says. Another option is to stir a nut flour such as almond flour into a food your baby has already eaten many times before.
Pay attention to texture when feeding your baby, making sure food is soft enough to chew. Dip whole wheat bread in breast milk or water, for example, and mush shellfish and fish with a fork. You can mash a hardboiled egg and serve it as is or blend it with breast milk. Yogurt is an easy one to introduce since you don’t need to do anything to it. Start with plain yogurt made with whole milk, Madison says. You can also stir the yogurt into a fruit puree to change things up.
Ask your doctor about your baby’s allergy risk
Talk to your pediatrician if your baby has eczema, because this can put your baby at higher risk for developing a food allergy. And children with one food allergy may develop other food allergies. Children with an egg allergy, for example, are at higher risk of developing a peanut allergy, Dr. Tam says. If your child already has a food allergy, your pediatrician can give you advice on when to introduce other potential allergens.
Keep in mind that you should not avoid giving your baby a food just because someone in your family has an allergy to it.
“Since we know that in some context giving food early can prevent food allergy, then it would be even more important for an at-risk child to have it introduced early and purposefully,” Dr. Tams says.
Follow the 3-day rule
Your pediatrician may have told you to give your child a new food for three days in a row before introducing another new food. The same goes for common allergens.
“We want to give the child enough time to actually ingest the food and see how their body does with it,” Madison says.
While you’re doing this, remember to keep offering your baby foods you’ve already introduced.
Prepare foods at home
With all the jars, pouches and puffs available at stores, the options for feeding your baby may seem endless—and overwhelming. But Madison says making meals for your infant can be really simple.
As you’re cooking foods for the rest of your family, you can set aside a portion that doesn’t have salt or other seasoning. Say you’re cooking cod and asparagus, for example. You can cook the cod on the stove with some olive oil and mush it up with a fork for your baby. You can also cook the asparagus with olive oil on the stove top or in the oven and then puree or slice into half-moon pieces for your little one.
Madison says that while store-bought baby foods can be a good option for parents in a pinch, it’s best not to depend on them too much since studies show they can have unsafe levels of lead, mercury and other metals.
Looks for signs of a food allergy
How do you know if your baby is having an allergic reaction? Look for changes that begin within minutes to two hours after he or she ate the food. Hives and vomiting are the most common symptoms in infants, Dr. Tam says. Shortness of breath, coughing or wheezing can also happen, but are more common reactions in older children. If your baby develops a rash, take photos to track whether it’s getting worse, he says.
Seek medical attention for serious symptoms
If your baby is acting normally but has a mild rash or some hives, you could give your baby an antihistamine. Diphenhydramine (Benadryl) can provide comfort, but second-generation antihistamines like cetirizine (Zyrtec) and loratadine (Claritin) last longer and are less likely to make your baby sleepy, Dr. Tam says.
If your baby is vomiting, coughing, having difficulty swallowing (pay attention to new, suspicious drooling), or acting very sleepy, seek immediate medical attention. Try to get a doctor on the phone or go to the emergency department, Dr. Tam says.
Focus on variety over the long term
As your baby grows up, remember to keep feeding your child a variety of flavors and textures to help him or her develop a taste for different types of foods.
“Children eat what their parents eat,” says Madison. “If parents eat vegetables and try new foods readily, babies and kids will too.”
Click here to learn more about raising a happy, healthy baby.
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Prevention of food allergies in children
And in the first year of a child's life, food allergies are the most common.
The leading risk factor for the development of allergies in a child is the presence of a burdened heredity in the family. If this is one of the parents, then the chances of getting sick and staying healthy in a child are approximately 50 x 50. At the same time, the likelihood of developing an allergy in a baby is much higher if female relatives are susceptible to it. If both mom and dad suffer from allergies, then the probability of an allergic reaction is already 75%.
A very important risk factor for the development of allergies is also the nutrition of the expectant mother during pregnancy . Excessive enthusiasm for allergenic products (for example, milk and dairy products), even if the mother herself is not allergic to them, can provoke the development of the disease in the baby both immediately after birth and also in the prenatal period.
Manifestations of allergies in young children
The main manifestations of allergies in children of the first year of life are dermatitis ( itching, redness, peeling, rash, scratching, dryness or weeping of the skin) and dyspepsia regurgitation, vomiting, loose stools or constipation, increased gas formation, abdominal pain. The baby becomes restless, naughty, often cries, as it seems, for no reason, eats and sleeps poorly. Very rarely, there may be a cough, the appearance of elements of urticaria on the skin, Quincke's edema - swelling of the eyelids, lips or the entire face, larynx. All these violations most often occur within 24-48 hours after the use of an allergenic product. But often the allergy "accumulates" in the child's body, while he eats food that is not suitable for him day after day. In this case, the disease is delayed and manifests itself within 5-7 days, gradually increasing.
Allergenic products
For children in the first six months of life who are on artificial and mixed feeding, allergens can be cow and goat milk proteins, soy protein (that is, adapted mixtures made on their basis).
Babies, who are receiving complementary foods , and older children can be allergic to more than obligate allergens ( citrus fruits, strawberries, strawberries, chicken eggs, fish, seafood and caviar, nuts, honey and other bee products, some spices, chocolate), but also quite ordinary foods (chicken, veal, beef, wheat and rye flour, vegetables, buckwheat, etc. that do not cause hypersensitivity in other children. Currently, food colorings and flavor enhancers are becoming significant allergens , which are added in the industrial production of food and sweets
Food allergy: treatment or prevention?
Allergy is a chronic disease. Of course, allergies, like any other disease, can be treated . At the same time, it is impossible to completely cure allergies, but long-term remission can be achieved. Treatment is prescribed only by a doctor and includes the identification and removal of the causative allergen, diet, the use of antiallergic drugs, active external therapy using various ointments and creams.
The best thing to do, however, is to try to prevent your baby from developing food allergies. And you need to start prophylaxis more before pregnancy , having been examined by an allergist at the slightest suspicion of an allergy. Perhaps the expectant mother will need to take special medications that will prepare her immunity for the birth of a baby. During the period of expectation of the child , it is necessary to avoid not only foods that are unsuitable for the mother, but also to limit any allergenic foods. Today, these include not only traditional citrus fruits and strawberries, but also dairy products, gluten, eggs, fish, soy
Nutrition for mother and baby
After the birth of a baby , the prevention of food allergies consists of several components
When breastfeeding, nutrition of a nursing mother is very important. She should continue to follow the diet and avoid the allergenic foods mentioned above in her diet.
If the child is on artificial or mixed feeding, the following factors must be taken into account when selecting a mixture:
- The bulk of the mixtures are prepared on the basis of whole cow's milk, therefore, in fact, they are obviously ALLERGENIC
- Children at risk for the development of food allergies are prescribed preventive and even therapeutic mixtures in which whole cow protein is subject to partial or complete hydrolysis
- Cow and goat milk proteins are cross-allergic. Therefore, mixtures based on goat's milk are NOT INTENDED for therapeutic nutrition of children with food allergies.
A pediatrician, an allergist-immunologist will help you choose the right breast milk substitute suitable for a particular child. The sooner competent diet therapy is started, the sooner remission will come
You need to be very careful with the introduction of complementary foods .
For breast-fed babies, the introduction of new products is recommended after 6 months, and for formula-fed babies - from 4 months of age
It is better to start complementary foods with one-component vegetable purees. Each new product must be introduced gradually without mixing with others, starting with half a teaspoon, bringing to the required amount within a week. This should be done only if the child is absolutely healthy , choosing at the first stage food with a low degree of allergenicity (for example, zucchini, cauliflower, green apple, green pear, plum, rice, corn, turkey, pork, rabbit). In any case, the selection of an individual diet for a baby with a food allergy should be carried out by a pediatrician,
The development of a food allergy in a child largely depends on the parents. The sooner you start its prevention, the less the risk of unwanted reactions in the baby to various products. So, when the baby grows up, his diet will be richer and more varied.
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