Food allergies have greatly risen over the last 20 years especially in Westernised countries.
Food allergies are not the same as food “intolerances” – genuine food allergies occur within 2 hours of ingestion or exposure, and cause symptoms ranging from swelling, itching, abdominal pain, vomiting, tingling in mouth or throat; to anaphylaxis – shortness of breath, swelling of mouth and throat, wheezing/cough, collapse.
Causes such as increased hygiene, an unhealthy fatty diet, obesity and lack of sunlight have been suggested, but the cause of this “epidemic” remains elusive.
Formula and breast feeding:
- Breastfeeding is recommended because of many beneficial aspects, but long term benefits, including in preventing allergies, are uncertain.
- Hydrolysed formulas rather than cow’s milk formula should be considered for infants who are not exclusively breast fed, if they are at high risk of allergies (parents or older siblings who have allergies).
- There is no evidence that mothers should modify their diet or take prebiotics or probiotics when pregnant or breastfeeding.
- Prebiotics or probiotics given to infants have not been found to prevent food allergy.
- It is recommended that solid foods (including potentially allergenic foods) are introduced at 4-6 months of age, irrespective of whether the infant has (or is at high risk of) eczema.
8 foods cause 90% of genuine allergies:
- Tree nuts
Diagnosis is made on the basis of testing (skin prick or blood tests) AND symptoms (some children can have a positive blood test (IgE antibodies) without symptoms – and should not have foods excluded on this basis)
Children with a suspected food allergy need to be assessed by an allergy specialist, for confirmation. Food challenges can be required.
Treatment of food allergy:
- Avoidance of the causal food
- Medication – ranging from antihistamines, for very minor reactions, to adrenaline auto-injectors for serious cases
- An Anaphyaxis Management plan should be carried and distributed to carers, the school, etc.
- Food allergies in childhood are often outgrown, especially in the cases of cow’s milk, egg, soy or wheat (less likely with nuts or shellfish).
- There is no currently available cure for food allergies.
Children should be followed up by their GP and Allergist, as repeat testing can be performed to determine if the level of reaction is dropping, and therefore food restrictions can be lifted.
Beware of misinformation, and heavily restrictive diets advised by practitioners without accurate confirmation of diagnosis!
Further information: www.allergyfacts.org.au
Adapted from Australian Family Physician, Vol 43 no 10, Oct 2014