Hearing that your child has a food allergy and/or watching your child have an allergic reaction to a food can be frightening and a cause for anxiety. Parents and patients are left with many questions. What is a food allergy? Is it curable? How are we going to manage this? With all of the questions running through your head it can be overwhelming, but the key to managing one’s food allergy is education. By learning how to deal with the food allergy and finding the appropriate support as well as foods, you and your family can be on the way to a more relaxed lifestyle for eating out and home.
What is a Food Allergy?
A food allergy is when the immune system recognizes the protein in a specific food as harmful. The immune system immediately wants to protect the body. It will create antibodies to attach the food (specifically the protein) once it is ingested. Your body will also release chemicals that can cause the reactions like wheezing, skin rashes, itchiness, hives, tightened throat, diarrhea, vomiting, and sneezing. The reactions can be immediate or delayed by up to two hours after ingestion. Reactions can be different for each individual. In order to avoid this reaction the food needs to be eliminated from the diet completely.
Your doctor should also provide you with the appropriate medication, epinephrine, should an accidental ingestion occur. This medication comes in a self-injectable device called the EpiPen. The allergy may last a lifetime or a patient may outgrow it. If your doctor feels your child may have outgrown the food allergy it is wise to schedule a food challenge in a doctor’s office or hospital setting to assure appropriate safety precautions are taken if a reaction were to occur. If you are having difficulty identifying whether an allergy is present, see your doctor before eliminating foods that may be essential for appropriate nutrition. A thorough food diary with corresponding symptoms plus blood and skin testing for allergies will help lead you to identifying the specific food protein you are allergic to.
The most common food allergies are milk, egg, soy, wheat, peanut, tree nut, fish, and shellfish. In 2011, a study in Pediatrics reported 8% of children developed a food allergy with peanut being the most common.
Here are some tips to cope with the most common food allergens.
Most patients who are diagnosed with peanut allergy are told to avoid all tree nuts even if they were never tested. There is a higher chance they will have an allergy to tree nuts and most nuts or nut butters are packaged in a facility with other nuts including peanuts. Seeds are also typically contaminated with nuts, especially sunflower seeds. Other common sources of contamination include chocolate, bakery and ice cream shop items, and ethnic foods like Chinese and Thai. Most peanut allergy children can have peanut oil, but should check with their doctor first.
Substitute milk in recipes for equal parts water, fruit juice, rice milk, or soy milk. (Check with your nutritionist for possible milk contamination with rice or soy milk. One safe product is Soy Dream and Rice Dream). Be aware of hidden sources, like some canned tuna, deli meat, and restaurant meats that may be cooked with butter. If a food has the kosher label D or DE, milk is present or the product was produces on equipment shared by dairy.
This is different than celiac disease, a permanent adverse reaction to gluten, which is included in the major grains of wheat, rye, oat, and barley. Wheat allergy means avoidance of only wheat products. You may want to experiment with different types of flours when substituting white or wheat flour in a recipe to find the appropriate texture. Always read labels because even foods like hot dogs, soy sauce, and ice cream may contain a wheat product.
Reading labels is important with baked products, including pasta. In addition to the food label, check with your nutritionist or manufacturer to assure the product is not produces on the same equipment as egg. Recipe substitution can be made with egg replacer. For other substitution ideas, see your nutritionist.
Many products contain soy or soybean, like cereal, baked goods, canned tuna, and soups to name a few. Soy has increased in popularity so check with restaurants and manufacturers for cross contamination.
If you test positive to one fish or shellfish, it is better to avoid all and get further testing before including other types in your diet.
Oral Food Allergy
This is usually a cross allergy between fruits and outside allergens like pollen and birch. Cooking fruits will denature the protein and should then be safe to include in the diet. Always check with your allergist first.
The key to food allergies are properly reading food labels, knowing hidden sources, learning recipe substitutions, and identifying sources for cross contamination. Don’t be afraid to ask multiple questions when out at a store or restaurant. If there are any doubts about a product, ask your nutritionist or check on the Food Allergy & Anaphylaxis Network website. You can visit the FAAN website and sign up for alerts on new products or changes in existing products.