Is your child at risk for a food allergy? As the number of children with allergies continues to grow, revised guidelines from the American Academy of Pediatrics may help to prevent such allergies in infants and young children.

by Lori Zanteson

Food allergies among children are on the rise. But this isn’t news to a generation of parents and kids for whom food allergies are as normal as, well, peanut butter and jelly used to be. Most kids today either have an allergy themselves or know someone who does. Food restrictions have become second nature.

What might raise a parent’s eyebrows, however, is how quickly the number of children with allergies is growing. In one decade, from 1997 to 2007, food allergies in children have increased 18 percent. In the November 2009 issue of Pediatrics, the National Center for Health Statistics reported that a staggering 3 million children under age 18 reported having a food or digestive allergy in 2007. That means one child in every hundred suffers from a food allergy.

It gets worse. Children with food allergies are two to four times more likely to develop additional food allergies, asthma, eczema, or other related problems than children are who have no food allergies. What’s a parent to do?

What is a food allergy?

A food allergy is an abnormal response to a food triggered by the body’s immune system. This means that the immune system mistakenly treats a food as a harmful invader. It tries to protect the body by producing antibodies that release chemicals into the bloodstream. Histamine is one such chemical that acts on the eyes, nose, throat, lungs, skin, or gastrointestinal tract and causes symptoms of the allergic reaction.

Prevention

Though there is no proven way to prevent a child from getting an allergy, the American Academy of Pediatrics (AAP) has revised its recommendations on mom’s and baby’s diets that include those at risk for allergies. Prior dietary restrictions such as avoiding certain foods during pregnancy and waiting to introduce solid foods until the baby is 6 months old have been updated.

The old AAP 2000 guidelines recommended that high-risk infants not begin solid foods until at least 6 months old, further delaying dairy products until age 1, eggs until age 2, and peanuts, tree nuts, and fish until age 3. The new guidelines, published in the January 2008 issue of Pediatrics, recommend delaying solid foods only until 4-6 months old, even solids that are generally considered highly allergenic like wheat and dairy products.

The guidelines were updated because there is not enough evidence proving that food avoidance leads to fewer food allergies even in high-risk children with allergic parents or siblings.

The American Academy of Asthma Allergy and Immunology is also considering a revision of guidelines for the introduction of foods like eggs, peanuts, and shellfish. It’s long been recommended that these foods not be given until age 2 or 3. But a 2008 British study reported in The Journal of Allergy and Clinical Immunology found that early exposure to peanuts actually lowered the risk of allergy.

Breastfeeding continues to get high marks as a child rearing style. AAP’s only unaffected guideline is to continue breastfeeding. There is evidence that exclusive breastfeeding for at least three months will boost your child’s immune system and protect against allergy. It is recommended that high-risk babies with allergic parents or siblings breastfeed exclusively for four months. 

When breastfeeding is not possible, some evidence backs the current recommendation that hydrolyzed formula like Alimentum and Nutramigen or partially hydrolyzed formulas like Good Start and Gentleease may delay or prevent eczema. The guidelines state that there is no evidence that the use of soy prevents allergies.

Moderation and variety

As most food allergies are dose-related, introduce each food very slowly and in small amounts. For example, a teaspoon of peanut butter may not affect a child, while two tablespoons might. Practice variety for this reason.

To keep track of any reaction, introduce only one new food every four to five days. Some parents keep a small journal or notebook for this purpose.

Avoid additives

All of those boxed, canned, and instant foods contain additives that expose our kids to allergens. Our bodies tend to rebel against foreign substances like additives and preservatives. They may be approved by the U.S. Food and Drug Administration, but they are approved at an adult level. Keeping food simple, whole, and pure is safest for children.

Many children outgrow allergies

The highest food allergy rate affects newborns through age 5, but fortunately, many children outgrow their allergy.

The most common foods to cause allergies in children are cow’s milk, soy, eggs, wheat, peanuts, tree nuts, fish, and shellfish. By the time they are 3-5 years old, most children will outgrow an allergy to milk, eggs, wheat, and soy. Peanut and tree nut allergies are not often quick to disappear.

Additional resources:

• American Academy of Allergy, Asthma, and Immunology
• American College of Allergy, Asthma, and Immunology
• American Academy of Pediatrics
• Kids With Food Allergies – a national non-profit education and support organization

 

Lori Zanteson is a Southern California-based writer and mother of three who specializes in health, food, and fitness for families.

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