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Does your child have food allergies?

Air Force Senior Airman Catherine Settles, 633rd Medical Group aerospace medical technician, numbers a baby’s back to record which allergen will be applied for a skin prick test at U.S. Air Force Hospital Langley, Virginia. The allergy clinic also conducts skin patch and oral challenge tests to identify a patient’s allergies. (U.S. Air Force photo by Airman 1st Class Austin Harvill) Air Force Senior Airman Catherine Settles, 633rd Medical Group aerospace medical technician, numbers a baby’s back to record which allergen will be applied for a skin prick test at U.S. Air Force Hospital Langley, Virginia. The allergy clinic also conducts skin patch and oral challenge tests to identify a patient’s allergies. (U.S. Air Force photo by Airman 1st Class Austin Harvill)

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Children's Health

FALLS CHURCH, Va. — Rachel Conley lived relatively allergy-free. But when two of her three children were diagnosed with severe food allergies as infants, her life changed. She had realized something was wrong soon after her first daughter was born.

Conley, who was breastfeeding her infant daughter, noticed she seemed to be in constant discomfort. Her daughter developed severe skin issues, began vomiting, and had blood in her diaper.

“As a mother, my instinct is to fix things as quickly as possible, and I was determined to do anything that I could to make her feel better,” said Conley, who’s married to a Coast Guardsman. “It’s hard as a parent to see your child in pain, especially when they can’t explain what’s wrong so that you can immediately fix it.”

At her doctor’s urging, Conley removed high-allergen foods – soy, milk, wheat, shellfish, nuts, and eggs – from her own diet while breastfeeding. As a parent, the trial and error approach seemed daunting and slow at first, but after six weeks of following a bland diet, her daughter’s symptoms started to clear up.

Allergies occur when the body has an immune response to certain triggers, such as food, pollen, or pet dander. The body creates antibodies to fight off the allergen so when a person comes into contact with it again, the antibodies release chemicals, such as histamine. This triggers an allergic reaction that can include symptoms like a runny nose, itchy skin rash, tingling, swelling, pain, or wheezing.

Dr. Ronald DeGuzman, allergist at Fort Belvoir Community Hospital in Northern Virginia, said most allergic reactions to food are due to ingestion of milk, eggs, shellfish, wheat, soy, and nuts. Allergies to milk, egg, soy, wheat, and peanuts are more common in infants, he said.

“Most children outgrow these allergies as adults,” said DeGuzman, but added that in some cases, food allergies can develop later. A 2014 national health survey conducted by the National Center for Health Statistics found 5.4 percent of children under the age of 18 have food allergies.

According to the Centers for Disease Control and Prevention, children with food allergies are two to four times more likely to have asthma or other allergic reactions than children without food allergies. And the prevalence of food allergies among children has increased 18 percent between 1997 and 2007. Food allergies are less common in adults, but affect almost 15 million Americans overall.

Food allergies can produce skin reactions like hives and eczema. An allergic reaction can also cause redness and swelling of the face, lips, tongue, mouth, or extremities. Other signs include abdominal pain, nausea, vomiting or diarrhea, sneezing, coughing, shortness of breath, and light-headedness.

“If a child shows symptoms of an allergic reaction, the first step is to see a primary care provider,” said DeGuzman. “Providers are able to tease out possibilities and send patients to an allergist if needed.”

If a child shows severe symptoms quickly, such as trouble breathing, DeGuzman recommends going to a hospital to get evaluated immediately as some allergies can be life-threatening. Allergies can be identified through a variety of tests, but the most important factor for diagnosis is a patient’s history, said DeGuzman. This can help providers decide if an allergy runs in the family, if the reaction is caused by something other than an allergen, or if an allergy test is necessary.

The type and reliability of the test depend on what allergies providers are looking for in a patient. For example, for allergic asthma, a skin prick or blood test for up to 50 different allergens in the environment that can cause upper or lower respiratory symptoms. However, taking a test isn’t always the answer.

“When we do an allergy test, we’re looking for an antibody that you make for a specific allergen,” said DeGuzman. “The problem is, the test only shows that you make the antibody. Some people who test positive for antibodies are able to tolerate the allergen, meaning they may just be sensitized, rather than allergic, to that substance.”

Depending on the type and severity of an allergy, treatment can also vary. It can involve a diet, environmental, or lifestyle change to avoid or lessen immune responses to triggers, or medications such as over-the-counter allergy pills, said DeGuzman. If something appears to cause a problem, avoid it if possible, he advised.

For Conley’s daughters, the allergies have never fully gone away, but the family has learned to manage them. Conley continues to keep all high-allergen foods out of her house and often wipes down public spaces to ensure that her daughters don’t come into contact with an allergen, she said.

“Parents are the best advocates for their children,” said Conley. “You know your child better than anyone else, and you know when something doesn’t feel quite right. I encourage parents to follow their instincts and discuss that with a doctor.”

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