Everything Parents Need To Know About Food Allergies
Back in the day, your packed school lunch served as cafeteria currency. Days depended on the ability to swap that same-old Twinkie for a pudding cup – or better yet – a Nutter Butter. Sad news folks, those days are long gone. Over 15 million Americans currently have food allergies, and this epidemic has transformed the lunch room drastically. The sandwich trade has come to a screeching halt, and in its place, peanut-free tables abound, seating one loan nut-free soul.
To understand how your kid’s favorite nutty spread became the schmear of fear, we sat down with allergist Debra Lebo M.D. to ask her all of our burning questions about food allergies. Learn about the basics and how to protect your kids come the start of the school year.
1. What causes food allergies?
“Unfortunately, no one seems to know exactly what causes food allergies. We’ve certainly seen an increase in food allergies, particularly peanut allergies, as of late. There is something called the Hygiene Hypothesis which is a belief that since the environment is cleaner, our bodies don’t have to respond against infection as much. For that reason, they are looking for something to do. Instead of fighting infection, they take on an immune response and they react to things they shouldn’t react to.
2. What is actually happening in an individual’s body when they become allergic to food?
When you have an allergic reaction, your body is making IGE antibodies. In order to develop these antibodies, an individual has to be pre-exposed to whatever they’ll react to. When it comes to food, babies for example can be pre-exposed through breastmilk or in utero. Once the IGE antibodies are made, the next time an individual is exposed to the food the antibody binds to it by attaching to the mass cell, or allergy cell. The cell then bursts and the allergy cells come out to cause a reaction.”
3. What are the most common types of food allergies?
“Seafood and shellfish, milk, eggs, wheat, soy, peanuts (legume) and tree nuts make up 90% of food allergies. Interestingly, sesame is an up-and-coming allergy we’ve been noticing a lot.”
4. What ages do food allergies typically present themselves? Why can someone have a life-long love affair with shellfish and suddenly break out in hives?
“Allergies don’t discriminate based on age. The truth is, they can show up at any time. Elderly people are less likely to exhibit a new allergy, but it is still possible. Children are mostly allergic to milk and nuts or legumes. Adults are typically allergic to nuts and fish. While there has been research done, we still don’t fully know why a body suddenly changes later in life.”
5. Is there a way you can see early signs before someone has a full blow allergy attack? If so, what are early symptoms parents should be aware of?
“Some people do show subtle signs and some have a full-blown attack right off the bat. If you have milder allergy symptoms, it doesn’t necessarily mean the next time will be worse - it’s different for everyone. However, if you do exhibit any of the following mild symptoms when eating a specific food, I suggest carrying an EpiPen to be safe. Milder symptoms include itching, a funny feeling in the throat, and abdominal discomfort. They can be as extreme as vomiting, swelling, diarrhea, and full-blown anaphylaxis. Interestingly enough, before having an actual attack, some younger children will tell their parents that they don’t like the way a food tastes or smells. Usually it’s just a taste preference, but it can be an indication of an allergy before the symptoms are present.”
6. Are allergies hereditary?
“Allergies in general run in the family, but the likelihood of a child developing the same type varies. If there is one family member with a peanut allergy, a child has a 7% chance of developing one as well. For general allergies, like asthma or eczema, the likelihood is slightly higher. If one parent has a general allergy, one out of three children typically develop the same kind. If both parents have a general allergy, the child has a 60% chance of developing it, too.”
7. Are there certain types of food that are generally on the safer side when it comes to allergies?
“It’s important to remember that there’s a difference between an allergy and an intolerance. It’s actually pretty uncommon to be allergic to a multitude of foods. One safe option is fruits and veggies. However, some individuals will exhibit Oral Allergy Syndrome when they eat them raw. This syndrome is caused by tree pollen. Those individuals may be able to have the same fruits or veggies that cause oral itchiness if the ingredient is cooked. Meats are also a safe bet, like beef, chicken, pork, and turkey. Also, grains like rice and barely, for the most part, are safe. One way some allergists will test for a specific allergy is with an elimination diet that consists of one meat, one grain and a fruit or vegetable. Then, they slowly add foods back into a person’s diet and gauge their reaction.”
8. If your child is allergic to one type of food, is there a potential for cross-reactivity with other types in the same family? If so, how can you know what other foods may cause that reactivity?
“Often times we do see cross-reactivity when we do an allergy test, however it doesn’t mean that the test is 100% positive. When a person tests positive on an allergy test, they are actually allergic only half the time. In the event that a test comes back positive for cross-reactivity, we do an oral test in our office to see what happens by giving the patient a small amount of that food and monitoring them over the course of several hours.”
9. If a child goes into anaphylaxis for the first time, what should a parent do?
“The first time can be very scary because a parent won’t be prepared with an EpiPen. If it seems as though your child is going into anaphylaxis, the first thing to do is call 911. While you wait, see you have Benadryl at home to give them.”
10. What steps should a parent take when a child has a food allergy and they are sending them to school for lunch?
“Before school starts, make sure the faculty has been made aware. Many schools now, thanks to recent laws, have EpiPens on hand. However, you should always check and you should provide your child’s teacher with an EpiPen on the first day of class”
11. What are the best ways to teach your child about their allergy so that they can also be safe when they’re on their own?
“The first step is educating your child about their symptoms. They should know what the start of an allergy attack feels like so that they can let their teacher know immediately when the symptoms start. Second, educate your child to not take food from others at lunch and snack time. Third, your child should be trained to use their EpiPen themselves. There is a training manual in the kit you can use together. Practice this at home. As your kids get older, they will likely start eating out at restaurants and their friends’ houses. Parents should teach their children to always ask about ingredients, notify their server and read labels. Often times food preparation changes, and even if you’ve eaten a pre-made meal 100 times, you should always read the box to check that it’s still safe.”
12. Is there any hope for the future of people who have food allergies?
“While the only current solution is avoidance, scientists are working on other procedures that should help. We are studying the process of desensitization, in which people are given micro-doses of the food they’re allergic to in order to build a tolerance. There’s also a peanut patch being developed that would release small amounts of peanut into an individual’s body to achieve the same effect.”
13. Any other advice?
“Don’t forget to see a board-certified allergist because not all doctors are trained. Everyone that has an allergy needs an EpiPen, no matter how mild it seems, and no matter what a doctor tells you.”
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