Babies typically start solids anywhere from four to six months old which can be a very exciting time but also anxiety ridden as parents hope that they are not feeding their child something they are potentially allergic to (Spergel, 2021). There are so many signs of early food allergy detection in children that are often overlooked or misconstrued as a symptom of something else.
What is a Food Allergy?
Food allergies result from a child’s immune system overreacting to the exposure of a food allergen. In the case of my son, he was 6 months old when he had a lick of ice cream that cost us a trip to the emergency room with hives on the verge of anaphylactic shock. This goes to show that one accidental exposure can have life-threatening impacts (Spergel, 2021). There is also the large misconception of food allergies and food intolerances. The simple way to know the difference is that allergies involve the immune system while intolerances do not. Food intolerance or food sensitivity is rarely ever life threatening (Spergel, 2021). Think of those who are lactose intolerant and should avoid dairy, those individuals have intolerances.
Reactions can come on within minutes or not reveal themselves until up to two hours later. These signs of reaction include but are not limited to (Spergel, 2021):
• Itching
• Hives
• Swelling
• Nasal congestion
• Runny nose
• Cough
• Shortness of breath
• Wheezing
• Rapid heartbeat
• Low blood pressure
• Fainting
• Loss of consciousness
• Eczema
The image below goes into more detail on how different body parts exhibit symptoms of food allergy reactions.
Diagnosing Food Allergies in Children
In one of my earlier posts, I mentioned how food allergies have come a long way, especially in the last 20 years or so. This section is going to break down the methods of diagnosis currently in use.
Skin Prick Tests
If a food allergy is detected, a skin prick test or SPT is the first series of tests an allergist will run in conjunction with routine blood tests. SPTs are extremely effective in the sense that they are inexpensive and produce immediate results (FARE, 2023). An allergist during this test will place a drop of solution containing the food allergen on either the forearm or back. From there, the allergist will gently scratch the skin, typically with a needle, just enough so that a tiny amount of solution can enter below the surface of the skin. For parents or caregivers, there is no need to worry for this test is essentially painless and there is no bleeding (FARE, 2023). However, that doesn’t mean that they get any easier. I still get upset every time my son cries from his STP.
Blood Tests
When someone is allergic to specific foods, there will be IgE antibodies present in the blood that can be measured through blood tests to determine the severity of the allergies. IgE or immunoglobulin E is the antibody that triggers allergy symptoms to food that should be considered harmless (FARE, 2023). The results of these tests should always be explained to you by a doctor since some reports may use different scoring systems or units. We have found the class levels to be helpful with 0 being the lowest and 5 being the highest to predict the severity of an allergy. It is important to note that this test is based off chance – it is not a definite yes or no which is why it is paired with a skin prick test (FARE, 2023).
Food Elimination Diets
In babies who are constantly introduced to new foods in the beginning, food elimination diets a very helpful way to initially detect a food allergy (FARE, 2023). For example, the best practice is to introduce one food at a time for a few days to see if a reaction occurs. If a baby is given apple sauce and vomits, your allergist may suggest temporarily eliminating the food for two to four weeks to see if an allergy is the cause. During this suspension, your allergist might further advise gradually reintroducing the problem food and if symptoms do not reoccur, then allergies can be ruled out (FARE, 2023).
Oral Food Challenges
If the three diagnosis methods above are determined to be inconclusive or inconsistent, an oral food challenge will be scheduled since it is a highly accurate diagnostic test (FARE, 2023). Personally, this test filled me with so much anxiety because of the serious reaction that can occur but be rest assured, it is completed only at a doctor’s office in a controlled medical environment. This test is done by feeding the patient small doses of the suspected food in measured doses (FARE, 2023). The allergist and nursing staff will then closely monitor the patient for a period of time to see if a reaction occurs. From there, larger pieces are gradually introduced and if significant symptoms do not reveal themselves the allergist will clear the suspected problem food. If it does start to take a turn for the worse, medication is given immediately (FARE, 2023).
Currently, we go to the Jaffe Food Allergy Institute out of Mount Sinai Hospital in New York City and our experience has been nothing short of amazing. It took a lot of research before deciding to go here but for those interested in oral challenges and developing a plan for desensitization, do your homework and evaluate all options that will work for you and your family. We recently passed our baked milk and baked egg challenge. For us, and the extreme severity of my son’s allergy, this is a major win that gives us hope.
Myths and Misconceptions
For those who are fortunate enough to not have to deal with food allergies, the topic can be confusing and frankly, is largely ignored. I have found that unless you personally have food allergies or know someone who does, then they are widely unknown despite all the research and great strides that have developed in recent years.
Food Allergies Are Not Serious – Have a little bite
Not only are they life-threatening as we discussed earlier, but food allergies are life altering and not just for the individual that has them but for their loved ones as well. People with allergies and their caretakers must take extreme precautions to ensure they avoid a potentially bad situation (FARE, 2023). Even a contact trace can trigger a severe reaction let alone having a small bite, so the best case is to avoid problem foods entirely.
You’re Stuck with Food Allergies for Life
This could not be anymore false. With the science behind allergy testing rapidly developing, allergists are coming up with patient plans to help people with food allergies grow out of them. While this is not the case for everyone, those with allergies to egg, milk, soy, and wheat for example, have a higher chance of outgrowing their allergies than someone who is allergic to peanuts, tree nuts, shellfish, and fish (FARE, 2023).
Moving forward, the best thing anyone can do is research the facts surrounding food allergies and learning how to best accommodate them. The diagnosis of my son’s food allergies brought on an entirely different lifestyle that combined with being a new parent, was extremely challenging at first. I am confident in the direction that the medical field is heading in for we can and will do better to understand, diagnosis, and treat food allergies. It is my hope that this blog at the very least will help someone who was just as lost and confused as I was in the beginning.
References
Pioneering advances in diagnosis – food allergy diagnosis (2023). FARE. https://www.foodallergy.org/research-innovation/accelerating-innovation/food-allergy-diagnosis-and-testing
Spergel, J. (2021, July 30). Food allergies in babies: signs and prevention tips. The Bump. https://www.thebump.com/a/food-allergy-baby