Was It the Peanuts?
Food allergies are on the rise. Here's how to recognize one
Leigh Ann Coleman of Frederick, MD, is used to making sure that 1 her daughters eat safely at school, in restaurants, and at others' homes-both Ann, 6, and Caroline, 5, have multiple food allergies. But a recent outing to a Baltimore Orioles baseball game took her by surprise. "The day was so windy, peanut husks were everywhere, including on Ann's seat and hands," recalls Coleman. Such exposure could cause Ann's throat to swell and close up, so Coleman asked an usher to help her find a peanut-free zone. The episode served as a serious reminder that food allergies require nonstop vigilance.
For unknown reasons, these allergies, which plague up to 8% of kids younger than 3, are rising. Peanut allergies in particular doubled in preschoolers, from 1 in 250 in 1997 to 1 in 125 in 2002, say researchers at Mount Sinai School of Medicine's Jaffe Food Allergy Institute. Parents are worried: Nearly a quarter of all US households have changed their eating habits because a family member might have a food allergy, shows a new University of Arkansas review of previous studies. But this precaution may unnecessarily restrict a child's diet and lead to growth and development problems, says lead author Amy Scurlock, MD. Here's what you need to know.
• Assess your child's risk Allergies can run in families. The sibling of a child with a peanut allergy is 10 times more likely to develop one than a child in an allergy-free family, says Scott Sicherer, MD, an associate professor of pediatrics at Mount Sinai and author of The Complete Peanut Allergy} Handbook. Severe eczema or asthma in the family raises the risk, too.
• Delay certain foods If there is a family history of allergy, the American Academy of Pediatrics recommends breastfeeding for 4 to 6 months and waiting until a child's digestive system matures (after age 1) before introducing cow's milk, wheat, corn, citrus, and soy, and until at least age 2 before adding fish, peanuts, tree nuts, and shellfish.
• Recognize symptoms An allergic reaction occurs when the immune system mistakes a harmless protein for a dangerous invader and produces antibodies to combat it. That reaction can trigger flushing, hives, facial and throat swelling, a runny nose, coughing, and wheezing. Unlike a food intolerance (say, to lactose), which is more common but does not involve the immune system, a food allergy may produce symptoms within moments of eating. Worst-case but rare scenario: anaphylaxis, a reaction that can cause breathing problems, a drop in blood pressure, and shock.
• Get a diagnosis If you suspect a food allergy, ask your pediatrician about a skin test to measure your child's reaction to a potential allergen or blood tests to measure antibodies against specific foods. If hives or high antibody levels indicate that an allergy is likely, "testing stops there," says Robert Wood, MD, a pediatric allergist at Johns Hopkins Children's Center in Baltimore. Questionable antibody levels call for an oral challenge, in which the child eats the suspect food under a doc's watchful eye.
Kids may outgrow allergies to eggs, milk, and soy, but nut and shellfish allergies are usually lifelong.
• Take steps to avoid trigger foods Once an allergy is diagnosed, you must learn to decipher food labels. That's not easy: In a recent study, parents correctly identified their child's allergen on labels just half the time for peanut, while for soy they scored 22% and for milk, 7%. By January, however, food makers must list potential allergens in clear, simple language. "It could be another year before all products bear new labels," says Anne Muñoz-Furlong, founder and CEO of the Food Allergy & Anaphylaxis Network. Kids with severe allergies should wear a medic alert bracelet and carry injectable epinephrine (go to www.prevention.com/epinephrine for more info).
By Rachelle Vander Schaaf
Rachelle Vander Schaaf is a freelance writer based in Pennsylvania.