According to the Centers for Disease Control and Prevention, food allergies are on the rise. This means that parents need to be aware of the signs of food allergy and know what to do.
The signs of food allergy aren't always obvious. Even as a doctor, I'm sometimes not sure. But knowing the possible signs means parents can talk to the doctor sooner rather than later.
In infants, the signs of food allergy can include:
- Poor weight gain
- Blood in the stools
- Vomiting, diarrhea or constipation
- Rash (eczema or others)
Obviously, there are many other things besides food allergy that can cause these symptoms. Many of them are more common than food allergy. But it's important to discuss the possibility with your doctor, especially if you haven't found another explanation for the symptoms.
The mothers breastfeeding an infant with food allergies need to watch their own diets carefully. Food the mother eats can affect breast milk.
Infants who are not breastfeeding need to get special formulas. They can be very expensive.
Both of these approaches can be difficult. If you or your doctor suspects your infant has a food allergy, ask for a referral to a specialist.
As children get older, the signs of food allergy may get easier to recognize. The classic sign is a rash called urticaria or hives. They are raised, pink, irregularly shaped spots that are very itchy. They usually appear shortly after eating. And they come and go.
But other reactions may be less immediate. These include eczema (a skin inflammation), poor weight gain, stomach aches or other vague symptoms. As with infants, it's very important that a child have formal testing and a consultation with a specialist before making a diagnosis.
Blood tests for food allergies can be unreliable and misleading. (Some companies will do them for a fee and not even involve a doctor.) They can miss an allergy or show an abnormal result when everything is normal. This can lead to unnecessary worry and further testing. Or lead to diet changes that can result in nutritional problems.
Oral allergy syndrome is a slight variation on food allergy. The symptoms are itching and swelling of the mouth and lips. They occur most commonly after eating raw fruits and vegetables, and some tree nuts. While uncomfortable, the symptoms are not dangerous. And they are limited to the mouth and lips.
The most important thing for parents to be able to recognize is anaphylaxis. Anaphylaxis is the name of a serious allergic reaction. It can be life threatening. The signs of anaphylaxis include:
- Rash — usually (but not always) hives that spread rapidly over the body
- Swelling of the face, eyes, lips or tongue (unlike in oral allergy syndrome, the swelling isn't limited to the mouth)
- Any trouble breathing, such as wheezing, coughing or tightness of the throat or chest
- Vomiting, diarrhea or stomachache
- Dizziness or fainting, or a feeling of anxiety
- Rapid or irregular heartbeat
Other illnesses and problems can cause these symptoms. But when a person with known allergies experiences these, call 911 immediately. If an EpiPen® is handy, use it.
Follow these same steps with a person with previously unknown allergies who is having even a couple of these symptoms. An EpiPen is an injection of epinephrine. It is very easy to give, and can save a life.
Speaking of saving lives, here are three things all parents of children with food allergies should do:
- Make sure that everyone who cares for your child knows about any allergy. Start talking to your child early about his allergy, so that he learns about it too.
- Make sure that there is an EpiPen always handy for your child. I usually recommend having three "2-packs" (you might need to give it again before the ambulance gets there): one for home, one for school or daycare, and one that "travels" with your child. (For example, keep a pack in the diaper bag, your purse or have handy for playdates.) If your child lives in two different homes or is in an afterschool program that isn't part of the school, more EpiPens may be necessary. Ask for as many as you need!
- Be fanatic label readers. Just because something doesn't have peanuts in it, for example, doesn't mean it is safe. It might have been made with machines that process peanut-containing foods. Read the labels of every food your child may eat.
Claire McCarthy, M.D., a senior medical editor for Harvard Health Publications, is an assistant professor in pediatrics at Harvard Medical School. She is an attending physician and Medical Communications Editor at Children's Hospital Boston.