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What parents should know about food allergies

Scott Schroeder, MD is a pediatric pulmonologist and allergist at Tufts Children's Hospital.It can be scary when a child’s immune system decides to go on the defense after consuming certain foods. Allergic reactions can occur up to two hours after eating a food, which may cause a wide spectrum of reactions; from an itchy mouth and hives to difficulty breathing. Chief of Pediatric Pulmonology and Allergy, Scott A. Schroeder, MD, shares what to expect when raising a child with food allergies and how to keep them safe.

What would you say are the most common food allergies seen in children today?

There are 7 common food allergies:

  1. Cow's milk
  2. Hen's eggs
  3. Peanuts
  4. Wheat
  5. Soy
  6. Tree nuts
  7. Shellfish

Which food allergies are the most challenging for parents?

Milk protein allergies can be challenging since a milk allergy has been blamed for just about all maladies of infancy. The signs and symptoms can be non-specific and similar to colic, excess irritability, and, on the extreme end, bloody diarrhea and chronic vomiting. Fortunately, a cow’s milk allergy tends to resolve through childhood.

peanut butter

Peanuts and tree nuts are also challenging, but for a different reason. In children they are the most common offenders for severe, life-threatening allergic reactions. These reactions can include swelling of the throat or tongue, difficulty breathing, rapid heart rate and/or shock. Children who develop these symptoms need to be treated with epinephrine and evaluated in an emergency room.

When should a parent bring an infant or child to see a doctor?

Parents should trust their instincts. If they think something is wrong with their child, they are usually right and should schedule an appointment with his or her pediatrician for guidance. This is especially true for babies and children born with food-allergy risk factors.

What are some risk factors parents should be aware of?

Up to one in three parents report adverse food reactions in their children, although the studies report that only between five and ten percent of children have true immune-system mediated food allergies.

Children with eczema or a family history of allergies are at an increased risk of developing food allergies. In infants with the aforementioned risk factors, recent studies show that delayed introduction of certain foods after four to six months of age may increase the risk of allergy. Introducing risky foods as early as possible is best.

Can allergies change or resolve?

Food allergies can resolve dependent upon the food and the severity of the allergic reaction. Parentally reported food allergies have increased from three percent to six percent over the past twenty years. However, reported food allergies decrease to about three percent by adolescence.

Studies have also shown that peanut allergies are increasing in the United States, although a number of children have been found to lose their sensitivity over time. About twenty percent of children outgrow their peanut allergy, and about nine percent outgrow their tree nut allergy. Wheat allergies are also commonly outgrown.

Do allergies ever develop in older children or adults?

The majority of food allergies are acquired in the first two years of life. Food allergies can develop at any age, but the most common allergies that teenagers and adults develop are to shellfish and fish. These allergies usually are life-long and severe.

What are some tips you recommend to parents of children with food allergies?

A parent should know how to read labels on packaged foods, educate their child’s schools, summer camps and childcare providers, and create a personalized allergy action plan. This plan would include:

  • A list of foods the child is allergic to
  • Signs and symptoms that they may have during an allergic reaction
  • Medications used to treat the child’s allergy
  • Emergency contact information

To book an appointment with Dr. Schroeder, call the Pulmonology + Allergy Department at: 617-636-7917 or fill out an online request.