Dealing with allergies in early childhood -®
Dealing with allergies in early childhood
This week qualified Dietitian and Adult and Infant Nutritionist Kate Di Prima advises on the best ways to identify and avoid food intolerances and allergies. Read Kate's profile here.

What does an allergy look like?

Awareness of food allergies when introducing solids

Food allergy occurs in around one in 20 children and one in 100 adults with the majority of allergies being mild and many children growing out of them over time. Most children allergic to cow's milk, soy, wheat and egg will be able to tolerate varying amounts by the time they go to school; this is in contrast to allergic reactions to tree nuts, peanuts, seeds and seafood which can be lifelong in around 75 per cent of children diagnosed.

The recommendation for introducing solids around the six months of age is due to the sensitivity of little gut linings. It is not recommended to introduce solids before four months as some proteins from food may leak through the lining of the gut causing irritation and potential an allergy to the food.

Most of the time children with food allergies have parents who are allergy free however siblings of a child with an allergy are at a slightly higher risk of developing a food allergy themselves.

Degree of reaction

Underneath the lining of the skin, lungs, nose and eyes are cells filled with chemicals including histamine which is released when irritated. A severe reaction will affect swallowing and breathing where a mild reaction may present as a skin reaction or symptoms similar to that of hay fever.

Reactions may be mild to severe depending on a number of factors such as:
  • the amount of the food eaten
  • the form of the food (liquid form can sometimes be absorbed faster)
  • whether the food was eaten alone or mixed with others
  • whether to food was cooked or uncooked
  • running around or other exercise can increase the severity of the reaction
A mild reaction may cause hives (small red welts) or wheels (red rings) on the skin which can be warm and itchy, swelling around the mouth and nose and vomiting within half an hour of eating the food. Other symptoms include pains in the tummy, diarrhoea or a blocked or runny nose. A severe reaction called anaphylaxis (due to swelling in the throat) can involve breathing difficulties and requires urgent medical attention. Treatment involves using adrenalin usually in the form of an "epipen" injection to reduce the reaction. Deaths from food allergy are rare in Australia.

Intolerance and allergy

Food allergies affecting only two-three per cent of children aged zero-six years are often confused with the more common reaction of food intolerance. There are many common symptoms including vomiting, stomach cramps or diarrhea however the difference is allergies involve an immune reaction and histamine release causing various forms of swelling around the body. Intolerances are less severe and the reaction can take a lot longer to appear, an example being lactose intolerance which causes bloating, gut distention and loose bowel motions. This is due to the body being unable to break down the sugar found in milk (called lactose) causing wind, stomach cramping and diarrhoea until the body has expelled it.

Can allergies be prevented?

It appears food allergies are on the increase which is driving further study in this are. Recent research presented at the 2008 CNRC (Children's Nutrition Research Centre) Conference at the Royal Brisbane Hospital has shown that there doesn't appear to be any link between changing the mothers diet or delaying the start of solids in babies and decreasing children's risk of developing a food of allergy.

What should you do if you suspect reaction?

If you suspect a child in your service is having a reaction try to calm them down, especially if they are vomiting and explain that their body is trying to tell them it doesn't like the food and is getting rid of it. Use a damp cloth on their face to cool them down and make them feel better. Offer sips of cool water only – nothing fizzy or sweet and plenty of reassuring cuddles. If they complain that it is hard to breathe, their voice becomes hoarse, they become dizzy or they become limp and floppy call an ambulance.

Once diagnosis of an allergy has been made it is important to eliminate all traces of the food from the child's diet. Sometimes there are traces of the food or it is listed under another name in our everyday foods; for example milk may be listed as caseinates in a muesli bar or cake.

Box 1 Culprits

The most common triggers are:
  • Peanut and tree nuts
  • Hen's eggs
  • Cow's milk
Less common is:
  • Seafood
  • Sesame
  • Soy
  • Fish
  • Wheat

Box 2: Recommendations to minimise the risk of allergies in children as much as possible are

  • Wherever possible encourage breastfeeding babies for at least four-six months
  • Do not introduce solid foods (anything other than breast milk or formula) before four months of age
  • If you suspect an allergy advise the parents/carers.
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