No Nuts, Please!

By Scott Klepach, Jr.

Parents have an endless list of things to worry about when it comes to their children, perhaps none more worrisome than food allergies.

Some skeptics say the increase in food allergies is an illusion fueled by parents’ worst fears and the media, but many doctors agree the rise in food allergies is a real problem, even if the reasons remain unclear.

“No one has any real understanding why there is such an increase,” said Dr. Nola Attaway, a pediatric allergist with Northwest Asthma and Allergy Center in Yakima. “In the countries that are industrialized, it’s moreso.”

“I see a lot of kids with food allergies,” said Dr. Heidi Robel, naturopathic physician and licensed acupuncturist in Yakima. “The question is, are we (simply) noticing it more? Yes, but it’s also increasing.”

A variety of foods will cause different symptoms. Robel said dairy, wheat and corn allergies typically produce eczema, chronic ear infection, worsened seasonal allergies, diaper rashes and even attention deficit hyperactivity disorder (ADHD). Nausea, vomiting, rashes and hives are other common symptoms. But other food allergies — those to peanuts, tree nuts and shellfish, especially — can be fatal.

“The body has made an antibody against a peanut,” said Attaway, adding that’s why symptoms can be so extreme.

One clear-cut and potentially fatal reaction is anaphylaxis, which can result from severe food allergies (to peanuts and other foods), bee stings or medication. Symptoms of anaphylactic shock might swelling of the lips and throat and difficulty breathing.

Attaway said it is important for parents of children with severe food allergies to have an anaphylaxis plan so they are fully prepared in the event a child goes into anaphylactic shock. This plan should cover mild and severe reactions. A few hives around the mouth with no other accompanying signs of shock — such as swelling of lips, trouble breathing, and fainting — can be treated first with an appropriate dose of Benadryl.

But symptoms can escalate quickly, and parents should have an EpiPen or similar auto-injector device always nearby. An EpiPen contains a dose of epinephrine, and when injected, the hormone can relieve a victim’s symptoms of anaphylactic shock — and ultimately become a lifesaver — until he or she can be taken to the emergency room.

Parents are advised to have their child tested if they are concerned about a food allergy, but doctors warn that individual tests may produce a false positive or false negative result.

“Someone may have a positive skin test, and be sensitive, but a skin test alone does not tell you they are allergic,” said Attaway.

Instead, a child might take both the skin-prick test and a blood test, but other factors are also considered, such as a record of suspected reactions and a look at any family history of various allergies.

“A lot of it depends on genetics. If dad has asthma and mom has seasonal hay fever, children have increased risk for food allergy,” Attaway said. “And if parents have some children who are allergic, that’s the biggest predictor of another sibling having a food allergy.”

Robel said diets today are not as clean as they used to be — foods are more refined and contain red and blue dyes, pesticides, hormones and antibiotics — which might cause more allergies. She recommends holding off introducing various foods to children until they reach a certain age.

“The immune system gets developed by two years of age,” said Robel. “Wait six months before introducing foods, and introduce fruits and vegetables first.”

Dairy, wheat and eggs should be introduced after six months, but Robel recommends waiting longer if there are allergies in the family.

Attaway said reading labels becomes essential for someone with a food allergy to avoid coming in contact with potentially fatal ingredients.

“Read the labels. If it says it may contain peanuts, avoid those,” Attaway said. “I’ve had patients come in who ate a blueberry muffin made on machinery exposed to peanuts. Those children who have a true, bona fide allergy should not eat those (foods).”

In fact, even the most unlikely foods could contain traces of peanuts: sauces, glazes, salad dressing, cookies, candy, pudding, specialty pizzas, some Asian and Mexican dishes, and pet food, according to the Food Allergy and Anaphylaxis Network (FAAN).

Attaway said many schools and day cares in the nation have gone nut-free, but she recommends that parents of children with food allergies pack a special goody bag of food and snacks so their kids don’t come in contact with other possibly problematic foods. Parents should also check with their child’s school about its policy regarding food allergies.

Attaway said there is a good chance children will outgrow certain food allergies, but most will continue to be prone to peanut, tree nut and shellfish allergies.

“They say up to 20 (percent) to 25 percent of children with (a) true peanut allergy can outgrow it, which is more than they used to believe,” she said. “But there’s no way of knowing which child can, and which child can’t.”

Children allergic to milk, wheat, egg and soy, however, have an 85 percent chance of outgrowing the allergy by age 8, and many of them show signs of outgrowing them by 3.

Jaclynn Bell’s children are living examples of how some people can outgrow a peanut allergy, even if their case is somewhat rare. All three of Bell’s children developed the allergy, but two of them outgrew it by age 4. Her second child, who is 2, still struggles with the allergy.

“The most difficult part of having a child with a food allergy is trying to explain the situation to someone who has never experienced or been around food allergies,” Bell said. “Having a peanut allergy can be one of the most dangerous allergies, and so many people don’t understand the severity of it. I have learned to read labels very well.”
Food Allergy or Food Intolerance?

Kids can react to foods in different ways, and it’s important not to assume they have food allergies.

“A lot of parents want to find a reason for it. Maybe it is an allergy, but there has been a lot of changes in food, with hormones and antibiotics,” said Dr. Judith Harvey of Yakima’s Family Medicine.

These changes could be contributing to the rise in adverse reactions in children, but Harvey advises parents to understand the difference between food allergies and food intolerance. She said while six percent of children suffer from some type of food allergy, up to one third of children experience food intolerance.

“Allergy and intolerance aren’t the same thing,” she said. “Diarrhea from cherries isn’t an allergy.”

Resources

Here are some great resources for parents of children with food allergies:

Mayo Clinic. The website lists the eight most common food allergies and their symptoms. These food allergies are milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat. The site also provides tips on reading labels properly and how to allergy-proof your house. mayoclinic.com/health/food-allergies/AA00057

Food Allergy and Anaphylaxis Network (FAAN). “This is the best resource for parents,” said Dr. Attaway. The website offers a wealth of information on all major food allergies and includes a link to a useful pamphlet called “The Peanut Answer Book.” Attaway noted that a toll free number is available any time of day or night if parents need to call to ask questions. foodallergy.org

Kids With Food Allergies. A non-profit organization that promotes and develops plans for children with food allergies to live nutritious and healthy lives. The group focuses on educating the public about food allergies and providing networking to those with food allergies. kidswithfoodallergies.org

Sunbutter is an alternative to peanut butter, and the company states it is peanut-free, tree nut-free, and gluten-free. The website also offers a variety of recipes to make the most out of the product as well as other safe ingredients. sunbutter.com

Filed under Featured Stories, From the Mag, Health