From peanut-free school lunches to gluten-free birthday parties. If it seems like more and more kids have food allergies these days – you’re not alone in that thought. Most likely you’ve even had discussions with other parents about how food allergies weren’t an issue when you were growing up, and that everyone ate peanut butter and jelly sandwiches “back in our day.”
Food Allergies on the Rise
The fact is food allergies are more prevalent than they were just a few decades ago. One in 13 children now have food allergies, which is equivalent to two students per class. The most common food allergies are milk, egg, peanut, tree nuts, soy, wheat, fish and shellfish. Sesame is an emerging allergy.
So why are children getting more food allergies? There are a couple reasons. First, what we eat has dramatically changed. We now have a more industrialized diet, in which foods are being modified for factory farming, processing and mass distribution. We’re also too clean. We sanitize everything - our hands, our homes and our work environment. Food allergies are developed when the body’s immune system thinks a certain food is harmful and the person becomes sick whenever the food is eaten. Basically, our immune system is fighting things it doesn’t need to fight.
Food Allergy Facts
While there is certainly more awareness about food allergies there is also a lot of misinformation out there. Here are some important facts to keep in mind.
Fact #1: Food allergy is not the same as food intolerance.
Most people don't understand there is a big difference between the two. A food allergy involves the immune system and can be life-threatening, while a food intolerance tends to only be the GI system and is never life-threatening.
Someone with a food allergy can never eat the food they are allergic to because they’ll have a reaction each and every time. During an allergic reaction, the immune system releases histamine and other chemicals to try and fight off the food allergen. Symptoms can also impact more than one body system, which include:
Skin: hives, rash, itching
Lung: repetitive cough, difficulty breathing
Abdomen: immediate vomiting and/or diarrhea
Mouth: swelling tongue and lips
Nose: immediate runny nose, sneezing and itching
Throat: change in voice, trouble swallowing, drooling
Heart: fainting, dizziness, loss of conscience
Other: sense of impending doom, doesn't feel right
Timing of symptoms is also key. Food allergy symptoms usually happen within two hours of ingesting the food. So a kid that wakes up the next day and complains of a bellyache is not having an allergic reaction.
Kids with food intolerances have trouble digesting food and may experience belly pain, gas and constipation. The most common intolerance is to lactose, which is a natural sugar in milk.
Fact #2: Most foods cannot cause an airborne reaction.
A significant allergic reaction can only happen when the food is ingested. Walking in a room where there’s an open jar of peanut butter and smelling the food won’t cause someone with a peanut allergy to have an allergic reaction. (It is possible for someone to have a reaction if someone is cooking fish.)
Many schools have peanut-free or allergen-free lunch tables but isolating kids from friends is not the answer. School-aged children can safely navigate the world by not sharing food and washing hands properly.
Fact #3: Soap and water - not hand sanitizers - are best to protect against food contact.
Some people who come in contact with a food may develop a rash at the site of contact. Washing with soap and water is the only way to stop the reaction from progressing. Hand sanitizers don’t kill protein and therefore cannot prevent or protect your child from a contact reaction.
The same is true for cleaning tabletops. A soap-based cleaner must be used. Simply using a wet rag won’t work.
Fact #4: All food allergic children should carry epinephrine.
Antihistamines can be used to relieve mild allergy symptoms, such as a skin rash or a one-time episode of GI symptoms. However, if a child is having anaphylaxis (a two-body system reaction such as a rash or swelling and vomiting) or difficulty breathing the child needs an injection of epinephrine.
A delay in treatment can be life-threatening, so its important children with food allergies have an emergency plan, have an epinephrine injector on hand and know how to use it. It is important to have 2 injectors with the child and not split a 2 pack up, as some children will need the second dose. After using epinephrine or if you’re with a child and they don’t have an injector call 9-1-1 immediately.
Fact #5: Kids with food allergies can enjoy activities such as going out to eat.
The only way to treat a food allergy is avoidance of the allergen, so preparation is key. You can go out to eat, but plan ahead. Look at the restaurant’s website and ingredients. Call ahead and ask how food is prepared and if accommodations for food allergies can be made. Avoid buffets and salad bars where cross-contact from food allergens may occur. Carry a “dining out card,” which displays the food the child is allergic to that can be given to the chef. Kids can carry the cards so if they’re at a restaurant without their parents they can take responsibility for their food allergy and feel more involved in their treatment.
It’s not just restaurants. Pack safe snacks for school and birthday parties, so kids can eat with everybody else. Same goes for when you fly with your children. In the airplane, be sure to wipe down tray tables and seats, and practice good hand-washing habits. Avoid letting small children crawl on the airplane floor.
Fact #6: Although not a cure, a new option is available to treat peanut allergy in children and adolescents 4 to 17 years old.
To prevent life-threatening allergic reactions, children with peanut allergies are taught to avoid peanuts, ask what’s in food before eating it, check nutrition labels and always carry 2 epinephrine autoinjectors. That can work well, but there is always a risk of accidental ingestion and reaction. A new FDA-approved treatment, PalforziaTM, may help children and their parents worry less by reducing the severity of allergic reactions caused by accidental ingestion of peanuts.
Palforzia is an oral immunotherapy and works by exposing the child to a small amount of peanut, so they become less likely to have an allergic reaction if they accidentally eat a peanut product. It’s important to know that the treatment has its risks and is not a cure. Whether or not they are taking Palforzia, if a child with a peanut allergy has a reaction, they should inject their epinephrine and call 911.
Food allergies can be scary and life-threatening, but with the right education, kids can live a very happy, healthy and normal life. And while food allergies aren’t the norm, we want it to become the norm to treat kids with food allergies like everyone else. If your kids come into uncomfortable situations or you think they are being bullied, encourage them to talk to you or their teacher.