For many of us a sniffly nose and itchy eyes when the summer rolls around is all too familiar. We call our hay-fever ‘hellfever’ to make light of it. But for some people, allergies are a much bigger issue. The number of people living with allergies in the UK is rising by 5% every year. Figures from 2012 suggest at least 1 in 40 children in the UK are suffering from at least one serious allergy. In the last decade, A&E departments have seen a huge increase in anaphylaxis admissions. When it comes to parenting a child with food allergies? It’s a different ballgame all together.
An allergy happens when your little one’s immune system reacts to a substance that’s usually harmless. Food, medication, washing detergents, pets, pollen, dust mites and mould are all allergens that can irritate us. Though they can be common, allergies in babies, infants and kids can be harder to identify because it’s trickier for them to tell us what’s going on.
Risky, even fatal
Parenting a child with food allergies can be particularly distressing. They can be incredibly risky, even fatal. When someone eats even a small amount of a food they’re allergic to, a minor reaction can cause itching, swelling or stomach ache. One in four people have food allergies and even those mildly affected will at some point experience anaphylaxis – a state of shock defined as a reaction involving two of the body’s organs. Anaphylaxis is usually characterised by symptoms like wheezing, dizziness and vomiting. The number of fatal cases has been on the increase in recent years.
But, as parents, how do we know what we’re looking out for? How do we know when to seek help?
Signs and symptoms
Consultant Paediatrician and allergist Dr Nick Makwana explains: “There are two types of allergies that can present. First of all, there’s IGE mediated allergy, which is a type of allergy where we understand the underlying mechanism. And it’s mediated by a molecule called IGE. This is a type of allergy that most people understand and are aware of. Very soon after eating a food you’re allergic to, you would get lip swelling, eye swelling, or a hives kind of rash appearing. This is also the type of allergy that can lead to anaphylaxis.”
Dr Makwana adds: “The second kind of allergy is what we call Non-IGE mediated allergy. And it is called that because we know it happens, but we don’t really understand the mechanism for it. And this is a type of allergy whereby two to 25 hours after eating, you may get a flare up of eczema occurring, you may get worsening of reflux, you may develop runny stools. In some babies you might get fresh red blood in the stool while the baby remains otherwise well. If you have it, sometimes it can cause abdominal pain and lead to significant and prolonged crying episodes.”
How are allergies diagnosed?
Because it’s often harder for babies and toddlers to tell us what they’re experiencing, they tend to be diagnosed based on the symptoms parents tell doctors about. “If we think your baby has got an IGE mediated or an immediate type of allergy,” explains Dr Makwana, “then we might use skin testing to diagnose, where we put little blobs of water on your skin, and then use a small lancet to prick through. We’ll then wipe the blobs of water off, which will contain a bit of protein from the allergen we’re interested in. And then we’d wait 10 minutes to see if you’ve got a little red lump. The size of that red lump tells us whether or not you have an immediate type allergy. These types of allergies can also be diagnosed using blood tests.”
If you think your baby has a non-IGE mediated allergy, things are a little less straight-forward. “There’s no test available for this, because we don’t really understand the mechanism,” explains Dr Makwana. It’s about diet exclusion and reintroduction.
“For example, if your baby has severe eczema, you’re using the appropriate creams and the eczema is not improving and we suspect it may be driven, for example, by cow’s milk, we may suggest you remove cow’s milk from the diet for a period of four weeks to see if there’s an improvement in the eczema. And then we would ask you to reintroduce it for four weeks to see if there’s a deterioration.”
Tanya Laperouse, founder of Natasha Allergy Research Foundation aka NARF, whose daughter Natasha had severe allergies agrees that when parenting a child with food allergies, it’s often about parental instinct. “If you suspect your child has a food allergy ask your doctor, don’t try to medicate or treat them yourself. Ask for allergy testing as soon as possible.”
What’s the best way to manage allergies?
There are numerous ways to manage allergies and they all depend on the type and severity of the allergy. When it comes to excluding food from diets completely, it’s really important that a dietician is involved. They can help give a better understanding of avoidance. This might include how we make sense of food labels, but also make sure there’s alternatives for whichever food has been excluded.
For those non IGE mediated allergies, managing symptoms is trickier. Many symptoms may already be things we’d see in childhood anyway. Eczema and reflux for example are already common in babies and might not be directly related to an allergy. The priority then would be making sure we’re treating the underlying problem correctly.
Dr Makwana explains: “The best way to manage allergies is to get the correct diagnosis using the appropriate methods and tests. Once you’ve done that, the next step is to exclude the food that’s causing or suspecting the allergic reaction. And to make sure that we’re doing this properly, we’d need to have a dietitian involved. And that dietician would also make sure or that appropriate alternative substitutes are available for whatever food is being excluded”.
Do kids grow out of allergies?
According to WexnerMedical, eight foods make up more than 90 percent of all food allergies: egg, milk, wheat, soy, peanuts, tree nuts, fish and shellfish. The good news is about 80 percent of people with egg, milk and wheat allergies outgrow them, usually by age 16. About 20 to 25 percent of children with peanut allergies outgrow them. 80 percent of those who do will do so by age eight. Allergies to tree nuts, fish and shellfish may be tougher to outgrow and are often lifelong.
When children don’t grow out of allergies, it is possible to learn to manage them. Tanya explains: “Upon an allergy diagnosis, don’t panic. Arm yourself with as much allergy information as possible, there is a lot out there. Follow an allergy charity for information and to connect with other parents and carers of allergic children. It is a caring community that is very supportive of each other. Start spreading allergy awareness.
Tanya adds: “A big worry for those parenting a child with food allergies is that people without allergies, including family, friends and school teachers don’t understand their dangers so there is a need to educate everyone that comes into your child’s life on what they must or mustn’t do round your allergic child. Empower your child to not be afraid of their food allergies but to respect their dangers. It’s not an easy balance to find but it is achievable. Make sure you get lots of support because stress can build-up and be quite overwhelming especially in the early days of diagnosis.”
Where to get support
Tanya and her husband launched The Natasha Allergy Research Foundation, a charity that is a legacy to their daughter Natasha who died from her allergies aged 15. Here, they have created a space for research, campaigning and support. If you’re a parent of a child with allergies, you’ll find support on their blog.
Allergy UK is also a valuable resource for those living with an allergy and parenting with an allergy.
If you’re parenting a child with food allergies, however severe, know you’re not alone.