If you are a parent of one of the 5-8 percent of American children who has a food allergy, preparing your child for going back to school is an exhilarating, yet cautious proposition. A peanut butter and jelly sandwich and a glass of cold milk can be the perfect kid’s school snack. But, for a child with a specific allergy to one of those foods, this snack, which has potential food allergens (see box), can produce life-threatening reactions.
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8
TOP
ALLERGENS
eggs
milk
fish
shellfish
wheat
soy
tree nuts
peanuts
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There is documentation of allergies to many foods and food ingredients, but the most common food allergens are peanuts, tree nuts (such as walnuts and almonds), milk, eggs, soy, wheat, fish and shellfish. "These foods are responsible for over 90 percent of serious allergic reactions to food," according to Susan L. Hefle, Ph.D., co-director of the Food Allergy Research and Resource Program at the University of Nebraska-Lincoln. "Onset of food allergy in infants and children can depend on genetics and how early potentially allergenic foods are introduced into children’s diets."
Hugh Sampson, M.D., director of pediatric allergy and immunology at Mt. Sinai Medical Center, New York, reports, "If both parents have allergies, a child may be at greater risk to develop a food allergy. For such children, it is helpful to withhold introduction of food items such as peanut and nut products until after 3 or 4 years of age."
Food Allergy Basics
A food allergy, or "food hypersensitivity," is a reaction of the body’s immune system to a protein in a food or an ingredient. It is a serious condition involving the immune system, and should be diagnosed by a board-certified allergist.
Food allergy symptoms vary greatly among individuals and can be different in the same person under different exposures. Reactions to food can vary in severity and time of onset, and may be affected by how recently the food was eaten. Common food allergy symptoms include: gastrointestinal symptoms such as diarrhea and vomiting; skin irritations such as rashes, hives and eczema; and sneezing, runny nose and shortness of breath.
The most severe reactions lead to a rare but potentially fatal condition called anaphylaxis, which requires immediate medical attention. This is characterized by rapid onset of simultaneous reactions—itching, hives, swelling of the throat, difficulty breathing, lowered blood pressure and sometimes unconsciousness. Standard emergency treatment often includes an injection of epinephrine (adrenaline) to open up the airway and blood vessels. Individuals with severe food allergy reactions should set up a response plan with their doctor and learn how to self-administer epinephrine.
Anyone who believes they have a food allergy should obtain a diagnosis from a board-certified allergist. A registered dietitian can work with the patient, family and allergist to help food-allergic patients manage diet issues without sacrificing nutrition or the pleasure of eating.
Understanding Food Allergy at Home and School
At the July 1998 annual meeting of the American School Food Service Association in New Orleans, a panel of science and communication experts discussed the basics of food allergy, myths about food allergens, management of food allergy in day care and schools, and good sources of educational materials.
Living with and managing a food allergy for a child is very similar to some other health conditions that need to be controlled through diet. Children with food allergies need to make management and emergency preparedness part of their daily routine.
For children or adults with food allergy, strict elimination of the problem food is the only way to avoid an allergic reaction. Reading food labels and understanding the names of food ingredients made from the top eight food allergens is essential. As food manufacturers continuously refine and improve food products, food labels must be read for every product each time it is purchased.
In the school or day care cafeteria, personnel should know their products and ingredients by carefully reading labels. School managers, cooks, food service personnel and teachers should understand the symptoms of food allergy and have a plan if a child has a reaction.
When preparing and serving food, it is critical to make sure that food preparation and serving utensils are not exposed to allergens and then used for another food. "There could be enough peanut protein on a spatula that was used to lift peanut butter cookies and then used for sugar cookies to cause a reaction in a child," stated Dr. Hefle.
| New consumer and patient education brochure, Understanding Food Allergy.
New from the IFIC Foundation, Understanding Food Allergy provides general consumers, patients and parents with the basics of food allergy, food intolerance and food idiosyncrasy. It contains information on understanding symptoms, the need for proper diagnosis, label reading and emergency preparedness..
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The International Food Information Council (IFIC) Foundation has produced a poster to assist food service personnel in identifying the most common food allergens, recognizing allergic reactions and responding appropriately. The poster is written in English and Spanish and illustrates food allergens, lists symptoms and provides tips.
In the classroom, parents should work closely with teachers, school nurses and other staff to understand the needs of children with food allergy and ensure measures are in place to prevent allergic reactions and be prepared if a reaction occurs.
In recent years, there have been several reports of parents, schools and day care centers calling for a ban of allergenic foods to protect allergic children against a reaction. "Banning food eliminates numerous food choices and can limit balanced nutrition for non-allergic children," noted Robert Earl, M.P.H., R.D., IFIC’s director of public health. "It also goes against the central message in the Dietary Guidelines for Americans—eat a wide variety of foods in moderation."
The Food Allergy Network (FAN) has several materials to assist parents and school staff with food allergy management. "As a parent of a child that outgrew severe food allergies, I started the FAN to spread the word and empower parents with information that was lacking when I was first faced with managing food allergy," noted Anne Munoz-Furlong, president and founder, The Food Allergy Network. "With proper information, education and support, all those affected with food allergy can be prepared for emergencies and enjoy life to its fullest."
The good news is that many children outgrow food allergies. However, for those with lifelong allergies, learning about allergy management and making it part of your daily activities will provide for enhanced safety and a lifetime of food enjoyment.
For additional information, contact:
American Academy of Allergy, Asthma and Immunology
The Food Allergy & Anaphylaxis Network
International Food Information Council
