Food allergies are on the rise, but still remain uncommon in little ones, and are very often outgrown. It helps to be aware of the symptoms, and to know where to turn. The best advice is not to panic, and to talk to your doctor if you have any concerns.
Q: How will I know if my baby has a food allergy?
A: Food allergies are much more common among children in families with a history of allergy. Babies who suffer from eczema are particularly at risk—and the more severe the eczema, the more likely there is to be a food allergy. Some food allergies are fairly easy to spot—as soon as the food is eaten, often for the first or second time, a reaction occurs (see Immediate food allergies).

Delayed allergies may also be a problem for infants. In the past, these were sometimes called food intolerance, but this isn’t the correct term, because an intolerance doesn’t involve the immune system. Delayed allergic reactions do involve the immune system, but parts of it that take longer to respond. This means it can be difficult to pinpoint a particular food as the problem, as sufferers may continue to eat and drink it. Milk, soy, egg, and wheat are often the main culprits, and symptoms include eczema, reflux, colic, poor growth, diarrhea and constipation (see Delayed food allergies). These get better only when the food is removed from the diet. However, all of these symptoms commonly occur during childhood and an allergy is only one possible explanation. You’ll need the help of an experienced doctor to diagnose a food allergy (see How are allergies diagnosed?).

Q: We have a family history of allergies; should I avoid certain foods?
A: A If you have a history of allergy in your family (including asthma, hayfever, eczema, as well as food allergies), and your baby suffers from eczema, she is more likely to have food allergies.

It was thought that potentially allergenic foods (milk, eggs, tree nuts, shellfish, seafood, wheat, and soy) should be avoided until babies are a year old, and peanuts for the first three years of a child’s life. However, some recent studies have suggested that there is no value in delaying the introduction of these allergenic foods.

The jury is still out regarding what the best weaning policy is for babies at risk of food allergies, and more research is required. If your baby is in this “high-risk” category and you’d like more advice, it is a good idea to see your doctor or a dietitian.

Q: How are allergies diagnosed?
A: If you suspect an allergy, you must see a doctor with experience in allergy. There are many private allergy tests available, such as hair analysis and kinesiology, however these are costly, inaccurate, and can put your baby’s health at risk.

The best way to diagnose immediate allergies, where the reaction occurs within two hours, is with a skin prick test and/or a blood test. These determine which foods, if any, are triggering allergic symptoms by detecting the presence of antibodies called IgE—which help to identify the problem foods. The allergens that will be tested are usually those about which you have expressed concern, although your doctor may also test other foods in the same group, other common foods (from the “big eight,” for example: cow’s milk, wheat, soy, fish, shellfish, eggs, peanuts, and tree nuts), or anything else that appears possible. The results must be interpreted by an experienced doctor.

Q: What about delayed food allergies? Are these very difficult to diagnose?
A: If your baby experiences a delayed reaction to a food (where symptoms take up to 48 hours to appear), the best way to diagnose the allergy is for you to keep a food and symptom diary, and eliminate the suspected food or foods for a minimum of two weeks, and see if the symptoms cease. The foods need to be reintroduced under the supervision of a doctor or dietitian who are experienced in allergy. It’s never a good idea to try an elimination diet without support from an expert, because the nutrients lost in key parts of your baby’s diet are crucial to his growth and development, and will need to be replaced.

Immediate food allergies

Moderate symptoms

These typically affect the skin, the respiratory system, and the gut. Seek medical advice.

  • A flushed face, hives, or a red and itchy rash around the mouth, tongue, or eyes. This can spread across the entire body

  • Mild swelling, particularly of the lips, eyes, and face

  • A runny or blocked nose, sneezing, and watering eyes

  • Nausea, vomiting, tummy cramps, and diarrhea

  • A scratchy or itchy mouth and throat

Severe symptoms (anaphylaxis)

This an emergency—call 911.

  • Wheezing or difficulty in breathing

  • Swelling of the tongue and throat, restricting the airways. This can cause noisy breathing (especially on breathing in), a cough or a change in your baby’s cry or voice

  • Lethargy, limpness, or collapse

Delayed food allergies

Symptoms include:

  • Eczema

  • Reflux

  • Poor growth

  • Swelling in the small bowel

  • Constipation and/or diarrhea

  • Raising knees to chest with tummy pain

  • Frequent distress and crying

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