Managing food allergies in babies & children

Did you know that about 10% of children aged up to one year will be affected by a food allergy! Whilst this does improve with age, dropping to a rate of 8% of children up to age five being affected by a food allergy, it is undoubtedly a challenge to manage for many parents of young children affected by a food allergy. In this article, we explore what food allergies are, and provide some of our top tips to help manage food allergies in children. Of course, it is essential that you connect with your child’s healthcare professional team to discuss their individual needs and management plan.

 What is a food allergy?

An allergic reaction involves the immune system reacting to a usually harmless substance, this could include food, pollen, animal dander or dust mites. It can also include medications or insect bites. In children with allergies, the body mounts an immune response producing antibodies to the allergen to combat the foreign substance.

Symptoms of a food allergy can be mild to severe, and may not always be obvious like colic, eczema, poor growth or ongoing loose bowel actions in babies.

They may range from:

          - Swelling of the face, lips, eyes

          - Hives or rash on the skin

          - Abdominal pain

          - Vomiting

          - Noisy breathing

          - Swelling of the tongue

          - Swelling or tightening of the throat

          - Wheezing or a persistent cough

          - Collapsing

         - Pale and floppy

Sometimes allergic reactions can become so severe that anaphylaxis occurs. This is a less common type of allergic reaction – however, it is important to know how to manage anaphylaxis if and when it occurs, as it can be life threatening. More on this later in this article.

Diagnosing food allergies in children requires a medical professional, typically an allergist or immunologist. A typical consultation will involve taking a thorough medical history for your child and also performing some tests such as a skin prick test. This is where a range of common allergens are introduced to tiny pricks on the surface of your child’s skin, before measurements are taken of the size of the skin reactions if any (which typically appear as a red, raised wheal) after a certain amount of time. Alternatively, your doctor may order some immune blood tests, this helps confirm or exclude potential triggers.

Some of the most common allergens include:

              - Peanuts

              - Tree nuts

              - Fish

              - Eggs

              - Milk (a2 Milk™ products are not suitable for children with a cow’s milk protein allergy)

              - Wheat

              - Soy

               - Sesame

               - Shellfish

              - Lupin (a type of legume)

Food allergies are sometimes confused with other adverse food reactions, commonly referred to as food intolerances, which do not involve the immune system.

Learn more about food intolerances and managing them in childhood here .

How to manage food allergies in infants and children

Managing a food allergy can be tough, especially when your child has multiple food allergies.

Strict exclusion of all allergens is required to avoid an allergic reaction. Your healthcare professional will advise which foods need to be excluded. They will also be likely to prescribe you an adrenaline autoinjector (otherwise known as an epipen). This is for the quick delivery of adrenaline into your child’s upper thigh in the case of a severe allergic reaction or anaphylaxis where your child is having trouble breathing. The adrenaline is delivered directly to the bloodstream and helps to regulate your child’s breathing and blood pressure, as these can be affected when your child is experiencing a severe allergic reaction like anaphylaxis.

Your healthcare professional will give you an allergy and anaphylaxis management plan when you are prescribed an autoinjector and this should be provided to your child’s regular caregivers, daycare and/or school.

If your child is having a severe allergic reaction or anaphylaxis, please call 000 or your local ambulance number for immediate medical attention, even if you have administered an adrenaline autoinjector.

The day-to-day of managing a food allergy may feel overwhelming at first. Taking a look through your pantry and fridge for food items that may contain the allergens your child is reacting to, is a good place to start. 

A great strategy many families use is to create a separate container of allergy-safe foods for their child with allergies and keeping foods that contain an allergen that your other children or family members use out of reach.

 Speak to your dietitian about any potential foods that you may have overlooked that are likely to contain the allergen your child is having a reaction to. For example, if your child is allergic to soy, you should be aware that many common breads contain soy flour. If you’re uncertain about the ingredients used in a particular product or in a particular restaurant dish when dining out, the motto is: If in doubt, leave it out. It isn’t worth the risk of a potential allergic reaction.

You will also need to be mindful of cross-contamination in the kitchen. For example, if one of your children has a wheat allergy, and your family shares the same toaster where both wheat and non-wheat breads are toasted, there will be a high risk of cross contamination. A great work around is to get a wheat-free toaster dedicated for your child with a wheat allergy to reduce the risk of cross-contamination by any wheat crumbs.

Top tips for managing your child’s food allergies

 - Get familiar with food labels - even if you’re familiar with the product, companies can reformulate their products without you knowing, so regularly checking the nutrition information panel, ingredients list and allergen warnings is important to ensure you don’t accidentally slip-up. Learn more about food labelling for food allergies here.

 - Social occasions like parties can be challenging. Having a conversation about your child’s allergy with those who care for them and supply food for them (including day care, pre-school, school, other family members or friends) is important. Don’t be afraid to call ahead, and discuss with caterers about your child’s dietary needs and ask again on arrival and when ordering to confirm which foods need to be avoided by your child. Top tip: always order first so your details aren’t missed!

 - Check your child’s medications and any other products they ingest (like supplements) for allergens, ask your doctor or pharmacist if you’re uncertain.

  - If your child has been prescribed an adrenaline autoinjector, ensure it is physically with them at all times, and restock when it is close to expiry.

  - Connect with an allergist or clinical immunologist.

  - Speak with your local dietitian  with an interest in childhood allergies.

Having a child with a food allergy can be challenging, especially if your child has multiple food allergies. However, getting the right information, finding a supportive healthcare team, and learning how to navigate the supermarket and your child’s dietary needs over time will eventually become second nature to you as you learn how to keep your little one happy, comfortable and most importantly safe.

Article written by accredited practicing dietitian & nutritionist, Stefanie Valakas.

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