90 | April 2013 www.womanthismonth.com To treat a food allergy you must first understand the nature of the culprit behind the allergic reaction experienced by your child. There are two types of allergies which could be causing the irritation. The first is a fixed food allergy and is usually quite obvious to detect. After ingesting peanuts, your child’s lips swell up and their throat immediately starts to itch. The cause of this reaction is similar to inhalant allergies, so the diagnosis is more easily ascertained. Blood testing (such as a RAST test) is typically used to verify fixed food allergies. Approximately five to 15 per cent of food allergies are of the fixed variety. The second type is a cyclic (delayed) food allergy that is far more common but less implicit. In this instance, symptoms can take up to three days to appear and the reaction is associated with the body’s immunoglobulin G (IgG), or antibodies. Unlike fixed food allergies, this allergic response is cyclical in nature. For example, a child may be IgG sensitive to milk; consequently, symptoms might appear if the child increases the intake and/or frequency of milk consumption. Children and adults are equally susceptible to food allergies. The bad news for children is that they often have more skin reactions, such as eczema, to foods than do adults. But the good news for the young patient is that a child often outgrows their food sensitivities over time, even when a positive RAST test occurs. Unfortunately, while food allergies may dwindle, inhalant ones, such as those associated with dust and pollen, tend to subsequently manifest themselves. Dealing with allergies Your paediatrician may suggest eliminating a food type from your child’s after undergoing an ‘Elimination and Challenge’ diet. This test consists of the three primary steps. Firstly, keep a meticulous food diary, tracking what was eaten (including ingredients), when it was eaten, any medications that are taken, and any symptoms that develop. Your child can receive the best diagnosis if the diet records are precise, timed accurately and candid. The second step is to conduct your own elimination and challenge diet at home based upon your paediatrician’s assessment of your child’s diet diary. During this diet your child must refrain from one, and only one, of the probable food offenders at a time for a period of four days. Any cheating will invalidate the results. On the fifth day, you will be asked to feed your child the suspected offender. This is the challenge! Offer your child an average-sized portion of the food in question to be eaten in five minutes. In one hour the child should eat another half portion if no symptoms have developed; any that do are then timed and recorded. With a true cyclic food allergy you would expect a substantial worsening of the symptoms described in the original diet diary, although the challenge symptoms may vary as well. The final step, if the Elimination and Challenge diet confirms a cyclic food allergy, is to abstain from feeding your child this food for a period of three to six months. After this time you can gradually reinstate the food on a rotary basis; but it should not be eaten more often than every four days. Fixed food allergies should never be intentionally challenged except under the direct supervision of a physician. For feedback, comments or questions contact Dr Jinan Darwish via email at: [email protected] Parents and guardians of children with food allergies must be able to tell the difference between a mild or moderate allergic reaction, and a severe life-threatening one known as anaphylaxis. Without this knowledge, the child’s life can be put in jeopardy; anaphylaxis necessitates an urgent injection of adrenaline with an EpiPen. Signs of a mild to moderate allergic reaction: l Hives l Swelling of the lips, eyes or face l Vomiting and abdominal pain Signs of anaphylaxis include any of the preceding signs together with these: l Persistent coughing l Wheezing or noisy breathing l Difficulty breathing l Hoarse voice l Loss of consciousness or collapse l Pale and floppy (infants and young children) Tips for Detecting Allergies Parenting Column Managing Food Allergies Every playgroup has one; the mum who examines every last morsel in her bundle of joy’s lunch box because she has allergies.
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