Food allergies can come in different forms and via a variety of foods. From cow’s milk, eggs, soy and wheat to tree nuts, sesame, fish and shellfish, there are a host of foods that affect children (and adults) and present as rashes, tingling or itchiness, swelling, difficulty swallowing and even difficulty breathing. The question we, as paediatric dietitians, often get asked is, “can I prevent food allergies in my child?”, and the simple answer is yes.
Let’s first look at exactly how widespread food allergies in children are in Australia and why they’ve been on the rise in recent times… About 10 percent of babies less than one year of age have food allergies. This number falls to between 4 – 8 percent in children under 5 and 5 percent in 10-14 year olds. Interestingly, food allergies are prevalent in only 2-4 percent of adults, showing that as we mature, allergies reduce.
Allergies to cow’s milk, egg, soy and wheat usually resolve in childhood (though they’re persisting longer than they used to). Milk and egg allergies commonly resolve by 3-5 years of age. Allergies to peanut, tree nuts, sesame, fish and shellfish, however, are more likely to persist into adulthood. It’s also true that children are less likely to outgrow their allergies if the reaction is more severe.
Why is The Prevalence of Food Allergies Increasing?
We don’t really have a good understanding of why food allergies have increased so quickly over recent times, increasing more rapidly in young children. From what we know, there appears to be many factors involved, including the Western lifestyle, the environment, genetics, delayed introduction of allergens, food processing methods, skin exposure to allergens, the use of medications to reduce gastric acids, improved hygiene (resulting in reduced childhood infections) and Vitamin D status.
Can I Prevent my Child from Developing Food Allergies?
The keys to preventing food allergies appear to be:
Introduction of common food allergens before one year of age, especially peanut, egg and cow’s milk.
Research shows that introducing peanuts in the first year of life can reduce the risk of developing a peanut allergy by 80% in high-risk children. A high-risk child is one with severe eczema and/or an egg allergy.
Optimal management of eczema
Food allergies do not cause eczema, though children with eczema appear more prone to food allergies (as well as hay fever and asthma). Research suggests that food allergies can develop through skin exposure if the skin is broken down due to eczema, also known as sensitisation. The use of creams or moisturisers that contain nut oils, on inflamed skin, can cause allergies to foods. Children with eczema have been found to be more likely to develop a peanut allergy if other people in their house consume peanuts due to peanut dust exposure or due to being touched by others who have been eating peanuts.
Foods are more likely to be tolerated if first exposures are through the mouth and gut rather than through the skin.
The ASCIA (Australian Society of Clinical Immunology and Allergy) guidelines for allergy prevention include:
- When your infant is ready, at around 6 months, but not before 4 months, start to introduce a variety of solid foods, starting with iron rich foods, while continuing breastfeeding. If breastfeeding isn’t possible, a standard cow’s milk infant formula should be used until 12 months of age (unless there is a diagnosed cow’s milk allergy).
- All infants should be given allergenic solid foods including peanut butter and tree nut pastes, well cooked egg, dairy, wheat products, soy, sesame, fish and shellfish in the first year of their lives. This includes infants at high risk of allergy. Introducing the common allergy causing foods one at a time will make it easier to identify the problem food if an allergic reaction occurs at any point. If introduced foods are tolerated, be sure to include them in their diet regularly (twice per week).
Note: Hydrolysed (partially and extensively) infant formulas are not recommended for prevention of allergies. These formulas are often called HA or hypoallergenic formulas and are cow’s milk-based formula in which the milk proteins have been broken down into smaller components.
Despite following the above guidelines, some children will still develop food allergies. It’s important that parents and carers learn to recognise the signs of an allergic reaction and how to manage it. If you suspect your baby has developed an allergic reaction to a particular food, stop giving that food and seek medical advice. If you require help in managing food intolerances or allergies, get in contact with SS Diets.
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