Food Allergies in Infants and Children

1. Food Allergies in Infants and Children • Shana Spector

2. Food Allergies in the U.S. • More than 6 million Americans suffer from food allergies • 3 million specifically allergic to peanuts, walnuts, and pecans • Other common food allergies: milk, fish, shellfish, wheat and soy

3. What Causes Allergic Reactions? • Overactive immune system • Body believes a substance is harmful • Body wants to protect itself by fighting that substance off • Immune system releases chemicals and histamine, triggering the reaction

4. IgE Mediated Allergy Disorder • Cause acute onset of symptoms after digestion • Affect skin, respiratory tract, gastrointestinal tract and cardiovascular system

5. IgE Mediated Allergy Disorder • IgE antibodies are cells that are released from specialized B cells during contact with allergen • IgE antibodies attach to IgE receptors on mast cells

6. IgE Mediated Allergy Disorder • If the allergen is again presented in the body, it binds to surface of mast cell, triggering release of histamine and other chemicals • Picture and animation

7. Types of IgE Mediated Disorders • Type 1 Hypersensitivity: most common disorder • Symptoms include hives, swelling of face, itching, vomiting, diarrhea, coughing, wheezing and decrease in blood pressure

8. Types IgE Disorders • Oral Allergy Syndrome • Caused by allergies to fruits and veggies • Itching swelling of lips, tongue, palate and throat

9. Types IgE Disorders • Respiratory Hypersensitivity Reaction • Effects respiratory tract • Causes runny nose, nasal congestion, wheezing and coughing

10. Types IgE Disorders • Airborne Food Allergy Reaction • Transpires from smelling an allergen through cooking • Causes nasal congestion, inflammation of the eyes and hives

11. Types IgE Disorders • Food-Associated Exercise-Induced Anaphylaxis • Occurs when allergic person exercises 2-4 hours after eating certain foods • No reaction without exercise • More common in females (esp. teenagers)

12. Other Food Disorders • Subacute or chronic • Usually affect gastrointestinal tract • Mediated by T cells • Mainly found in infants and children • Usually caused by hypersensitivity to cow’s milk or soy

13. Symptoms of Food Allergies • Hives are most common • Other symptoms: tingling in mouth, swelling in the tongue and throat, difficulty breathing, abdominal cramps, vomiting, diarrhea, and eczema

14. Anaphylaxis • Serious allergic reaction occurring within a few minutes to two hours after contact with allergen • Acute and potentially fatal • Causes 300,000 hospital visits and 150-200 deaths per year

15. Infants, Children and Food Allergies • 6-8% of children develop food allergies within the first three years of life • 90% of food allergies in kids involve cow’s milk, egg, peanut, wheat, soy, tree nuts, or fish

16. Infants, Children and Food Allergies • Most children outgrow their allergies to milk, egg, wheat and soy by age 3-5 • Only 20% of infants with peanut allergy will eventually tolerate peanuts

17. Problems Associated with Food Allergies in Children • Poor nutrient intake • Constipation • Eczema • Potential death

18. Food Allergies Linked to Poor Growth • Increased risk for poor nutrient intake • Parents may eliminate too many foods from child’s diet or neglect to supplement • In severe cases, children can develop failure to thrive

19. Studies Showing Poor Growth • Children with one or more food allergies more likely to be under 25th percentile height for age than healthy children • Subjects with 2 or more food allergies significantly shorter than children with 1 • Children with specific allergy to cow milk showed lower height for age than healthy children

20. What to do if Child has Food Allergies • Consult with an allergist and dietician • Use growth charts often to assess child’s growth

21. Food Allergies and Constipation • Recent studies have linked infantile constipation to cow’s milk allergy • Study shows infants switching to soy milk from cow milk alleviates constipation • Study shows 5 year olds eliminating milk protein from diet and no longer suffering from constipation

22. Food Allergies and Atopic Dermatitis • Atopic dermatitis: skin condition associated with food allergies in infants and children • Atopy: refers to a tendency for excess inflammation in the skin, linings of the nose, and lungs • Eczema usually runs in families

23. Food Allergies and Eczema • 10% of infants suffer from eczema • Skin becomes infected, with itchy rashes on face and scalp

24. Food Allergies and Eczema • Study suggests that introducing solid food later in life will decrease prevalence of eczema • Low-birth weight significantly correlated with a lower risk for food allergies and atopic dermitis

25. Potentially Deadly Reactions • Most severe reactions in children: peanuts and other tree nuts • Many are accidental: hidden nuts in brownies and cookies, peanut oil, etc. • Symptoms progress with maturity • Skin reaction during infancy to respiratory and gastrointestinal reactions later

26. Maternal and Familial Influence on Food Allergies • Food allergies and atopy run in families • 20% of children with eczema are the only one in family with problem

27. Maternal Influence and Possible Prevention • Prevalence of peanut allergy is rising • Pregnant women advised to eliminate peanuts from diet • Allergy to peanuts may be preventable

28. Breastfeeding Mothers • Breastfeeding may prevent food allergies and atopic dermatitis • Can pass peanut allergy through breastfeeding • It is recommended for mom to eliminate peanuts from diet while breastfeeding

29. Prevention of Cow’s Milk Allergy • Hydrolysated formula • Extensive or partially • Only given to babies at high risk for atopic disease due to family history

30. Prevention of Cow’s Milk Allergy • Babies given eHF combined with breast milk and no solid food until after 6 months of age • Prevalence of food allergy and atopic dermatitis significantly reduced • Babies given eHF or pHF: atopic disease greatly reduced in those given eHF

31. Diagnosis of Food Allergy • What happens in the case of a mild reaction? • What happens in the case of a severe reaction?

32. Tests and Procedures to Determine Food Allergy • Skin Prick Test • Identifies food specific IgE antibodies • Test is either negative or positive

33. Tests and Procedures to Determine Food Allergy • Radioallergosorbent Test (RAST) • Done if test positive on SPT • RAST is a blood test to determine food specific IgE • RAST and SPT detect sensitization, but sensitization can occur without reaction

34. Elimination Diet • Determines if given food is causing allergic reaction • Food thought to be causing symptoms removed from diet • Infants: change of formula or diet for breastfeeding mother • Lasts 1-6 weeks

35. Food Challenge • Also determines if specific food causes allergic reaction • Performed under certain circumstances: 1)When several foods are under consideration, 2)IgE tests positive for several foods, and 3)elimination diet caused symptoms to end

36. Relevance to Parents • Valuable for new parents and those thinking about reproducing • May be able to prevent certain food allergies • Be aware: unusual symptoms of child may be caused by food allergy • Education is Key: inform teachers, babysitters, and any caretaker of child in order to prevent severe reactions