by Heather Legg

“On his first birthday, I was reluctant to serve my youngest child an enormous amount of sugar and other processed who-knows-what from the grocery store’s bakery. But, my sister just loved the idea of giving him a little cake to destroy, so I gave in. As my little guy, Aidan Thomas Hornaday, tore into his cake, my feelings of reluctance became immediately warranted. Within seconds, Aidan developed welts that seemed to be open sores all over his body. Some were even bleeding,” recounts Toren Anderson. “It turns out these welts were a result of his severe allergy to soy.”

Since that day, now 6-year-old Aidan carries an Epi-pen and Benadryl with him at all times. It has also become evident that he is allergic to peanuts and has developed asthma. “We are now very aware of what we bring into our home and what we put into our bodies,” says Anderson. “The hardest part for my husband, Chris, and I is that we know Aidan feels guilty. He’ll hear us say we can’t go somewhere, and he’ll ask ‘Is that because of me?’”

Many children have intolerances to certain foods, but only about 2-8 percent are truly allergic like Aidan. The most common foods that cause allergies are milk, soy, eggs, wheat, peanuts, tree nuts, fish and shellfish. Whereas intolerances can cause discomfort, even slight exposure to a food allergen can cause severe, even life-threatening reactions in individuals with food allergies.

According to Dr. Jon Stahlman, a specialist in pediatric allergies at The Allergy & Asthma Center LLC of Atlanta, Lawrenceville and Conyers, food allergies can develop at any age, though most often in infants and young children. “Usually the first symptoms are mild, presenting in skin reactions,” he says. Mild reactions can consist of hives and itchy skin, as well as headache, stomachache and general discomfort. “We first discovered my son David’s allergy when he was 18 months old,” says Tracy Adams of Atlanta. “He kept getting rashes that we couldn’t explain.” Anaphylaxis, the most severe and life-threatening reaction to a food allergy, rarely occurs at the first exposure to an allergen.

“Chronic eczema can be an indicator of a food allergy as well,” Stahlman says. Allergies should be looked into if a child has skin problems that won’t go away. A large percentage of children with food allergies also have eczema and/or asthma, and overall health and well-being actually do play a part in the severity of allergic reactions. According to the website of The Allergy & Asthma Center (www.theallergyasthmacenter.medem.com), “A reaction to a particular food can be affected by an individual’s physical condition at the time. For example, susceptible individuals may be more likely to experience allergic reactions to food when they are suffering from colds, upset stomach, stress or other allergic diseases such as hay fever.”

A food allergy is usually diagnosed after a child ingests or comes in contact with the food and a reaction occurs. Walter and Mona Henderson of Decatur brought their son, Walter, in for testing after he had eaten peanut butter in childcare. He was almost 2 years old at the time and had “a moderate but immediate reaction, breaking out in hives,” his father says. He tested positive for a peanut allergy.

Cate Lemmon, now 19 months old of Marietta, was diagnosed with a milk protein and soy allergy at 10 weeks old. Though she didn’t have as obvious a reaction as Walter, her parents knew something was wrong. “She started having symptoms within her first two weeks,” her mother, Meredith Lemmon, says. “She cried 23 hours a day. She kicked a lot and resisted nursing; she wildly pulled away from the breast and there was some blood in her stool.” After weeks of these symptoms and finally a 36-hour crying bout, the Lemmons took her to a specialist. The positive diagnosis of her food allergy came back quickly, and since Lemmon was still breastfeeding, she had to radically change her diet. “I had already taken all dairy out of my diet...beginning when she was about 2 weeks old,” she recounts. “The gastroenterologist instructed me to start reading all labels and not to eat anything with dairy, butter, eggs, soy or soy protein. Within 24 hours of the diagnosis and my diet change...she was like a new baby.” 

By the time Cate was about 8 months old, she had grown out of her allergy. Like Cate, some children do grow out of their allergies, especially milk and soy. With peanuts, tree nuts and shellfish, however, it is usually a lifelong condition. Some allergists recommend skin testing every few years to see if the allergy is still present, especially when symptoms were mild and no recent reactions have occurred.

The Hendersons now check product ingredients carefully for peanuts and make sure friends, teachers, family and neighbors know of Walter’s allergy. They have taught their son, now 5, to tell others of his allergy. They keep Walter away from peanuts and foods with peanuts, though he can eat tree nuts (cashews, pecans, walnuts, etc.) with no reactions. People often mistakenly think that peanuts and tree nuts are in the same family and if a child has a tree nut allergy, he must stay away from peanuts or vice versa. Though some children may be allergic to both, it’s not always the case.

As the Hendersons know, avoidance is key with a food allergy. It is the only way to really prevent a reaction. With food allergies, it’s hard to tell what the next reaction will entail, so “avoidance measures are standard,” Stahlman says. It is possible to have an anaphylactic reaction with only mild previous reactions. “David carries his epi-pen everywhere. We’ve only had to use it once, when he was about 2, but his peanut allergy is a constant concern,” says Adams.

Stahlman also advises parents and patients to be careful of cross contamination and hidden sources of food allergies. “Peanuts and peanut butter are a big culprit,” he warns. For instance, plain M&M’s may have traces of peanuts from the peanut M&M’s manufactured in the same plant. Some foods, like milk, go by many different names, and it is important to learn all the ways they may be listed in ingredients, such as “lactose,” “whey” and “casein” for milk. Parents need to learn and help their children learn all the names of their food allergen and always check ingredients. Lemmon remembers that even things like jarred spaghetti sauce contain soy protein.

The Food Allergy & Anaphylaxis Network (FAAN, www.foodallergy.com) is a national nonprofit organization for parents and children dealing with food allergies. Food-safe recipes are available as well as practical tips from parents and kids. Wallet-sized cards are available that list all the names for different foods so families can shop with the cards to check ingredients or share them with other caregivers and family members.

It may be difficult to know when to bring your child in for testing for a food allergy if there is a chronic lingering problem, like eczema or the symptoms Cate experienced instead of an immediate reaction. Sometimes the symptoms may look like another condition. Lemmon says, “My only advice is to trust your gut. Despite my pediatrician’s initial claims that she was just a fussy baby with a touch of reflux, I couldn’t shake the feeling that it was something else.”

Education is imperative not only in seeking a diagnosis but in helping your child be comfortable and cautious with his or her allergy. Children need to learn to check ingredients before eating anything new, or have an adult check if they’re not sure. It is also important that the child’s friends and friend’s parents are aware of the allergy. Because injectable epinephrine (Epipen) is the most common and reliable form of medication if a severe reaction does occur, any adult in charge of a child with a food allergy must be knowledgeable about and comfortable administering it.

Other histamine blockers, like Benadryl, are effective if a minor reaction occurs. Most parents keep a kit with an Epipen and Benadryl with them and one at school or childcare. Keeping track of expiration dates is critical, as an out-of-date medication might not be effective.

It may seem that the school nurse’s office is overloaded with Epipens and Benadryl, that there’s always a milk alternative, and that even some airlines are no longer serving peanuts. Are allergies more prevalent today or just more commonly diagnosed? “It’s a little bit of both,” Stahlman says. “There is a rise in prevalence, partly due to lifestyle changes in the past 100 years” and partly due to medical technology. People are more aware now and seek diagnosis. America’s diet has also changed and includes a lot more peanut butter. Certain cultures can become overly sensitized to overexposure to certain foods. For example, in Asia there is a prevalence of rice allergies and in Europe, olive allergies.

While avoidance and education are the surest ways of preventing food allergies, some alternative treatments are on the horizon. In the Northwest, a doctor is working on a herbal blend for peanut allergies, and a shot, the Anti-IgE antibody, is being developed for severe peanut allergies. Another alternative treatment, called NAET, uses acupressure and acupuncture. Food allergies are scary, especially at first diagnosis. It’s important to learn the facts, the precautions and the treatments. Luckily, with increased awareness, new laws on food labeling, and possible new treatments, management is easier.