Serious food allergies in children

One in twenty children in Australia are thought to have allergies to food and it’s more likely in families with a history of eczema, hayfever or asthma. Often allergic reactions occur in young babies so parents have to be observant and alert to the signs their child is having a reaction. The Australasian Society of Clinical Immunology and Allergy (ASCIA) infant feeding guidelines have changed to recommending children are given specific types of foods early to help substantially reduce the rates of allergies.

Here’s the most important bits to know…

​Immediate reaction requires immediate action​

In Australia, the most serious allergy for children is known as ‘immediate food allergy’ and it can be life threatening.

Nuts, milk and eggs are the three most common foods to trigger this type of reaction in babies and young children.

What causes it?

Brisbane-based General Practitioner, Dr Richard Triggs, says immediate food allergy occurs when a person’s immune system mistakenly recognises a food as being harmful, and on subsequent exposure reacts to it.

“While some immediate food allergy is mild, causing only an itchy tongue or throat, the most severe reactions result in anaphylaxis,” he explains.

The serious signs

The Australasian Society of Clinical Immunology and Allergy (ASCIA) defines anaphylaxis as a potentially life threatening, severe allergic reaction that should always be treated as a medical emergency (dial Triple Zero 000 immediately).

Symptoms can include swelling or tightness in the throat, swelling of the tongue, difficult or noisy breathing (including wheezing and coughing), difficulty speaking or a hoarse voice, dizziness and collapse.

A young child going “pale and floppy”, swelling of the face and lips, itching, hives or welts and vomiting are other signs an allergic and possibly anaphylactic reaction is taking place.

Underexposed?

Australia has the highest rate of diagnosed peanut allergy in the world: a whopping three percent of infants younger than one year of age have received the diagnosis.

Dr Triggs says one theory behind the high rate of allergy in Australian children is known as the “hygiene hypothesis”.

“The theory suggests that a lack of exposure to infections in childhood makes the immune system less effective at recognising when something, such as a peanut, is not a threat,” he explains.

The Western diet, which is high in processed foods and has a late introduction of allergenic foods, may also be a cause.

“People moving to Australia from non-Western countries, where allergy rates are low, have very high allergy rates in second generation family members — the first generation born in Australia to immigrant parents — indicating that environmental factors such as diets, infections and antibiotic use play a big role,” says Dr Triggs.

Follow the guidelines

Parents unsure as to how to introduce allergenic foods to their babies can follow ASCIA’s recently updated Infant Feeding Guidelines.

The guidelines were changed in light of a study that showed a 10 times higher-rate of peanut allergy in the United Kingdom, where children had no early peanut ingestion, compared to Israel, where children consumed peanuts from an early age.

The guidelines now recommend the introduction of solids, including allergenic foods, in forms that will not present a choking hazard, at around six months of age, but not before four months of age. These include peanuts, tree nuts, fish, shellfish, cow’s milk, egg, wheat, soy and sesame.

Getting in early

Dr Triggs says parents of babies who have a sibling or a family history of allergy or other allergic diseases (such as eczema and asthma) should take their child to their GP for a discussion before they introduce the allergenic solids at six months.

In some cases, the GP may advise referral to an allergist for assessment.

For the general infant population, testing is not usually recommended before introduction of the allergenic foods, but rather on the basis of symptoms noticed after they have sampled new foods.

While anaphylaxis is at the severe end of the reaction spectrum, Dr Triggs says a common initial symptom can be a rash around the baby’s mouth that appears soon after exposure to a new food.

In that case, his advice is simple: “See your GP.”