ThedaCare Family Medicine Physician notes ways to detect a baby’s food aversion

Summer and fall seem to be the seasons parents discover their infants have allergies. ThedaCare providers report seeing an increase in the number of cases this time of year, especially when the allergens come in the form of food, insects, or medicines—the most common triggers for anaphylaxis, a life-threatening reaction.

“Be watchful of what your baby eats at family gatherings or what family members feed them,” said Jose Hernandez, MD, a family medicine specialist at ThedaCare Physicians-Appleton North. “Children are typically exposed to more food and different foods at picnics, backyard barbeques, and weddings that might contain peanut oil or cow’s milk powder, which are common allergens.”

Most times, the only way a parent knows if their child has a food allergy is when the child eats food that results in an adverse reaction. Food allergies are the most common among all the potential allergens. According to the most recent data published from the Centers for Disease Control and Prevention National Health Interview Survey (2014), 4.7 percent of children under age four suffer from a food allergy.

“For infants under two, peanut allergies seem to be most prevalent,” notes Dr. Hernandez. “In addition to peanuts, top foods children tend to be sensitive to ingesting include tree nuts (almonds, cashews, pistachios, etc.), cow’s milk, eggs, wheat, fish, and shellfish (shrimp, lobster). Small children also could be sensitive to fruits like strawberries, mango and pineapple.”

To help reduce a baby’s food allergy risk, the American Academy of Pediatrics now suggests parents slowly introduce foods like peanut, egg and milk in small amounts when their baby is four to 11 months old. Dr. Hernandez illustrates putting a tiny amount of peanut butter on a child appropriate cracker to expose them to peanuts. You should always discuss when to start introducing foods with your provider, as there are some children who may need allergy testing before introducing foods, such as children with severe atopic dermatitis or severe asthma.

“And you want to be sure to be in a safe environment at home, where you have access to a phone to call 911, or a car to drive your child to the hospital, in the event there is a severe allergic reaction,” Dr. Hernandez said. “It’s important to keep safety in mind when allowing your child to try new foods.”

Dr. Hernandez added if a child presents with an allergy before age one, then there’s more of a concern that it is a true allergy that will last a lifetime. Environmental allergies are not as common in children, explained Dr. Hernandez. He said babies can react strongly to bee stings and mosquito bites. “Because a baby’s time outdoors is limited compared to ingesting food, it’s rare when seasonal allergies present themselves in infants,” he said.

According to the American Academy of Allergy, Asthma and Immunology, medicines cause the most allergy related deaths. Dr. Hernandez explained that antibiotics are the most common allergen.

“There is still a question whether it’s a true allergy” he said. “That’s because typically, with an infection, children get rashes and are flushed in the face, so it is not necessarily an allergic reaction.” If a parent suspects their child might be experiencing an allergic reaction to food, medicine or the environment, they should know the symptoms: Coughing; sneezing; itchy eyes, mouth or ears; runny nose and scratchy throat.

More severe symptoms, which can present a few minutes to an hour after the allergen exposure, include: Skin rashes, hives and red swollen welts that come and go; facial and lip swelling; under the eye lids inflammation; low blood pressure; breathing trouble; vomiting; wheezing.

Babies can have into-lerance to certain foods—when food doesn’t agree with their system—but it is not a true allergy. Those symptoms are less severe and include bloating, diarrhea, gas and pain.

Dr. Hernandez said parents who see their child having a severe allergic reaction, called anaphylaxis, need to take the situation seriously. “Call 911 right away,” he said. “The greatest concern is the blockage of an infant’s small airway, which can be very dangerous.”

The most common treatment for anaphylaxis is an epinephrine auto-injector device. The swelling typically goes down quickly. It is short acting. “It’s important to continue with epinephrine,” said Dr. Hernandez. “It usually comes in an IV drip form, so infants are in the hospital for two days, especially if there’s concern about the airway being compromised.”

 

When it comes to allergies in small children, the best prevention is parents realizing the red flags in the first two years of their baby’s life—the triggers, symptoms, and the best course of action when anaphylaxis occurs.