Have you been wondering how food allergies present in babies and what to do if your
child has an allergic reaction? In this video I’m going to talk about the foods
that are the most common allergens, what an allergic reaction looks like, how to respond,
and the things you can do to decrease your child's risk for developing food allergies.
If this is our first time meeting, I’m Dr. Belousov. I’m a board certified pediatrician
and I equip parents with knowledge, so they can care for their children with confidence.
Many parents are nervous about introducing the common allergenic foods to their baby,
because of fear of an allergic reaction. But delaying the introduction of the allergenic
foods can increase a child’s risk of becoming allergies to these foods. That’s why I decided
to create this video series to give you confidence in introducing the potentially allergenic foods.
This is the first video in the series. In subsequent videos I’m going to go into detail
on how to introduce each of the common allergenic foods, and at what age you should start. So be
on the lookout for those. I’ll have them linked at the end of this video once they’re released.
Let’s start off talking about the foods that are the common allergens. There are 8 major foods that
are responsible for 90% of all food-induced allergic reactions. They are peanuts, milk,
shellfish, tree nuts, eggs, fish, wheat, and soy. More recently sesame has been added to
the list as the 9th most common food allergy as it’s becoming increasingly more prevalent among
U.S. children and adults. Approximately 8% of children have an allergy to one or more foods.
And about 40% of children with a food allergy are allergic to more than one food.
Allergies to milk, egg, wheat and soy tend to resolve in childhood by early school age.
However allergies to peanuts, tree nuts, fish and shellfish are more likely to be life-long.
Although the majority of food allergies arise in childhood, at least 15% of people
develop food allergies as adults. So what are symptoms to be on the
lookout for that would indicate your child is having an allergic reaction?
When exposed to an allergen, the body releases histamines
that cause inflammation and allergic symptoms. As a result, the baby may have anything from
a mild to moderate or even severe reaction. An allergic reaction to a food typically will occur
seconds to minutes after exposure. And very rarely after 2 hours of ingestion.
The majority of allergic reactions happen with subsequent ingestion of that allergen,
although there are cases where it happens with the baby eating it for the first time.
A mild allergic reaction will typically present as a localized raised, red skin rash known as hives.
Among children who have eczema, which is a skin condition that causes them to develop patches of
dry, itchy, scaly rashes, up to 30% of them will also have food allergies. The presence of eczema
in itself is not an indication that the child has a food allergy. It’s more so a risk factor.
The majority of kids who have eczema will not have food allergies, but for the children who
do have eczema and a food allergy, in their case, after exposure to a food that they’re allergic to,
they will have worsening eczema. Other symptoms that indicate a child
is having an allergic reaction include swelling of the face, lips or tongue;
itchy, puffy, watery eyes; rapid onset of nasal congestion or sneezing. And some children
vomit or have diarrhea shortly after ingesting the allergenic food.
When a baby’s immune system overreacts to being exposed to an allergen, and the allergy symptoms
occur in combination affecting more than one organ system, it’s called anaphylaxis. These reactions
are more severe and can be life threatening. They tend to occur quickly after the baby is
exposed to the allergen. The most common symptoms seen in babies with severe allergic reactions
include a full body hives rash and vomiting. They can also have swelling of the eyes,
face, lips or tongue. Some will develop difficulty breathing, wheezing or cough. They can also become
either pale or flushed. In severe cases their blood pressure can drop and they can become
unconscious. One of my patient’s had a severe allergic reaction to one of the common allergenic
foods. Her parents gave me permission to show this so you could see an example of what an
anaphylactic reaction could look like in a baby. Her face and eyelids are swollen, her skin is also
covered with a hives rash. And we can audibly hear that she’s having difficulty breathing.
Fortunately the likelihood that your child will have a reaction like this
is very rare. And studies show that symptoms of allergic reactions in babies are much less severe
than in toddlers and older children. And even in cases where a baby has a severe allergic reaction,
it’s unlikely to be life threatening. There are also situations when a baby
experiences a food intolerance or sensitivity to a food, which causes the parents to question if
the baby is having an allergic reaction. When a baby has a food intolerance or sensitivity
the body has trouble digesting certain foods, such as dairy products containing lactose,
or the digestive system is irritated by a specific substance, such as gluten in certain grains. You
may notice bloating, gas, irritability, abdominal pain or diarrhea. Even though
there may be similar symptoms, food intolerance is very different from a food allergy and does
not involve a true allergic reaction. Also some babies will develop a rash around the mouth, neck
or upper chest. Basically anywhere the food came in direct contact with the skin or through saliva
that dripped out of the baby’s mouth while eating the food. This rash is not a sign that the baby is
having an allergic reaction to the food and is not a reason to remove the food from the baby’s diet.
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Now let's talk about how you should respond if your baby has an allergic reaction to food.
In the event that your baby has mild symptoms of an allergic reaction, like a localized hives rash,
you can observe the baby at home to see if other symptoms develop. Take a photograph of the rash
so you can show it to your child’s healthcare provider. Call the doctor’s office for advice
on what you should do. Depending on the symptoms, you may be instructed to just watch for resolution
of symptoms. Most times the rash will resolve on its own. Or you may be advised to give either
benadryl, also known as diphenhydramine, or zyrtec, also known as cetirizine.
These medications can be helpful in decreasing the itchiness of the rash and speed up the resolution
if your child is bothered by it. Depending on what symptoms your child has, you may be instructed to
have the baby evaluated by a medical professional. Sometimes food allergies are obvious, such as the
child eats yogurt and immediately develops a hives rash. Other times it can take some detective work,
such as the child getting dry itchy patches on the skin each time after eating food baked with eggs
and milk. If you suspect that your child has a food allergy, stop offering that food and schedule
an appointment to see your child’s healthcare provider to further evaluate if your baby is
allergic to that food. It’s helpful if you keep a log of specific symptoms and what your child
had to eat or drink within two hours before each symptom started. It’s also helpful when there’s
a rash or swelling, that you take photographs of it to show your child’s healthcare provider.
In the event that your baby develops a severe allergic reaction after ingesting a food,
call for an ambulance and try to keep your child calm while you wait for their arrival.
If your child has had a severe allergic reaction before and the doctor prescribed an epinephrine
auto-injection medication, then the first step in your case is to administer it following the
steps as you were instructed, because timely treatment is crucial. Giving an antihistamine
medication or breathing treatments won’t stop an anaphylactic reaction from progressing,
only epinephrine will. That’s why it’s so important to have timely treatment in these
situations and then of course your child will need to be evaluated by a medical professional.
Now let’s talk about how you can reduce your child’s risk of developing food allergies. For
many years experts thought the best way to fight food allergies was to avoid exposing
babies to them in their first years of life. It was thought that delaying would also prevent
the development of other allergic conditions, especially eczema. However more recent studies
have shown the opposite to be the case. In fact, delaying the introduction of the common
allergenic foods can increase a child’s risk of becoming allergic to these foods. In 2015 the
Learning Early About Peanut Allergy or LEAP study, showed that feeding peanut foods early to babies
at high risk for peanut allergy reduced their chances of developing a peanut allergy by 80%.
According to the study, babies who were considered high risk for peanut allergy were those who had
severe, persistent eczema and/or a diagnosis of an egg allergy. According to the study
peanut-containing products should be introduced to high risk babies as early as 4 to 6 months.
It’s strongly advised that babies who are considered high risk for peanut allergy
get an allergy evaluation or allergy testing prior to trying any peanut containing products.
So if this is the case for your baby, speak with their healthcare provider regarding how
and when to introduce peanuts. If the baby tests positive for a peanut allergy, they will most
likely recommend the initial introduction in the supervised setting of a medical office.
Babies with mild to moderate eczema are also at a slightly increased risk of developing peanut
allergy. To decrease their risk, they should be introduced to peanut containing products around 6
months of age and continue to be exposed to peanut containing products regularly. The introduction of
the peanut products may be done at home and these babies don’t require allergy testing beforehand.
Additionally the Enquiring About Tolerance or EAT study
showed that early introduction of peanut products, eggs, milk products, wheat, fish and sesame,
and continued weekly exposure to these foods for at least 5 weeks,
has the potential to lower the risk of developing these allergies. Experts believe that the window
of opportunity for early introduction to prevent food allergies closes by 11 months.
In the next several videos I will be going into more detail on how and when to introduce each of
the common allergenic foods to your baby, so be on the lookout for those. See you in the next video.