How to recognize food allergies in your child (or yourself)

Food allergies can be difficult to understand and to explain, and yet they cannot be ignored as they play a major role in children’s health. A wide array of symptoms, from chronic ear infections to hyperactivity, bedwetting or even grinding teeth can often be resolved when one or a few offending foods are identified and removed from the diet.

Some of the confusion may originate from the very word “allergy” because it immediately evokes images of sneezing, congestion or hives – yet these symptoms are rarely seen with what are known as “hidden” food allergies.

When foods do cause reactions such as sneezing or hives, they do so through the same mechanism as allergies to mold, dust or pollen. Sometimes smelling a food is enough to set off the reaction and, in extreme cases, we may hear of a child who went into life-threatening anaphylactic shock after smelling a peanut. Reactions to these substances tend to be immediate, and as a result the allergies are easy to identify. They can also be confirmed by skin testing, a process whereby a tiny amount of allergen is injected beneath the skin.

However, a completely different type of allergy can occur with foods. A reaction does not take place immediately after a food is consumed. In fact, a reaction may not manifest itself fully for hours or even a day although certain physical signs can be observed sooner. Often, the foods that trigger these types of allergic reactions are the very ones a child likes the most or even craves. Since in most cases they are consumed every day (wheat, milk, corn) it becomes practically impossible to identify them without some kind of test.

Hidden food allergies differ from common allergies in another respect: they are dose-related, and may not be triggered until a significant amount of a food is consumed. This means that, in some cases, complete avoidance of offending foods is not required. Simply cutting back to having them every few days may be enough to correct the problem. In more severe cases strict avoidance is required, but not necessarily forever. It is often possible to reintroduce the offending food or foods after a period of time without causing a reaction.

There is also a link between food allergies and poor digestion. This means that supporting a child’s digestive system, for example by supplementing with enzymes, can help moderate reactions. However, avoiding the foods without dealing with digestion may lead to a child developing new allergies.

There are multiple mechanisms underlying food allergies. As a result, it has been very difficult to produce a single laboratory test that will identify problem foods in a reliable manner. Skin tests are usually negative and, although many types of blood tests are available, none are completely accurate. At most, a blood test can identify 60 to 70 percent of reactions. An elimination diet, in which suspected foods are avoided for one to two weeks and then re-introduced one at a time, can be very helpful but is often difficult to implement with children.

Parents can easily learn to spot physical signs of allergy. These signs can help determine if a child is likely to have food allergies, if enough has been done to correct the problem, and can even identify the problem foods if an accurate journal is kept. Here are some of the signs to look for:

• An increase in pulse rate: if you suspect that a food may be a problem, take your child’s pulse before eating and again half an hour to an hour after eating. An increase of 10 beats per minute or more is highly suspicious.

• Dark circles under the eyes – these are some times known as “allergic shiners”

• Swollen eyelids that make a horizontal crease under the eyes.

• Red ears or cheeks after eating certain foods.

• Dilated pupils that do not respond normally to light (this may also lead to abnormal sensitivity to light)

• Hyperactive or aggressive behavior

• Restless legs

If you become suspicious of a food, remove it for a while and then reintroduce it and see if the problem recurs.

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