Food Allergies In Children: What You Need To Know To Keep Your Family Safe

Blog Food Allergy Web

So, what do you do when your child has a food allergy?

It’s no secret that food allergies are on the rise—and I see it firsthand. As a board certified pediatrician and allergist at Riley Hospital for Children at Indiana University Health since 1994, I have helped many families deal with food allergies. The statistics are striking: Food allergies affect up to 8 percent of children and the numbers are climbing. On a more personal note, our allergy clinic sees over 600 new patients for food concerns each year. One particular item, peanuts, has been particularly problematic. It’s an allergen that has the ability to kill and that possibility, however remote, can make a diagnosis devastating for all involved.

So, what do you do when your child has a food allergy?                       

1.       Is there a chance that this food allergy will just go away?

2.       Is there a chance that some of these test results are falsely positive?

3.       Is there a way to verify an allergy test result?

The answer is yes: Food challenges (allergy tests where a child consumes the allergenic food in the company of their allergist and is then monitored for physical reactions in the clinic by the medical team) can provide helpful clarification. When is it warranted? When the patient’s history is obvious and an allergy skin test supports the suspicion, an allergy blood test called specific IgE may also help sort out the risk of a reaction to the allergen. If the risk is low, then a food challenge can be a consideration.

At Riley, we do food challenges in an environment where we have the “e’s’;

1.       Experience

2.       Expertise

3.       Equipment

We take this experience seriously, which is why we have been named by FARE (Food Allergy Research and Education) as one of their Centers of Clinical Excellence for Food Allergy.

How is a food challenge done?

The challenge takes about 4 hours to complete. When you arrive we review the patient’s history and have the parents sign a consent form. We explain the procedure to the entire family and we make it clear that at any time there is a concern, we will stop the food challenge. We do gradual introduction. We administer about 10 exposures of the food, building on the amounts until a full serving has been given. We pay close attention for signs of reactivity, acutely aware that we are exposing the child to a food that may have caused a devastating reaction in the past.

We’ve had reactions that have caused us to stop. We’ve had long talks with the children who are petrified about the process. We work through these issues. We’ve done food challenges for egg, milk, wheat, peanut, soy, shellfish, tree nuts and more. Our track record is a ‘pass’ in 80 percent of cases—which means no reactions present and a clear path to eating that food thereafter.

So, a food challenge serve many purposes: they pave the way for good nutrition, end the need for injectable epinephrine, and most importantly, help patients and their families resolve the fear of a food allergy.

-- By Fred Leickly, MD

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