Although it is often possible to prevent an allergic food reaction, it is impossible to prevent the allergy from developing in the first place. The exception to this general rule is food allergies in babies. Miles Weinberger, MD, director of the pediatric allergy and pulmonary division at University of Iowa Children’s Hospital, located at UI Hospitals and Clinics, talks about children, food allergies, prevention, and treatment:
What is eczema and how is it related to food allergies?
Eczema is an inflammatory rash of the skin that tends to be very itchy. There are different types of eczema, but I think the type of eczema we’re talking about today is what’s commonly called atopic eczema or infantile eczema—the eczema that is very common in infants and very strongly associated with a predisposition to develop allergy to both foods and things in the air, things that they inhale.
If a child develops itchy rashes and does not have food allergies, is it still considered eczema?
Yes, foods contribute to atopic eczema only in about 30 percent of the cases. Although this is a group that’s very predisposed to develop food allergies, they can certainly have infantile eczema, what’s called atopic dermatitis, suggesting they’re at risk for developing allergies. But it doesn’t mean definitely that they’re going to develop the allergies.
If food allergies run in a family, is it possible to prevent or at least delay their development in the children of that family? How?
Since infants can be exposed, even in utero, from things that the mother eats that pass through the placenta into the baby—or even to a greater extent during breast feeding—if there is a high risk in the family because of the family history of atopic eczema or food allergies, then if the mother avoids high risk foods (like peanuts, cow milk, and eggs), then that is likely to decrease the risk of the infant developing the allergy so long as the mother continues that restricted diet during the period of breast feeding.
Do children outgrow allergies?
Some food allergies have a higher likelihood of going away as the child gets older. Studies on milk, eggs, and peanuts have been very convincing. Milk and eggs have about an 85 percent likelihood of decreasing and having sensitivity go away by age 4—even when it’s present during infancy. Peanuts, on the other hand, have only about a 20 percent risk of sensitivity being lost by age 4, and so 80 percent are probably going to continue to be peanut-sensitive throughout life.
Can a child outgrow eczema?
About two-thirds of children do have eczema go into remission after age 3. The skin continues to be abnormal and many adults who had eczema as an infant still recognize that they have sensitive skin. Especially women who, as a result of having had eczema when they were infants, still have dry skin, use a lot of emollients and creams because they’re aware their skin is very sensitive and dry. But they don’t necessarily continue to have active itchy rashes like they had when they were infants and toddlers.
Can children also develop allergies that involve their breathing?
Yes, severe reactions to foods and to inhalants—of course inhalants that these children are also prone to develop sensitivity to do cause problems with breathing. But foods, when reactions are severe, can compromise respiration and, on rare occasions, can even be fatal.
Is it possible for children to develop asthma as a result of a childhood allergy?
The children with atopic eczema are prone to develop inhalant allergy that cause hay fever-type symptoms and asthma. Both are at risk and about half of children with atopic eczema do go on to develop asthma and hay fever symptoms.
At what point should parents bring their infant to see a pediatric specialist when they suspect an allergic reaction?
These problems range from very minor and easily managed in primary care to very severe and very difficult to manage. Any time primary care is not satisfactory, and in most cases it will be, but when it’s not, this is where the specialist has something to offer, to identify whether or not foods are contributing.
It is not a good idea to go on restricted diets without having an allergic evaluation because that’s been shown not to be effective. Restricted diets should be directed by careful allergy testing and since not all positive tests, skin tests, or laboratory tests truly identify a true clinical allergy. Those have to be confirmed either by a history of such reactions or by medically supervised food challenges. |
