Special thanks to Nutricia, maker of Neocate®, for supporting our educational blog series on managing food allergies in infants and toddlers. The post is the third in a three-part series.
As a parent, you always want your child to grow and develop in a healthy way, checking off each milestone from first smile to first step with ease. But what should you do when you suspect your infant or toddler may have a food allergy? Perhaps you notice a small patch of hives on her skin, or she displays more serious symptoms like vomiting and diarrhea. You wonder if it is something in the mother’s breast milk, a new solid food you introduced, or a new brand of formula. Here are some basic first steps to take when you believe your infant or toddler may have a food allergy.
Know what to do in an emergency situation
If your child is displaying any symptoms of anaphylaxis within minutes to hours of ingesting food, seek immediate medical treatment. Symptoms of anaphylaxis can include:
- Difficulty breathing
- Loss of consciousness
- Pale or blue skin
- Repetitive cough, wheezing
- Hives, redness or itching
- Diarrhea or vomiting
- Swelling of lips or tongue
- Itchy/runny nose, sneezing
Very young children or toddlers may put their hands in their mouths or pull or scratch at their tongues in response to a reaction. Children have unique ways of explaining how they feel during an allergic reaction. Learn more about how a child might describe a reaction at www.foodallergy.org/symptoms#howachild.
Seek appropriate care
If your child shows signs of a severe reaction, call 911 and seek immediate medical treatment.
If you are noting mild symptoms, such as an itchy/runny nose or a few hives, know that suspected food allergies should always be evaluated, diagnosed and treated by a qualified medical professional. Visit your pediatrician and ask them to refer you to a board-certified allergist. To find a pediatric allergist near you, search the physician directories maintained by the American Academy of Allergy, Asthma & Immunology or the American College of Allergy, Asthma & Immunology.
Work with a doctor for an accurate diagnosis
Do not diagnose a food allergy on your own. Self-diagnosis can lead to unnecessary dietary restrictions and inadequate nutrition, especially in children. An allergist will take a thorough medical history, asking questions about overall health and eating habits to determine if food allergy may be causing your child’s symptoms and to identify the culprit food(s). The allergist will also perform a physical exam. Keeping a food and symptom journal prior to your visit can be a helpful tool to assist the doctor in establishing your child’s medical history.
The allergist may decide that further testing is needed before a diagnosis can be made. You can learn more about food allergy diagnosis and testing at www.foodallergy.org/diagnosis-and-testing.
Food allergies should also be considered when your child has previously been diagnosed with one of the following disorders. Symptoms among these disorders are often similar or related, so it is important to work closely with your doctor for an accurate diagnosis.
- Atopic dermatitis, also known as atopic eczema – food allergens can bring on redness, hives, itching, and flares of eczema, all of which may aggravate atopic dermatitis.
- Eosinophilic Esophagitis (EoE) – Eosinophilic esophagitis (EoE) causes large numbers of eosinophils, a type of white blood cell, to gather in the esophagus (the tube that connects the mouth to the stomach). As a result, the lining of the esophagus becomes inflamed, making it difficult for food to go down. EoE can be triggered by certain foods. Symptoms vary, depending on age. With infants and toddlers, families often note feeding difficulties, refusal to eat, irritability, and occasionally poor weight gain. EoE is most common in infants, children and adolescents.
- Food Protein-Induced Enterocolitis Syndrome (FPIES) – Food protein-induced enterocolitis syndrome (FPIES) is a serious, non-IgE-mediated type of food allergy. FPIES is usually triggered by cow’s milk or soy, though some cereal grains (especially rice and oat) and other foods may cause it. The symptoms typically include severe vomiting and diarrhea. Reactions are often delayed by 2-3 hours after the trigger food is eaten. In most cases, FPIES is resolved by the age of three.
- Food protein-induced enteropathy syndrome – This is an uncommon disorder that presents in young infants as chronic diarrhea (commonly with abnormal quantities of fat due to reduced absorption), weight loss and growth delay. It is most often caused by milk allergy, though some other foods (e.g., soy, chicken, rice and fish) may cause it. Virtually all affected patients “outgrow” their symptoms by 2 to 3 years of age
- Food protein-induced allergic proctocolitis – With this condition, an infant will seem generally healthy but have visible specks or streaks of blood mixed with mucus in the stool. Many infants begin showing this symptom while being breastfed, presumably as a result of maternally ingested proteins excreted in breast milk. There are no specific diagnostic tests for this condition, so the role of allergens is typically discovered based on the history of reactions.
If diagnosed with a food allergy, seek resources and support
A food allergy diagnosis is life-changing, both for the child and for the entire family. Connecting with others who are in the same situation and sharing experiences and support can be incredibly helpful. It also helps to know you are not alone.
- Download “Your Food Allergy Field Guide” on the FARE website to help with the transition from diagnosis to living well with food allergies
- Find a local or online support group at www.foodallergy.org/support-groups
- Seek counseling if you or your child are experiencing feelings of depression, isolation or fearfulness
- The National Institute of Allergy and Infectious Diseases expert panel recommends nutritional counseling and regular growth monitoring to help patients avoid allergens and have a healthy diet
- Follow FARE on Facebook and Twitter, and subscribe to email updates to stay informed on the latest news and tips for managing food allergies
This blog series is made possible through a gift from Nutricia, maker of Neocate®.