Health Topics

Healthy Living

May 2012
Food Allergy Is Not For Life, But Infants Need Help
Dr J Shyamala
Food allergies are the adverse health effects arising from the immune response triggered in the body when certain kinds of food are eaten. It affects children more than adults – manifests in six per cent of young children and three to four per cent of adults.

8 Common Allergy Causing Foods

  • Egg
  • Cow’s milk
  • Peanuts
  • Tree nuts, e.g., walnuts and almonds
  • Wheat
  • Crustacean shellfish
  • Soy
Though incidences of allergies to milk, eggs and wheat are common in India, they are relatively less common than in the West. A recent Delhi-based study conducted by the Indian Council for Medical Research, estimated the prevalence of food allergy to be 4.5 per cent in adolescents and adults with asthma and/or allergic rhinitis. The common offending agents were found to be rice, citrus fruits, black gram and banana. Food allergies are the adverse health effects arising from the immune response triggered in the body when certain kinds of food are eaten. It affects children more than adults – manifests in six per cent of young children and three to four per cent of adults.

Symptoms Of Food Allergies
  • Vomiting
  • Diarrhoea
  • Atopic dermatitis
  • Hives
  • Asthma
  • Life-threatening anaphylaxis
Severe and fatal reactions can occur in people of any age bracket, but the risk is the greatest in adolescents, young adults with asthma and those known to be allergic to peanuts, tree nuts, fruits, milk, wine, vegetables and/ or seafood.

Is Food Allergy An Isolated Case?
Patients with food allergies are more likely to have asthma, eczema or exercise-induced anaphylaxis.

If One Has Positive Skin Prick Tests To A Few Allergens, Does It Prove That One Is Allergic To Those Foods?
There are blood tests and skin tests that can identify the suspect foods behind a particular allergy, but unless clinical symptoms coexist, they cannot be considered the cause.

  • Once a definite diagnosis of food allergy is made, the offending food must be strictly avoided under medical advice.
  • Patients must be educated on how to identify and recognise the reactions, some of which may be life threatening.
  • Allergen-specific immunotherapy is not recommended to treat food allergy, since its safety is uncertain.
  • Know that there are no medications available to prevent food allergy. Drugs like antihistamines may decrease allergic reactions to foods but do not block serious life threatening reactions called anaphylaxis.
  • In case of anaphylaxis, the life saving measure is in the administration of adrenaline and it must be done promptly.
Can Anaphylaxis Be Prevented?
  • Patients who are at risk of anaphylaxis must carry adrenaline with them at all times and they must be educated on its administration.
  • Adrenaline (EpiPen/Anapen) autoinjectors are available in western countries. In India, it is given only in a hospital setting.
  • The patient needs hospitalisation for advanced care. It includes Oxygen supply, IV fluids, monitoring of vitals and management of shock.
Do Food Allergies Persist For Life?
Most children outgrow their sensitivity to much of the allergenic foods (egg, milk,wheat, soy) within the age of five years, while some have symptoms up to their teens. About 85 per cent of infants with allergy to cow’s milk turn tolerant by the age of three. When it comes to egg allergy, up to 80 per cent of them turn tolerant by five years. Twenty per cent of children with peanut allergy develop tolerance by the school-going age.

Is There Any Relation Between Egg Allergy And Vaccinations?
Patients who have IgE mediated egg allergy are at risk for anaphylaxis if injected with vaccines containing egg protein such as MMR, Chickenpox, Influenza, Yellow fever, and Rabies. As per the current guidelines of the Indian Academy of Paediatrics, it is safe for children with egg allergy to have MMR and Chickenpox vaccines but Influenza vaccines should be given with caution (some risk of systemic reactions exist); Yellow Fever and Rabies vaccines should not be given without proper allergy evaluation.
Precautions For Expectant Mothers To Prevent Food Allergies In Their Infants
Preventive measures do not require expectant mothers to restrict their diet during pregnancy or when breastfeeding. Established guidelines, however, caution them against delaying the introduction of solid foods including allergenic foods to their infants. It is best to introduce it by the fourth or sixth month to prevent the development of allergic diseases in the child. This includes giving the child foods containing milk, eggs, peanuts, tree nuts, soy or wheat.
Can Allergy Impact Nutrition?
Consumer surveys indicate that the perceived prevalence of food allergy is higher than the actual incidence and people perceiving so resort to some form of an elimination diet. For example, cow’s milk allergy is one of the most common allergies encountered in infants, in clinical practice. The only available treatment is elimination of milk from the diet. However, a diet sapped of milk may lead to significantly lower intake of energy, fat, protein, calcium, riboflavin and niacin. Hence, unless healthcare providers monitor growth and feeding patterns, serious nutritional deficiencies may result.
Dr J Shyamala Consultant Paediatrician & Neonatologist, Apollo Greams Hospitals, Chennai.
  • The information on this site does not constitute medical advice and is not intended to be a substitute for medical care provided by a physician.
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