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Food Allergies in Infants and Children. Shana Spector. Food Allergies in the U.S. More than 6 million Americans suffer from food allergies 3 million specifically allergic to peanuts, walnuts, and pecans Other common food allergies: milk, fish, shellfish, wheat and soy.

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Food Allergies in Infants and Children

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Food Allergies in Infants and Children

  • Shana Spector


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Food Allergies in the U.S.

  • More than 6 million Americans suffer from food allergies

  • 3 million specifically allergic to peanuts, walnuts, and pecans

  • Other common food allergies: milk, fish, shellfish, wheat and soy


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What Causes Allergic Reactions?

  • Overactive immune system

  • Body believes a substance is harmful

  • Body wants to protect itself by fighting that substance off

  • Immune system releases chemicals and histamine, triggering the reaction


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IgE Mediated Allergy Disorder

  • Cause acute onset of symptoms after digestion

  • Affect skin, respiratory tract, gastrointestinal tract and cardiovascular system


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IgE Mediated Allergy Disorder

  • IgE antibodies are cells that are released from specialized B cells during contact with allergen

  • IgE antibodies attach to IgE receptors on mast cells


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IgE Mediated Allergy Disorder

  • If the allergen is again presented in the body, it binds to surface of mast cell, triggering release of histamine and other chemicals

  • Picture and animation


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Types of IgE Mediated Disorders

  • Type 1 Hypersensitivity: most common disorder

  • Symptoms include hives, swelling of face, itching, vomiting, diarrhea, coughing, wheezing and decrease in blood pressure


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Types IgE Disorders

  • Oral Allergy Syndrome

  • Caused by allergies to fruits and veggies

  • Itching swelling of lips, tongue, palate and throat


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Types IgE Disorders

  • Respiratory Hypersensitivity Reaction

  • Effects respiratory tract

  • Causes runny nose, nasal congestion, wheezing and coughing


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Types IgE Disorders

  • Airborne Food Allergy Reaction

  • Transpires from smelling an allergen through cooking

  • Causes nasal congestion, inflammation of the eyes and hives


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Types IgE Disorders

  • Food-Associated Exercise-Induced Anaphylaxis

  • Occurs when allergic person exercises 2-4 hours after eating certain foods

  • No reaction without exercise

  • More common in females (esp. teenagers)


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Other Food Disorders

  • Subacute or chronic

  • Usually affect gastrointestinal tract

  • Mediated by T cells

  • Mainly found in infants and children

  • Usually caused by hypersensitivity to cow’s milk or soy


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Symptoms of Food Allergies

  • Hives are most common

  • Other symptoms: tingling in mouth, swelling in the tongue and throat, difficulty breathing, abdominal cramps, vomiting, diarrhea, and eczema


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Anaphylaxis

  • Serious allergic reaction occurring within a few minutes to two hours after contact with allergen

  • Acute and potentially fatal

  • Causes 300,000 hospital visits and 150-200 deaths per year


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Infants, Children and Food Allergies

  • 6-8% of children develop food allergies within the first three years of life

  • 90% of food allergies in kids involve cow’s milk, egg, peanut, wheat, soy, tree nuts, or fish


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Infants, Children and Food Allergies

  • Most children outgrow their allergies to milk, egg, wheat and soy by age 3-5

  • Only 20% of infants with peanut allergy will eventually tolerate peanuts


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Problems Associated with Food Allergies in Children

  • Poor nutrient intake

  • Constipation

  • Eczema

  • Potential death


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Food Allergies Linked to Poor Growth

  • Increased risk for poor nutrient intake

  • Parents may eliminate too many foods from child’s diet or neglect to supplement

  • In severe cases, children can develop failure to thrive


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Studies Showing Poor Growth

  • Children with one or more food allergies more likely to be under 25th percentile height for age than healthy children

  • Subjects with 2 or more food allergies significantly shorter than children with 1

  • Children with specific allergy to cow milk showed lower height for age than healthy children


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What to do if Child has Food Allergies

  • Consult with an allergist and dietician

  • Use growth charts often to assess child’s growth


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Food Allergies and Constipation

  • Recent studies have linked infantile constipation to cow’s milk allergy

  • Study shows infants switching to soy milk from cow milk alleviates constipation

  • Study shows 5 year olds eliminating milk protein from diet and no longer suffering from constipation


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Food Allergies and Atopic Dermatitis

  • Atopic dermatitis: skin condition associated with food allergies in infants and children

  • Atopy: refers to a tendency for excess inflammation in the skin, linings of the nose, and lungs

  • Eczema usually runs in families


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Food Allergies and Eczema

  • 10% of infants suffer from eczema

  • Skin becomes infected, with itchy rashes on face and scalp


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Food Allergies and Eczema

  • Study suggests that introducing solid food later in life will decrease prevalence of eczema

  • Low-birth weight significantly correlated with a lower risk for food allergies and atopic dermitis


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Potentially Deadly Reactions

  • Most severe reactions in children: peanuts and other tree nuts

  • Many are accidental: hidden nuts in brownies and cookies, peanut oil, etc.

  • Symptoms progress with maturity

  • Skin reaction during infancy to respiratory and gastrointestinal reactions later


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Maternal and Familial Influence on Food Allergies

  • Food allergies and atopy run in families

  • 20% of children with eczema are the only one in family with problem


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Maternal Influence and Possible Prevention

  • Prevalence of peanut allergy is rising

  • Pregnant women advised to eliminate peanuts from diet

  • Allergy to peanuts may be preventable


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Breastfeeding Mothers

  • Breastfeeding may prevent food allergies and atopic dermatitis

  • Can pass peanut allergy through breastfeeding

  • It is recommended for mom to eliminate peanuts from diet while breastfeeding


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Prevention of Cow’s Milk Allergy

  • Hydrolysated formula

  • Extensive or partially

  • Only given to babies at high risk for atopic disease due to family history


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Prevention of Cow’s Milk Allergy

  • Babies given eHF combined with breast milk and no solid food until after 6 months of age

  • Prevalence of food allergy and atopic dermatitis significantly reduced

  • Babies given eHF or pHF: atopic disease greatly reduced in those given eHF


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Diagnosis of Food Allergy

  • What happens in the case of a mild reaction?

  • What happens in the case of a severe reaction?


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Tests and Procedures to Determine Food Allergy

  • Skin Prick Test

  • Identifies food specific IgE antibodies

  • Test is either negative or positive


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Tests and Procedures to Determine Food Allergy

  • Radioallergosorbent Test (RAST)

  • Done if test positive on SPT

  • RAST is a blood test to determine food specific IgE

  • RAST and SPT detect sensitization, but sensitization can occur without reaction


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Elimination Diet

  • Determines if given food is causing allergic reaction

  • Food thought to be causing symptoms removed from diet

  • Infants: change of formula or diet for breastfeeding mother

  • Lasts 1-6 weeks


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Food Challenge

  • Also determines if specific food causes allergic reaction

  • Performed under certain circumstances:

    1)When several foods are under consideration, 2)IgE tests positive for several foods, and 3)elimination diet caused symptoms to end


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Relevance to Parents

  • Valuable for new parents and those thinking about reproducing

  • May be able to prevent certain food allergies

  • Be aware: unusual symptoms of child may be caused by food allergy

  • Education is Key: inform teachers, babysitters, and any caretaker of child in order to prevent severe reactions


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