1. Food Allergies in Infants and Children
Shana Spector

2. 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

3. 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

4. IgE Mediated Allergy Disorder
Cause acute onset of symptoms after digestion
Affect skin, respiratory tract, gastrointestinal tract and cardiovascular system

5. 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

6. 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

7. 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

8. Types IgE Disorders Oral Allergy Syndrome
Caused by allergies to fruits and veggies
Itching swelling of lips, tongue, palate and throat

9. Types IgE Disorders Respiratory Hypersensitivity Reaction
Effects respiratory tract
Causes runny nose, nasal congestion, wheezing and coughing

10. Types IgE Disorders Airborne Food Allergy Reaction
Transpires from smelling an allergen through cooking
Causes nasal congestion, inflammation of the eyes and hives

11. 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)

12. 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

13. 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

14. 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 deaths per year

15. 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

16. 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

17. Problems Associated with Food Allergies in Children
Poor nutrient intake
Constipation
Eczema
Potential death

18. 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

19. 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

20. What to do if Child has Food Allergies
Consult with an allergist and dietician
Use growth charts often to assess child’s growth

21. 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

22. 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

23. Food Allergies and Eczema
10% of infants suffer from eczema
Skin becomes infected, with itchy rashes on face and scalp

24. 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

25. 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

26. 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

27. 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

28. 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

29. 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

30. 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

31. Diagnosis of Food Allergy
What happens in the case of a mild reaction?
What happens in the case of a severe reaction?

32. Tests and Procedures to Determine Food Allergy
Skin Prick Test
Identifies food specific IgE antibodies
Test is either negative or positive

33. 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

34. 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

35. 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

36. 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