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allergies in children

How to manage food allergies in children who attend child care

September 25th, 2018

Food allergies in children affect thousands of Australians with a significant increase in food allergy diagnosis in the last twenty years.

This means it is more important than ever to ensure that every parent and child is aware of potential food allergies in children.  This includes what foods to stay away from and how to manage this increasingly common health risk, especially for children attending child care.

Hearty Health have been providing allergen free meals to children in child care for the last eighteen years. Operating from an egg, nut and pork free kitchen, chefs in the Hearty Health kitchen have noticed a steady increase in allergen meal requests.  Our chefs continue to adapt recipes that are safe but still taste delicious for high risk children.

Common food allergies

The most common food allergies are to nine main foods:

  1. cow’s milk
  2. hen’s eggs
  3. soybeans
  4. peanuts
  5. tree nuts like cashews, pistachios, walnuts, pecans or hazelnuts
  6. sesame
  7. wheat
  8. fish
  9. shellfish

Diagnosing food allergies in children

If you think your child has a food allergy, your GP is the best place to start. Your GP might refer you to an allergy or immunology specialist for further checks and tests.

Tests for immediate-onset food allergies:

  • Skin-prick test: your child’s skin is pricked with a small device that looks a bit like a toothpick and that contains a drop of a specific allergen. If your child is allergic, a red lump might come up where the skin has been pricked.
  • Blood tests: the serum specific IgE antibody test uses your child’s blood to see sensitivity to specific allergens. Your child might have this test if she can’t have skin-prick testing because she has severe eczema or has taken an antihistamine in the five days before the test.
  • Oral food challenge: sometimes your child will be given the possible allergen in a safe, supervised setting. Medical and nursing staff will watch to see whether an allergic reaction happens. This test carries a risk of anaphylaxis so should be conducted only by medical specialists in a setting where anaphylaxis can be safely and quickly treated.

A positive skin prick test or serum specific IgE antibody test doesn’t always mean your child has a food allergy. Sometimes your child can have a positive test and actually be able to eat the food. It’s important that your child is properly assessed by a doctor so he doesn’t avoid foods he’s not allergic to.

Delayed-onset food allergies

If your child has a delayed-onset food allergy, diagnosis usually happens through an ‘elimination and re-challenge’ test.

This involves removing possible allergy-causing foods from your child’s diet, then reintroducing them when your child’s allergy specialist thinks it’s safe to do so. You reintroduce only one food at a time so it’s easier to identify the food that’s causing the allergy.

Managing food allergies in children

There’s currently no cure for food allergies in children, but many children grow out of them. You can also take some steps to make it easier for you and your child to live with food allergies.

  1. Avoid the food

    It’s important for your child to avoid the food. This can be challenging, particularly as eating even tiny amounts can cause an allergic reaction. Your child also needs to avoid any foods or cutlery that could have been in contact with the food she’s allergic to.

    You can do two important things to help your child avoid the food:

Read labels on all foods. Be aware that some allergenic foods have different names – for example, cow’s milk protein might be called ‘whey’ or ‘casein’. By law, ten allergens must be plainly stated on food labels – these are the nine foods listed above, plus lupin.

Be careful when you eat out and ask the following questions:

– what ingredients each dish includes
– how it was prepared
– whether it has touched any other foods
– whether there’s any risk of cross-contamination

Most restaurants are happy to tell you, but they might not know about the ingredients in some foods like sauces.

It’s best to avoid buffets and bain-maries (food warmers) because there’s a good chance that ingredients have been transferred from one dish to another.

  1. Have an action plan

    You should talk to your doctor about an ASCIA (Australasian Society of Clinical Immunology and Allergy) action plan. This will help you recognise and treat symptoms if your child eats something that causes an allergic reaction.

  2. Know how to use an adrenaline auto-injector
    If your child is at risk of anaphylaxis, he might be prescribed an adrenaline auto-injector like EpiPen®. These auto-injectors make it easy to self-inject adrenaline. Your doctor will teach you and your child (if old enough) how and when to use it.   It’s important that key people – like family, carers, babysitters and your Child Care Centre– know how and when to use your child’s adrenaline auto-injector.
  1. Consider a medical bracelet

    Your child might wear a medical bracelet that lets people know she has an allergy.

How long do food allergies last?

Most children grow out of their food allergies by adolescence, especially children who are allergic to milk, egg, soybean or wheat.

Allergies to peanuts, tree nuts, fish and shellfish are more likely to be lifelong. Allergy to gluten, known as coeliac disease, is also lifelong.

If you think your child might have grown out of an allergy, see your GP or allergy and immunology specialist for an assessment. Don’t experiment at home to see whether your child has outgrown the allergy. Your doctor will let you know whether it’s safe for you to introduce the food at home or whether this should be done under medical supervision.

Allergy risk facts and factors for children

Most children with food allergies don’t have parents with food allergy. But if a child’s parents have other allergy problems like food allergy, asthma, eczema or hay fever, the child has an increased risk of food allergies.

Babies with severe eczema in the first few months of life are at an increased risk of developing food allergy.

For more information on allergies in children visit raisingchildren.net.au or check out the National Allergy Strategy that has recently been released.  The Strategy provides practical information to parents about when and how to introduce the common allergy causing foods to children.

Hearty Health is passionate about providing allergen children with fresh healthy meals in child care.

Contact Hearty Health here to view a sample of our Allergen Spring Menu and to book in a tasting with one of our experienced Chefs.

Hearty Health
P:  1300 728 762
E:  info@heartyhealth.com.au

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