By Katherine Cook
When my son, Stanley, was seven years old I noticed that he was struggling with eating and had pretty much stopped growing. At meal time he would complain that he was full really quickly or that his stomach hurt. Often he would tell me the food made his mouth taste and feel weird. I thought he was being your typical picky eater. He also always had a stuffy nose, and a dry cough and would sniffle and sneeze a lot. I always assumed it was seasonal allergies, but around that time I realized that “seasonal” was all year for him. Something just didn’t feel right, so I decided to take him to the doctor. I am so glad that I did.
I told the doctor about Stanley’s problems with eating and asked why he seemed to have seasonal allergies year round. The doctor knew right away. The first thing he said to me when I stopped rambling on and on was, “sounds like food allergies.” For a minute I was confused. At the time he had never had a serious reaction. My mind went straight to the movies and how the people puff up instantly grabbing their throats gasping for air, and that hadn’t happened to him. It turns out that food allergies can develop at any age and some can either get worse or better over time. So even though Stanley hadn’t had a serious reaction yet it didn’t mean that he wouldn’t have one eventually.
I was unable to pinpoint certain foods that typically coincided with what I learned were his “mild” reactions. He seemed to have them all the time. We were told about the eight most common food allergies: milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish. It turns out these eight foods account for 90% of all reactions. The doctor sent us in for a blood test, but as the results can take a while, he recommended we try an elimination diet of the top eight foods until the results were in. If Stanley were to have a mild reaction he told us to give him Benadryl and to write down the foods he had eaten. If his reactions became more serious we were to take him to the ER right away.
The elimination diet did not yield good results for us. The symptoms seemed to persist. When the blood test came back we learned why. Stanley had multiple food allergies. The offending foods were tomatoes, corn, oats, wheat and peanut, only two of which were in the top eight food allergens. We were not prescribed an epinephrine auto-injector at the time because his reactions had only been mild. We were advised to eliminate the foods from his diet and watch his reactions should he somehow eat something he should not. I felt that I had been poisoning my son and really regretted that I didn’t know what was happening with him sooner!
Food allergies are serious conditions that nearly 15 million Americans are faced with. According to FARE (Food Allergy Research and Education), from 1997 to 2011 the number of children affected by food allergies has grown by 50%, which means that one 1 in 13 children are living with the ailment. Approximately 40% of children with food allergies have experienced serious or life-threatening reactions. It is a shame that more people don’t know what they look like!
Recognizing Food Allergies
When I look back, knowing what I do now about food allergies, all of the signs were there. I just didn’t know what I was looking at. These are symptoms to watch for when it comes to food allergies.
- Odd taste in mouth
- Hives (red, swollen, itchy areas on the skin)
- Redness of the skin around the eyes
- Eczema (a persistent, itchy, dry rash)
- Itchy mouth and/or ear canal
- Stomach pain
- Nausea and vomiting
- Uterine contractions
- Slight, dry cough
- Nasal congestion or runny nose
Children often do not know how to express what it is they are feeling. Stanley would always say he was full, that there was something stuck in his throat, or his mouth tasted weird or that the food tasted funny. He never said, “My throat is swelling a little bit.” So listen and watch closely. One response small children may have to a reaction if they don’t know how to communicate the issue with you is keep their hands in their mouths or pull and scratch at their tongue and ears. Their voice may also sound different. Often times Stanley would sound like he had one of those snot bubbles in the back of his throat after a meal.
Ways children might express that they are having a reaction
- “This food is too spicy.”
- “It feels like something is poking my tongue.”
- “My tongue (or mouth) is itchy.”
- “My mouth feels funny.”
- “My lips feel tight.”
- “My tongue is burning (or hot).”
- “My tongue (or mouth) is tingling.”
- “It feels like there is hair on it.” (In reference to their tongue.)
- “There’s a frog in my throat.”
- “My tongue feels heavy (or full).”
- “It (throat) feels thick.”
- “There is something stuck in my throat.”
- “I feel like there are bugs in there.” (Itchy ears.)
I mentioned above that over time food allergies may improve or become worse. For Stanley, tomatoes have developed into a much more serious allergy. About a year after diagnosis, he was at a grandparent’s house and ended up eating a gluten-free pizza. They remembered his wheat allergy, but had forgotten about the tomatoes. Being young, Stanley didn’t say anything about it, he just assumed that since it was handed to him it was okay. It wasn’t. He began to visibly swell, and he was having trouble breathing and swallowing. All it took was a slice of pizza.
- Trouble swallowing
- Sense of “impending doom”
- Chest pain
- Obstructive swelling of the lips, tongue and/or throat
- Turning blue
- Shortness of breath or wheezing
- A weak or “thread” pulse
- Drop in blood pressure (feeling faint, dizzy, confused, passing out)
- Loss of consciousness
It turns out he was at the onset of an anaphylactic reaction, had we not gotten him help it could have been much worse. After this reaction we were prescribed with epinephrine auto injectors.
Reactions to food allergies can range from a mild response to anaphylaxis, a potentially deadly reaction. Every three minutes someone is sent to the hospital from a reaction, every six minutes that reaction is anaphylactic. Anaphylaxis can occur within seconds or minutes of exposure to something your child is allergic to. However there are times when it takes up to a half an hour or longer for the reaction to take place.
Signs and Symptoms
According to the Mayo Clinic, the flood of chemicals released by your immune system during anaphylaxis can cause you to go into shock; your blood pressure drops suddenly and your airways narrow, blocking normal breathing. This is what that may appear like:
- Skin reactions, including itching, hives, and pale or flushed skin (This does not always occur with anaphylaxis.)
- A rapid and weak pulse
- Swelling of the face, eyes, lips, or throat
- Constriction of the airways, which leads to wheezing and trouble breathing
- Feeling warm
- Nausea, diarrhea or vomiting
- Dizziness, unconsciousness or fainting.
If your child carries an epinephrine auto-injector (such as an EpiPen or EpiPen Jr), give him or her a shot right away. Even if this appears to help it is important to get your child emergency treatment (get to the ER) right away. Symptoms of anaphylaxis are known to recur and an observation period of two to 24 hours is typically required.
Anaphylaxis can stop their breathing and even their heartbeat. If this is the case, you’ll need to begin cardiopulmonary resuscitation (CPR) right away. Call (or have someone call) 911 and if you have an epinephrine auto-injector use it, then begin CPR. The Mayo Clinic states that emergency responders may give your child the following medications:
- Epinephrine (adrenaline) which is used to reduce the body’s allergic response
- Intravenous (IV) antihistamines and cortisone to reduce inflammation of the air passages and improve breathing
- A beta-agonist (such as albuterol) to relieve breathing symptoms
- Oxygen, to help compensate for restricted breathing
Unfortunately, there is no way that the immune system condition that leads to anaphylaxis can be treated. However, there are steps that can be taken to prevent future attacks and to be prepared if one should occur.
- Avoid known triggers as much as possible. Read food labels carefully and don’t hesitate to ask questions when eating away from home.
- Have your child’s medication with you wherever you go.
- Have your child wear medical identification (e.g., bracelets, other jewelry) at all times.
- Your child’s doctor may recommend taking antihistamines or prednisone.
- Work with your child’s doctor to develop a written step-by-step plan of what to do in the event of a reaction. That way, you’ll know exactly what you need to do if anaphylaxis occurs, and you’ll have a written plan that you can share with teachers, baby sitters and other caregivers so that they’ll know what they need to do, too. (After my sons serious reaction I left one of these at each grandparent’s home.)
- If your child has experienced anaphylaxis, talk to his or her school nurse and teachers to find out what plans they have in place for dealing with an emergency. Make sure school officials have a current auto-injector in case your child needs treatment. FARE offers printable food allergy and anaphylaxis emergency care plans that can be given to teachers and school nurses.
Though dealing with food allergies can be stressful, especially in the beginning, it is manageable. With helpful information and support, you will find dealing with them becomes easier. Please look for my continuing post on food allergies where I will talk about our lifestyle adjustments and places to find support.
Read Part Two
- My Child Has Food Allergies: Part 2 (fillyourplate.org)