Allergies and intolerances explained
Food allergies and intolerances are actually two separate issues.
An allergy – be it to food or an environmental allergen – stems from the immune system, and is an abnormal response to a normally harmless substance. A food intolerance is related to a physiological inability to digest a certain food.
If you have a family history of any type of allergy, including hay fever, asthma, eczema or food allergies, your child’s risk developing an allergy or intolerance is increased. This makes it vital to talk to your pediatrician about when to introduce certain foods and also means it’s important that you don’t wean your baby before the recommended age of six months (four months is the absolutel minimum but the longer you hold off, the better.)
Food allergies
Food allergies are rare in babies and young children because they depend on a sensitivity that builds up over time. However it’s possible for your baby to become sensitized to a particular food allergen while in the uterus because what you eat passes to him via the umbilical cord – common food allergens include eggs, cows’ milk, peanuts, wheat, soy, tree nuts (brazils, pistachios, almonds, cashews and walnuts), fish and shellfish.
Take precautions when weaning your baby onto solids to introduce each new food one at a time and wait three to four days before introducing another to ensure the previous food doesn’t cause a reaction. If you have a history of food allergies avoid giving your baby potential allergens until he’s over 12 months.
As your child gets older it’ll be harder for you to supervise what he eats. Make sure anyone who cares for him is aware of his allergies and remind them that the foods he reacts to may be hidden within other foods (nuts in cookies; eggs in cakes). Keep your child aware of this too, so he knows what he should avoid when he’s on playdates. The good news is that the vast majority of children outgrow food allergies by the time they reach school age although some, including peanut allergies, may persist into adulthood.
Food allergies can cause a potentially life-threatening reaction called anyphalactic shock – symptoms include difficulty in breathing and swelling of the face, lips and airways. You’ll be provided with epinephrine (an EpiPen) to treat this if it should occur. Practice using it and make sure anyone who helps care for your child knows how and when to use it too. If your baby or child does suffer anaphylactic shock, this is a medical emergency – call 911 straightaway even if he seems to recover after you use his EpiPen.
Food intolerance
While an allergic reaction stems from your child’s immune system, food intolerance is a reaction to foods that your child is unable to digest for physiological reasons. Typical symptoms are bloating, gas and diarrhea.
The most common food intolerance is to lactose, which is a sugar present in present in cows’ milk – it occurs if your child lacks an enzyme that’s needed to digest lactose. Symptoms include diarrhea, wind, spitting up after feeding, colic and crying. Cutting back on dairy is the only solution – if you’re bottlefeeding, your baby may need a special lactose-free formula; if you’re breastfeeding you’ll be advised to reduce your intake of dairy products, since it’s possible for these to pass into your breast milk.
With your older child, you’ll need to cut back on the amount of dairy he consumes. Keep in mind that lactose is found in less obvious foods, including some breakfast cereals, soups, salad dressings and deli meats. Check labels and be on the alert for whey, curds, milk byproducts, dry milk solids and nonfat dry milk powder.
It’s also possible that your child may be intolerant of gluten, a protein found in wheat, rye and barley. This results in celiac disease, a condition that damages the digestive tract and affects your child’s absorption of nutrients from food. Signs that your baby might have gluten intolerance may arise around weaning, after he consumes his first wheat-based solids – he might have foul-smelling diarrhea, stomach pain (signaled by him crying and pulling his legs up to his chest. Over time, his weight gain may reverse, suggesting failure to thrive) and he may develop skin rashes. Symptoms can also arise out of the blue in older children, causing fatigue, diarrhea, bloating, weight loss and rashes.
Hold off on introducing your baby to wheat products for as long as possible if you have a family history of gluten intolerance. If your baby or child does have celiac disease you’ll likely be referred to a dietitian for advice on how to adjust his diet to avoid consuming gluten – it’s present in a whole range of unlikely sources including broth and bouillon, fried chicken, french fries, deli meats, salad dressings, yogurts, soft cheeses, dips and even some wheat-free products which contain barley and/or rye.
If you have any more queries about allergies or intolerances, you can chat to other moms about them in the guide to baby or feeding and food area of our chat forum.
The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.
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Last Modified: 17/06/2007