Food Allergies Keeping An Eye on the Edibles

Keeping an Eye on the Edibles

Your three-year-old breaks out in hives after eating scrambled eggs. Or your infant begins to wheeze after eating anything made with wheat.

Food sensitivity affects 2 to 5 percent of children in their first few years of life, says Hugh Sampson, M.D., a pediatric allergy/immunology specialist, professor of pediatrics and director of the Pediatric Clinical Research Unit at the Johns Hopkins University School of Medicine in Baltimore. Fortunately, many children outgrow some types of allergies by the age of three.

If you suspect a food allergy, an allergist or your doctor can help you pin-point the problem food or foods and tell you what to do if your child accidentally eats the food. In rare cases, you'll need to keep prescribed medications on hand to control anaphylaxis, a severe and potentially fatal reaction.

Once your child's doctor has confirmed an allergy, you need to help your child avoid that food and instruct your child, family and caregivers how to recognize a reaction and what to do if it occurs. Here's how to help keep your child safe from the offending food and what to do if she does eat it.

Become a wise shopper. ''Learn the technical and scientific names for foods your child is allergic to,'' says Dr. Sampson. Milk, for example, can be present in foods under many names such as caseinate or whey, and eggs could be listed as albumin or ovomucin. If you encounter names you're not familiar with on a label, look them up before you allow your child to eat the food, or call the manufacturer and ask about the ingredients. And read label ingredient information every time you buy a food product; manufacturers sometimes change ingredients without warning.

Beware of cross-contamination. If you're cooking an allergy-free dish for one child, be sure you don't stir it with the same spoon you're using for other dishes that might contain an allergen, says Anne Muñoz-Furlong, founder and president of the Food Allergy Network, a nonprofit organization in Fairfax, Virginia, established to help families cope with food allergies.

Be especially careful to wash all cookware, dishes and tableware thoroughly with soap and water and rinse them well to be sure no allergen remains. It's a good idea to put all your cooking materials in the dishwasher and run them through a regular cycle.

Involve your child. ''Allergic children should know what foods they're allergic to and be taught to be aware of their own bodily symptoms,'' says Gilbert Friday, M.D., professor of pediatrics and chief of clinical services of the Asthma and Allergic Disease Center at the Children's Hospital of Pittsburgh.

Explain to your child that certain foods make her body react, and that she should avoid them. For a young child, it may help if the two of you cut pictures of offending foods out of magazines and mount them on a poster. Explain symptoms to your child, and tell her she should let you or another adult know immediately when she feels those symptoms.

Role play situations. '' Your child may worry about avoiding temptation or may experience peer pressure to eat forbidden foods,'' says Muñoz-Furlong. ''Role-playing possible scenarios can help him learn how to handle whatever comes up.''

For example, pretend you're a friend of your child's at a birthday party, cajoling your child to taste ice cream although he's allergic to milk. Have your child practice saying no and explaining that the food will make him sick.

Reinforce the positive. ''Compliment your child every time she turns down an allergy-causing food,'' says Dr. Sampson. ''This builds independence and self-esteem, which is important because as she gets older it will ultimately be her responsibility to monitor her own diet.''

Alert caregivers. ''Before the school year begins, schedule a meeting with your child's teachers, school administrator, counselor, nurse, cafeteria personnel and office staff,'' says Muñoz-Furlong. ''Explain to this team what foods cause a reaction, what precautions should be taken and emergency procedures. Provide them with the name and phone numbers of three emergency contacts.''

If medication is needed to control allergic reactions, supply medical infor-mation forms from your doctor with the allergy information highlighted, suggests Dr. Sampson. If changes in allergy or medication occur, alert the school team.

And furnish the same information for any family members or babysitters who take care of your child.

Create a special alarm signal. ''Have your child create a signal to let the teacher know that he's having a reaction,'' says Muñoz-Furlong. ''Tell family, friends and school personnel what the signal is.'' This signal could be a code word or a gesture such as pointing to the throat.

Take special care when eating out. Allergens can be present in foods where you don't expect them. Make sure you know what ingredients are in prepared food, says Dr. Friday. ''I had a patient who ate what he thought was chocolate pudding at the school cafeteria,'' he says. ''It turned out that peanut butter was an ingredient in the pudding, and he was highly allergic to peanuts. He had a severe allergic reaction within minutes.''

Unless you can review the school menu with school personnel ahead of time, pack your child's lunch, and explain clearly to your child why he can't swap lunches with friends.

Plan before parties. Before your child attends a party or school function where food will be served, talk to the host so you know what will be served and the host will be aware of your child's allergies, says Muñoz-Furlong. If your child is allergic to anything on the menu, send along special treats that your child can eat.

Avoid bakery items. ''Baked goods are notorious for including possible problem foods such as nuts, eggs, milk and other ingredients,'' says Muñoz-Furlong. It's much safer to bake items yourself, either from scratch or using mixes with labels you've carefully scrutinized.

Beware of deli meats. If your child is allergic to milk, you'll probably want to skip deli meats. ''The same machine is often used to cut cheese and meat products, and can cause meat to contain trace amounts of milk,'' says Dr. Sampson.

Give an OTC antihistamine. ''Most kids get itchy hives if they eat a forbidden food,'' says Dr. Sampson. ''Over-the-counter antihistamines such as Benadryl Elixir will help relieve the symptoms.'' Be sure to read package directions to make certain the product is recommended for your child's age. For the correct dosage, follow package directions or consult your physician. Some doctors don't advise Benadryl cream or spray because it could cause a reaction.

Don't, however, substitute an over-the-counter product for one that your physician has prescribed. If your child has reactions severe enough to have prescribed medications, it's crucial to use them.

Buy a medical emergency necklace. ''If your child suffers from severe food allergies--the kind that can cause anaphylaxis--have her wear a medical emergency necklace and carry a personalized emergency-care card listing your doctor's name and number, medications used and foods that can cause reactions,'' says Dr. Sampson. Your doctor can help you order the necklace, or you can buy one at a jewelery or drugstore.

Keep medicines handy. If your child has a severe food allergy, your doctor probably will have recommended an antihistamine. Where there is risk of a very strong reaction, a doctor may prescribe epinephrine (Adrenalin), which is available in two forms for home use: Ana-Kit, a syringe, and EpiPen, a pen-shaped applicator. If an antihistamine or epinephrine is prescribed, be sure that your child carries the prescribed medications at all times, cautions Muñoz-Furlong.

Packing the medications should be part of the daily routine, like putting on shoes or socks. You may want to get your child a special fanny pack to carry the medications in. Put a checklist by the door, and have your child check off the items he's carrying before he leaves the house. You should also keep extra medications around the house and in your purse or briefcase.