A new study"Allergic Reactions to Foods in Preschool-Aged Children in a Prospective Observational Food Allergy Study," published this week in the July issue of Pediatrics had researchers looking at some 500 children diagnosed with risks of reactions to milk or eggs.
Allergies seem to be becoming more widespread, or we are simply more aware of the problem. Another common and increasingly seen allergy is to gluten, which rather inconveniently includes all wheat products, bread, pies, pasta, oats, barley, malt, and most baked products.
Researchers found a rather sloppy approach to protecting children from allergic reactions, with more than 10% of all exposures to egg, milk products or peanuts, being non-accidental: ie. the parent or care giver was aware of both the child's allergy problem and the ingredients of the food, but went ahead and gave the meal to the child just the same.
Half of allergic reactions were caused by food not given by the child's parents and whilst only a third of the allergic reactions were so severe they needed to be treated with epinephrine (also known as adrenaline, a powerful hormone that increases heart rate, blood vessel dilation), overall, there appeared to be lack of food safety. with not enough attention to ingredients, the children's needs or double checking labeling.
Obviously, it can be extremely difficult at times to avoid some of these common foods that maybe hidden ingredients in a product. An allergy to milk, peanuts or gluten, does require a strict discipline and vigilance. This becomes even more difficult with children who want to try the things their friends eat, or are simply out and about in the park or the mall, where food options are more limited. Any parent can understand the problem of needing to find something to feed a hungry and irritated young child. Nonetheless, the researchers felt that more education is needed in regards to allergies.
The 11% of cases where the child was deliberately given food they were allergic to, doesn't necessarily show malice of any kind, simply a lack of education and a deficiency on the part of the care giver to understand the ramifications and seriousness of a child who is allergic.
The authors continue, that there is also a need to better educate parents and care givers as to the use of epinephrine, providing them with reassurance about the safety of administering it, as well as offering basic teaching as to its proper use. During the study it seemed that correct and proper administration of epinephrine was not being carried out in for every case that it was needed for.
Dr. David Fleischer, assistant professor at National Jewish Health in Denver, the lead author of the study concluded:
"In terms of purposeful exposures, those percentages haven't been reported before ... Maybe parents were testing their children to see if they had outgrown their allergy. There's going to be a follow-up study, going back to families and asking exactly why caretakers were giving these foods on purpose."
The number of reactions from the 500+ children on the study was surprisingly high, with some 70% having at least one reaction and more than 50% having more than one reaction, and this, in spite of parents and caregivers being informed of the child's problems. The issue is even more pressing once you understand that some 8% of children in the United States have allergies of some kind.
Dr. Scott Sicherer, professor at Mount Sinai Hospital and co-author of the study concluded that their article should serve as a wake-up call in regards to children and allergies:
"The bottom line is that you have to maintain a high level of vigilance ... That applies to the parents, but also to other people taking care of the child: grandparents, siblings, babysitters, teachers. Basically everyone who is around the child needs to know about the allergy and understand what to do to keep the child safe."
It can be very difficult to avoid common foods, but once the discipline and awareness is in place it ought to become fairly straight forward. With such a high number of allergies around, it's clearly no longer a case where there's only one child, in a school of 500, who represents the awkward exception that has to be handled with kid gloves at meal times. Rather, dairy free, nut free, gluten free and other options should be becoming virtually standard fare.