A Guide to Dealing With Childhood Food Allergies

Certain food allergies, such as a sensitivity to peanuts, have become much more prevalent in Singapore in recent years. For children, food allergies can range from mild irritations to the life threatening, so as a parent, gradually exposing your child to different foods as a test is essential if you’re concerned about possible allergies.

Children and allergies

Around 6% of children in Singapore have food allergies, however this applies only to children under the age of one. The percentage decreases to 3% or 4% for children aged five and above, with some children with egg and milk allergies outgrowing their allergy by the age of five.

An allergic reaction happens when the immune system reacts in some way – the exact cause and process isn’t yet known – to a particular food. The symptoms or reaction can manifest immediately or only after some time, possibly hours after exposure to the food.

Allergies tend to run in families, but some children will have allergies even if no one else in the family has the same allergy. Exposure to allergen foods when the immune system has been weakened (such as after a viral infection) could also impact the risk of developing an allergy.

Testing for a food allergy

To test for possible food allergies, introduce one food at a time to babies who are starting on solids. If your baby has an allergic reaction and you’ve given your baby five different foods over a few days, you’ll find it difficult to work out which food they’re allergic to. Start with one type of food at a time, and then wait three to five days before adding another food.

Common allergenic foods

There are over 160 allergenic foods, but just eight foods may account for as much as 90% of allergic reactions. The top allergenic foods or food groups are eggs, milk, peanuts, tree nuts (such as walnuts or almonds), fish, shellfish, soy, and wheat. Children may also be allergic to pollen and other allergens that are not food, such as animal dander, insect stings, and medicines.

In Singapore, the most common food allergies are those caused by eggs, fish, and peanuts, followed by dairy, wheat, and soy. Peanuts are the most common cause of anaphylaxis in Singaporean children, while shellfish is the most common food allergen. Other allergies observed in Singapore that are less frequently observed around the world include an allergy to bird’s nest, an Asian delicacy, and an allergy to galacto-oligosaccharide, a prebiotic found in milk formulas.

Signs and symptoms to look out for

There are many different symptoms related to a food allergy, and these will vary depending on the child, the food, and the severity of the allergy.

• Hives – Hives are the most common type of food allergy symptom. Your child could break out in hives – an itchy skin rash – after eating something they have an allergy to.
• Rash around mouth – Some children develop a rash around the mouth when they ingest food they’re allergic to.
• Itching and swelling – It’s common for a food allergy to manifest itching and swelling of the mouth, throat, and tongue as a symptom.

• Dermatitis or eczema – Itching, redness, and scaly rashes are also associated with food allergies.

• Vomiting and diarrhoea – Vomiting and diarrhoea are common symptoms of food allergies.
• Abdominal pain – Some children experience abdominal pain when they eat foods they’re allergic to.
• Anaphylaxis – One of the most serious symptoms is anaphylaxis or anaphylactic shock, which can involve a persistent cough, hoarse voice, wheezing, shortness of breath, and difficulty swallowing. In very serious instances, the child could pass out and the allergic reaction can be life-threatening, and the child will need immediate medical attention.

Tips for managing your child’s food allergy

There’s no cure for food allergies – although children can grow out of them – so the best way to manage a food allergy is to ensure that your child avoids the allergenic food and where necessary, has appropriate substitute foods to make up for any resulting nutritional deficiencies.

Note that some research suggests that introducing peanut-based foods early to children could prevent peanut allergies. Sensitisation to food proteins may happen during gestation, and consuming probiotics during pregnancy could help prevent some allergies, while eating more peanut, milk, and wheat could also lessen the risk of allergies in children.

While eating out can be a challenge, you and your child can still enjoy eating in restaurants if you seek out eateries that are willing to cater to allergen requests.

It’s also vital, once your child starts school, to let teachers and other staff members at their school know about your child’s allergies. The more the school is aware of your child’s allergies, the better they can work to prevent accidental exposure.

Your child should also be taught about their allergy as they get older, so that they can make smart food choices and avoid the foods that they’re sensitive to.

In terms of allergy medication, you could consider options such as prescription medication, eye drops, nasal sprays, or allergy shots that help alleviate the symptoms.

Always consult with an allergist and/or your paediatrician if you have any doubts. A doctor can definitively diagnose an allergy with a skin-prick test or oral food challenge. Your doctor can teach you how to administer adrenaline auto-injectors in case of emergencies.

Keeping on top of food allergies in your child

Allergies in children can be mild or severe, so it’s vital for parents to gradually introduce foods one by one when babies are ready for solids. By looking out for common symptoms and seeking advice from your doctor when necessary, you can accurately identify your child’s allergy and prevent discomfort and more serious symptoms from occurring.

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