Diverse symptoms ranging from an infant “spitting up” to overt vomiting or diarrhea or colic are very common in newborn infants. Abdominal pain, flatulence and constipation tend to be more common in older children. All these symptoms often bear a timed relation to the ingestion of the suspected food item when parents notice them and the perception of a probable allergy or food intolerance is made as a result. The diagnosis of food allergy is beyond the scope of this article, however once the diagnosis is established, strict avoidance and elimination of the culprit food item becomes medically necessary. The Food Allergen Labeling and Consumer Protection Act of 2004 mandates food packaging companies to identify products containing milk, egg, soy, wheat, peanut, tree nut, fish and shellfish on the packaging label. This allows parents to make an informed choice to avoid known allergens and exclude these from the diet of their children.

Do allergies last a lifetime once established?

Food allergies as with other disease processes affecting the immune system can vary widely in their clinical courses over time. Most studies however posit that 70%-80% of patients outgrow milk and egg allergy, 60% to 70% outgrow soy and wheat allergy, and 10% to 20% outgrow peanut and tree nut allergy. Repeat assessment by your physician or allergy and Immunology specialist may be necessary with an updated patient history before conclusions about ‘outgrowing” a specific allergy can be made with certainty. These can be done yearly, but it is noteworthy even from above numbers that peanut, tree nut and fish along with shellfish are less amenable to “outgrowing” and repeat testing may need to be less frequent in these cases.

What do I do, if I’m accidentally exposed to a known food allergen?

The approach to care would depend on the appearance and severity of symptoms. Immediate reactions or those that occur within a few minutes or delayed reactions occurring many hours later are both common. They may be mild and benefit from comfort measures that often include anti-histamines. Anaphylaxis is a medical term used when severe allergic reactions involve multiple body systems after exposure to a known or unknown allergen. These reactions may affect, the skin, the gastrointestinal or respiratory systems commonly. Indeed any body system of tissues and organs can be involved in a severe allergic reaction like anaphylaxis. They are life-threatening emergencies. The epinephrine auto-injector comes in two strengths for different patients depending on their weight. These are administered via injection into the muscle through clothing in an emergency. Every child or adult with a known food allergy should carry one or have immediate access to one at all times. Observation in a medical facility after use of epinephrine is necessary and activation of the emergency medical service afterwards is recommended in our practice.