The best treatment for a food allergy is to completely avoid the problem food. Being diagnosed with a food allergy has a massive impact on the whole family.
Eating is such a central part of day to day life that having to be absolutely sure that a child has no contact with a particular food effects mealtimes, going to school, holidays and social occasions. A simple supermarket trip has been shown to be almost 40% longer when shopping for a food allergic child.
Parents also need to be able to recognise reactions and know exactly how to deal with them when they occur. This usually involves carrying antihistamines everywhere the child goes and also, for those children at risk of anaphylaxis, adrenaline injections (see below).
Children with food allergies are also at risk of missing out of the essential nutrients that they would otherwise get from the food they are avoiding especially in the case of infants with milk allergy. Fortunately, there are now many specially designed milk substitutes suitable for these children and with the help of a dietician, a nutritious diet can be achieved even in children with multiple food allergies. Dieticians can help parents with ideas about how to make sure that a child with a food allergy has a varied and nourishing diet, and this ensures healthy growth and development. It can also play an essential part of minimising the impact on your lifestyle by offering acceptable foods. It is also possible to obtain special foods for your child, such as wheat-free alternatives to bread and pasta; a member of the allergy team can advise you as to where to buy this, and if it can be obtained on prescription.
Many food allergies, such as egg and milk, are outgrown during childhood whilst allergies to peanuts, nuts, fish and shellfish tend not to go away. Children with food allergies also have a high chance of having other allergic problems such as asthma, eczema and hay fever.
It is essential that children with food allergies continue to be seen by their doctors as they grow up. Repeating allergy tests can help predict if the allergy has been outgrown so that the food can be carefully reintroduced into the diet. It is also essential that the child is carefully examined for any signs that they are missing out on any essential nutrients due to their restricted diet, or if they are developing signs of other allergic problems.
Unfortunately, there are no cures for food allergy in the immediate future although exciting research does promise real progress over the next 5-10 years, not only in our understanding of how to prevent allergies occurring in the first place but also for helping those who already have them.
Food allergy can potentially have the greatest impact upon the lifestyle and choices made by a child and their family. However, with clear understanding of the issues, and through having good routines in place to cover both food choices and emergency situations, the impact of food allergy can be kept to a manageable level.
Adrenaline injector pens are used for severe allergic reactions where the child may suffer from anaphylaxis and allow adrenaline to be injected quickly and easily to combat the allergic symptoms. The pens are prescribed according to the weight of the child, and are sometimes designated as junior or senior injector pens.
There are now a number of different adrenaline devices available, but they all contain exactly the same medication. They are made by different manufacturers and have a slightly different mechanism in how they are administered.
How to use
- Appropriate training is needed to administer an adrenaline auto-injector. Ask your GP, allergist or nurse to show you how and your child (if old enough) to administer the auto injector; they will probably have ‘dummy’ pens that you can use to practice with
- Injector pens come with instructions and are easy to administer, but it is essential that anyone caring for your child understands exactly when and how to use them, and know that immediate follow up with medical care is necessary
- Training injectors which do not contain adrenaline or a needle are available to registered auto-injector users, from both the Epipen, Jext and Anapen websites
- Contact Allergy UK for further information about training as well as information on available videos that show how to administer adrenaline via the pens. (Alternatively: A training video is available for viewing on the Epipen and Jext websites)
- Sometimes a second dose of adrenaline may be required, and for this reason it is important to have more than one auto-injector
- It is advisable to have between two and four auto-injectors (i.e. two at home and two at school). It can be difficult to get these prescribed but if you explain to your treating doctor your requirements then hopefully this will be achievable
- An ambulance should always be called following administration of adrenaline as sufferers of anaphylaxis can go on to have a later secondary reaction and the hospital can then administer additional treatment. The hospital can also provide a replacement for the auto-injector you have used once they have checked your child and monitored them
- Storage is important and injector pens should be in an easily accessible place that everyone at home knows about. In school the pens should be in an unlocked area which the child knows well. Some older children may carry the pens themselves
- Ask your treating doctor for a management plan that details your management of the condition and also what to do in an emergency
- Talk to a dietician for information on your child’s diet and adequate provision for nutritional needs. Dieticians can be accessed via your hospital doctor or GP and can also provide information on alternative foods and recipe adaptations
- It can be a good idea to have designated members of staff at school so that your child knows who to go to. All staff should be made aware of your child’s allergy so that if they develop any symptoms they can be monitored
- A protocol should be drawn up detailing treatment and advice and staff training (given by a medical professional) should be undertaken regularly
- A child’s photograph should be kept on the protocol form which should be inside any auto-injector box and staff should familiarise themselves with the photos and names of any children who are at risk of anaphylaxis
- Always talk to your doctor or dietician about reintroducing foods that have previously been avoided
- Remember that it is very important to be aware of potential cross-contamination when preparing food for allergic children. It is essential that all utensils and food preparation surfaces which are used to prepare foods that may be harmful to your child are not then used for preparing food for your child without thorough cleaning. In the same way cutlery for eating and dishes should not be shared between your child and other individuals
- Get together a list of foods that are safe and foods which must be avoided. Try to adapt recipes so you are able to include your child safely. Details of allergenic recipe books are available from Allergy UK and you can ask your local library to order them in for you
- Have a box of treats at home that always has something to eat in it, so that you will always have ‘safe’ foods available and your child does not feel that they are missing out on treats
- Think about packed lunches and carry spares in the car in case you are longer than you anticipate
- Try to be organised, pre-arrange your menus and shopping, freeze and bake essential supplies
- Make a note of new foods and products that are suitable for your child and where to access them. This can make shopping easier as you will probably find you cannot obtain all the special dietary products from one store
- Don’t let children share their food with others. Make sure they have suitable alternatives if they are going for example to parties or there are school activities involving food, and keep these supplied so that the teachers are confident they can provide something without having to isolate them due to their allergy
- Obtain a list of the different names used for food types, for example, food products containing dairy products are sometimes labelled as containing whey or casein. More advice on this can be obtained from the Allergy UK Helpline
- Try to help your child develop confidence in what they eat by helping them check menus and food labels for safe items (free from logos) and allergens. Also help them to learn how to ask about suitable foods when they are out
- Make sure your child will tell you if they have accidentally eaten something or if they are unsure about the safety of any foods. It is important that they are not frightened by their condition, but they understand that watching what they eat will allow them to stay healthy
- Some children, especially if they are forming friends, do not want to ‘tell’ on a friend if they have been given a snack which they should not have. Try to encourage them to tell you that way you can manage the situation and let them know there won’t be any repercussions with their friends
- Some children can feel pressured by their friends and general peer group to try foods that they are unsure of, or to go hungry rather than show that they are different because they have an allergy. A number of books are available that give advice on how you can help and encourage your child to cope with their condition and encourage them to resist peer pressure. For more information on the books available contact Blossom
- A number of organisations exist that can give advice on how to help children at risk of anaphylaxis. Allergy UK can provide you with help to access this support, as well as further information on precautionary measures that your child and anyone caring for your child can take to minimise exposure to allergens
- Translation Cards can prove useful when travelling abroad; they provide details of the food allergy in the language of your choice and are available from Allergy UK
Last updated: March 2012