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Expert Q&A: Eating With Food Allergies

An interview with Stanley Cohen, MD.

If you suspect your child has an allergy, what should you do?

For a few weeks, keep a diary of everything your child eats and at what time, any symptoms, and what time symptoms appear. Keeping a symptom diary will help you and your physician identify food triggers or patterns. Take into consideration any emotional factors in your child's life, such as stress, or whether the symptoms only occur on school days, or every time he has a baseball game or a visit with a stepparent.

Is there anything parents can do to keep children from developing allergies?

The cause of food allergies is not fully understood, yet there appears to be a hereditary association.  Children are 20% more likely to develop allergies if one of their parents has the allergy, and 40% more likely if both parents are allergic.

Breastfeeding may help prevent the onset of allergies, especially if the infant is breastfed for an extended period of time.

Some experts think an early introduction to the highly allergic foods may be beneficial in breastfed babies.  Introduction should occur slowly, between 4 and 6 months of age, with only one new food a week, and parents must be vigilant in watching for symptoms. It's recommended that you check with your doctor before introducing these foods.

What precautions should allergic moms take when feeding their newborns?

Breastfeeding is best. Protein hydrolysate infant formulas are the recommended formula for allergic infants. When you start introducing foods, only introduce one new food a week, starting with rice cereal or vegetables and ending with eggs. Be very cautious with egg whites, since they are highly allergenic in infants. Preferably, introduce them in the presence of your physician.

Can children outgrow food allergies?

Most allergies start in childhood, but not all. What is fascinating is that some kids outgrow their allergies and begin tolerating the protein by 5 years old if they avoid the offending foods when they are young.  In the case of milk allergy, this occurs primarily in infants and toddlers, and many outgrow it by the age of 3. 

However, allergies to peanuts, tree nuts, fish, and shellfish tend to be lifelong.

Why are wheat allergies and gluten intolerance on the rise?

More cases are being identified because we have better screening tools. It is now estimated that one in 133 people have a wheat allergy to the gluten (protein); previously we thought only one in 5,000 had the allergy. 

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