YVONNE POLYDOROU PAEDIATRIC ALLERGY SPECIALIST DIETITIAN 08-12-2016
An allergy is the response of the body's immune system to normally harmless substances, such as pollens, foods, and house dust mite. Whilst in most people these substances (allergens) pose no problem, in allergic individuals their immune system identifies them as a threat and produces an inappropriate response. Food allergies affect an estimated five to eight percent of children in the UK.
Allergy may cause many symptoms depending on the allergen and the site of the body affected: Runny itchy nose, sneezing, itchy red swollen eyes, skin redness, hives, wheals, wheezing, abdominal discomfort, nausea, vomiting and diarrhoea Severe allergies may result in throat swelling and a drop in blood pressure. Also known as anaphylaxis, and can be life-threatening.
Sometimes a delayed reaction may occur which can be up to a week later. With this type of reaction symptoms would be a flare up of existing eczema, refractive constipation (constipation that does not respond to treatment), persistent nappy rash, persistent abdominal pain, diarrhoea that may contain blood/mucus.
Although nearly any food is capable of causing an allergic reaction, there are nine foods that cause the majority of reactions. These foods are: Peanut, tree nut, milk, egg, wheat, soy, fish, shellfish and sesame.
If there are concerns regarding possible food allergies it is important that this is discussed with the GP and a referral made to an allergy service. Appropriate methods of diagnosis will then be used, such as; skin prick testing, blood testing, allergy focused clinical history, oral food challenge or elimination and reintroduction diets.
Usually total avoidance of the offending food/s is needed under the supervision of a registered dietitian or allergy paediatrician. Sometimes foods such as hypo-allergenic milk may be prescribed, or it may be that medication is needed such as, anti-histamines, adrenaline injector devices, or inhalers.
Regular allergy testing and follow up is needed as children will usually outgrow their allergies and it is important that food is put back into their diets as soon as possible to ensure there are no unnecessary restrictions.
If a child has a food allergy this must be confirmed by a doctor or registered dietitian. An allergy action plan needs to be in place which is accessible to all staff, so that everyone caring for the child is aware of their allergies and symptoms.
Any child with professionally diagnosed allergies will have an allergy action plan. If parents do not provide this, you must request one is provided. You have no obligation to provide a special diet without evidence of confirmed allergy. BSACI website has more info. http://www.bsaci.org/about/pag-allergyaction-plans-for-children
Includes a section about allergies-an overview of special diets. The Policy states that an allergy management plan (Action Plan)needs to be in place. This should include information regarding medications as well as food. The policy does not state that settings need to exclude nuts. Most healthcare professionals think it unnecessary and evidence does not show it to reduce accidental exposure.
Children with food allergies should be included in meal and snack times with the other children in your setting as it is importan that every child feels valued and included, and that they can have healthy food and drink choices appropriate for their needs.
Food allergy can potentially have a huge 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.
What are your thoughts and experiences?