“Want some?” your friend asks as he offers you a mouthwatering homemade piece of chocolate brownie. Oooh, you’re tempted, but then you see the crushed peanuts on top. Bugger! You’re allergic to nuts. It looks delicious… maybe just one little bite?

One little bite is one too many.

If you have a food allergy, even a very tiny bit of that food can make you sick. It’s better to say no thanks to the brownie and have a nut-free dessert. Lots of kids have food allergies.

According to Associate Professor, Rohan Ameratunga, a clinical immunologist at Auckland Hospital, there has been a significant increase in allergies in the last 20 to 30 years. This rise has mirrored the rise of other allergic diseases – asthma, hay fever and eczema – around the world.

It is estimated that between 5-8% of children have a food allergy – that’s about one in 15 Kiwi kids.

In children, the most common allergies are to cow’s milk and egg, followed by soy, peanuts, tree nuts and wheat. The majority of children will lose their allergies by age three to five years. But allergies to peanuts, tree nuts, fish and shellfish are generally prolonged, which is why these four allergies are the most common amongst adolescents and adults.

What is a food allergy?
Food allergies occur when your immune system makes a mistake. Normally, your immune system protects you from germs and disease. It does this by making antibodies that help you fight off bacteria, viruses, and other tiny organisms that can make you sick. But if you have a food allergy, your immune system mistakenly treats something in a certain food as if it’s really dangerous to you.

The same sort of thing happens with any allergy, whether it’s a medicine (like penicillin), pollen in the air (from flowers and trees), or a food, like peanuts. So the thing itself isn’t harmful, but the way your body reacts to it is.

If a kid with peanut allergy would have eaten that peanut-topped brownie, here’s what would happen. Antibodies to something in the food would cause mast cells (a type of immune system cell in the body) to release chemicals into the bloodstream. One of these chemicals is histamine.

What’s going to happen to me?
The histamine then causes symptoms that affect a person’s eyes, nose, throat, respiratory system, skin, and digestive system. A person with a food allergy could have a mild reaction – or it could be more severe. An allergic reaction could happen right away or a few hours after the person eats it. Some of the first signs that a person may be having an allergic reaction could be a runny nose, an itchy skin rash such as hives, or a tingling in the tongue or lips. Other signs include:

tightness in the throat

hoarse voice

wheezing

cough

nausea

vomiting

stomach pain

diarrhoea

In the most serious cases, a food allergy can cause anaphylaxis. This is a sudden, severe allergic reaction in which several problems occur all at once and can involve the skin, breathing, digestion, the heart, and blood vessels. A person’s blood pressure can drop, breathing tubes can narrow, and the tongue can swell.

People at risk for this kind of a reaction have to be very careful and need a plan for handling emergencies, when they might need to get special medicine to stop these symptoms from getting worse.

Many kids outgrow allergies to milk and eggs as they grow older. But severe allergies to foods like peanuts, certain kinds of fish, and shrimp often last a lifetime.

How do I know if I am allergic?
Sometimes it’s easy to figure out that a kid has a food allergy. He or she might get hives or have other problems after eating it. But other times, it’s more of a mystery what’s causing the problem. Most foods have more than one ingredient, so if a kid has shrimp with peanut sauce, what’s causing the allergy – the peanut sauce or the prawns?

Doctors believe that allergies could be hereditary, which means if your parent or other close relative has certain allergies like hay fever, you’re more likely to develop the allergies. Some kids are born allergic to certain foods, whereas others develop food allergies over time. This may be due to someone’s surroundings or changes in the body as they grow older.

Many people react to a certain food but are not actually allergic. For example, people with lactose intolerance get belly pain and diarrhea from milk and other dairy products. That doesn’t mean they’re allergic to milk. They don’t feel good after drinking milk because their bodies can’t properly break down the sugars found in milk.

What will the Doctor Do?
If you think you may be allergic to a certain food, let as many people as you can know. Go to your doctor to get it checked out.

If your doctor thinks you might have a food allergy, he or she will probably send you to see another doctor who specialises in allergies. The allergy specialist will ask you about past reactions and how long it takes between eating the food and getting the symptom, such as hives. The allergist also may ask about whether anyone else in your family has allergies or other allergy-related conditions, such as eczema or asthma.

The allergist may also want to do a skin test. This is a way of seeing how your body reacts to a very small amount of the food that is giving you trouble. The allergist will use a liquid extract of the food and, possibly, other common allergy-causing foods to see if you react to any of them. (A liquid extract is a liquid version of something that usually isn’t liquid.)

The doctor will make a little scratch on your skin and drop a little of the liquid extract on the scratched spot or spots. Different extracts will go on the different scratch spots, so the doctor can see how your skin reacts to each substance. If you get a reddish, raised spot, it shows that you are allergic to that food or substance.

Some doctors may also take a blood sample and send it to a lab. That’s where it will be mixed with some of the food or substance you may be allergic to and checked for certain antibodies.

It’s important to remember that even though the doctor tests for food allergies by exposing you to a very small amount of the food, you should definitely not try this at home. The best place for an allergy test is at the doctor’s surgery, where they are specially trained and could give you medicine right away if you had a serious reaction.

How will my food allergy be treated?
There is no special medicine for food allergies. Some can be outgrown, and others a child will have his or her whole life. The best treatment is simply to avoid the food itself and any foods or drinks that contain the food.

One way to figure that out is to read food labels. Any foods that might cause an allergic reaction will be listed near or in the ingredient list. Doctors and allergy organisations (visit www.allergy.org.nz) can help by providing lists of safe foods and unsafe foods. Some people who are very sensitive may need to avoid foods just because they are made in the same factory that also makes their problem food. You may have seen some lolly wrappers that say the treat was made in a factory that processes nuts too.

Be prepared, have a plan
No matter how hard you try, you may eat the wrong thing by accident. Stay calm and follow your emergency plan. What’s an emergency plan? Before a slipup happens, it’s a good idea to create a plan with your doctor and parents. The plan should spell out what to do, who to tell, and which medicines to take, if you have a reaction.

This is especially important if you have a food allergy that can cause a serious reaction (anaphylaxis). For serious reactions, people may need a shot of epinephrine with them. This kind of epinephrine injection comes in an easy-to-carry container that looks like a pen. You and your parent can work out whether you carry this or someone at school keeps it on hand for you. You’ll also need to identify a person who will give you the shot.

You might want to have antihistamine medication on hand as well, though if anaphylaxis is occurring, this medicine is not a substitute for epinephrine. After receiving an epinephrine shot, you would need to go to the hospital or a medical facility, where they would keep an eye on you and make sure the reaction is under control.

Living with my food allergy
Having a food allergy is a bummer, but it doesn’t need to slow a child down. If you have nut, milk, or egg allergies, create little carry cards that can help you spot problem ingredients in foods. Adults can help you steer clear of reactions.

But what if something you really like turns out to be on your “do not eat” list? Today, so many people have food allergies that companies have created lots of good substitutes for favorite foods – everything from dairy-free mashed potatoes to wheat-free chocolate chip cookies!

And finally, remember, just one two-thousandth of a peanut is enough to kill. Enough to stop you putting that peanut butter sandwich in the lunchbox?

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