CincyNanny Roundtable
Food Allergy Awareness and Safety
By: Lindsey Kanis
10.26.2010
It is estimated that 3 million U.S. children have a food allergy [FAAN]. 16-18% of those children have had reactions while at school [FAAN]. 25% of those cases occur before a child has been diagnosed with a food allergy [FAAN]. Several studies have found that a majority of school have inadequate allergy management and emergency preparation including epinephrine for such allergic reactions, many anaphylaxis.
A food allergy occurs when the immune system reacts to food. The body makes antibodies to the food causing asthma, hives and other symptoms.
Common Food Allergies:
- 8 foods account for 90% of food-allergic reactions [FAAN]:
–Milk. Only 2.5% of kids under 3 have a milk allergy. Most develop in the first year of life and many will outgrow the allergy in only a few years. Many of these children are just fine substituting with non dairy formulas and soy or rice milks while some are allergic to only cow’s milk and may use goat’s milk as an alternative, but is not recommended without doctor’s permission. Always read labels: milk and casein (a milk derivative and protein) are hidden ingredients in many non dairy products (including canned tuna and some meats). [FDA] Always ask: butter is used in most baked items and on most everything at restaurants. However, milk is easily substituted with water or fruit juice in many recipes. Deli meat slicers in most delis are used to slice both cheese and meat. Some children may have a reaction to milk or oils of these products just touching their skin.
–Egg. 1.5% of young children but is the allergy doctors believe most likely to be outgrown. Most reactions will appear as skin irritations (rashes, hives or intense dryness) but may include anaphylaxis*. Eggs are found in many baked goods, some pastas including those found in soup, and are used as a “wash” on a variety of items before baking, frying or topping (i.e. pretzels are washed in egg before being salted). Egg is also found occasionally in the froth or foam topping of coffee drinks, as well as egg substitutes that use egg whites. Some vaccines including the influenza vaccine contain egg proteins and a doctor should be consulted before using these vaccines. In baking, eggs can be substituted with several small recipes that are equivalent to egg.
–Peanut. Between 1997 and 2002, peanut allergies in children doubled [FAAN]. Reactions to peanuts can vary in intensity depending on sensitivity of the individual. However, 20% of these children outgrow the allergy. Younger siblings of these children are at a higher risk to develop peanut allergies. Individuals with peanut allergies are likely to develop other food allergies, including tree nuts and so most people allergic to peanuts avoid all nuts and always carry epi-pens (epinephrine shots) because most reactions include anaphylaxis*. Besides the obvious of peanut butter, peanuts and peanut oils can be found in chili sauces, hot sauce, pesto, gravy, salad dressings, pudding, cookies, hit chocolate, egg rolls, pancakes, pet foods, candies, Asian and Mexican dishes, vegetarian meat substitutes, glazed and marinades. Read labels: It is also important to note that equipment used to make many products may have been in contact with peanuts or peanut oils. When eating out, ask specifically for new utensils to be used for serving, preparing foods. [FDA]
–Tree nuts. It is estimated that 1.8 million Americans have allergic to tree nuts (walnut, almond, hazelnut, coconut, cashew, pistachio and Brazil nuts)[FAAN] and it is among the leading causes of fatal and near fatal reactions to foods. It is rare to outgrow a tree nut allergy. Unexpected sources of tree nuts include salad dressings, barbecue sauce, pancakes, pasta, honey, pie crusts and breading for chicken. Many reactions include anaphylaxis* and require a shot of epinephrine.
-Did you know: It is disputed whether or not a coconut is a nut. It is traditionally thought of as a fruit and carries low risk of allergic reaction for people allergic to tree nuts. The FDA only began classifying the coconut as a nut in 2006. [FDA]
–Fish. 2.3% of Americans report allergy to seafoods [FAAN]. Salmon, tuna and halibut are the most common culprits of fish allergic reactions, however it is recommended that all fish be avoided as well as seafood restaurants all together. Cross contamination is a risk as well the risk of reaction from airborne proteins in the steam while cooking. It is considered to be a lifelong allergy. Caesar dressing, Bouillabaisse, Worcestershire sauce, Barbeque sauces all contain fish ingredients.
–Shellfish. 60% of shellfish allergic reactions occur for the first time in adulthood. It is recommended that individuals with shellfish allergies avoid seafood all together, seafood restaurants as well as Asian restaurants (they use sauces and base ingredients with fish). Reactions can include anaphylaxis*.
–Wheat. Children most often have this allergy, but outgrow it before adulthood. It should not be confused with celiac disease (an intolerance to gluten). People with wheat allergies can eat other grains including amaranth, barley, corn, oat, quinoa, rice, rye, and tapioca. It is usually fairly easy to substitute wheat flour with alternatives in recipes. Read labels! Wheat can be in anything: ice cream, marinara sause, play doh, rice cakes and hot dogs.
–Soy. Soy allergies are difficult, but common especially in infants and children. Soy is in so many products that people with this allergy often need a nutritionist to help maintain a healthy diet without soy. Reactions can include anaphylaxis. Soy and soy beans can be found in baked goods, canned tuna, formulas, soups, and even peanut butter.
The Food Allergen Labeling and Consumer Protection Act (FALCPA) requires food manufacturers to disclose in plain language whether products contain any of the top eight food allergens, when present in any amount, even in colors, flavors, or spice blends. [FAAN]
Have your charges been tested for common food allergies?
Are you educated on their allergies (if any)?
– Pronounced: ana-fill-axis …. A serious allergic reaction that is rapid in onset and may cause death. An anaphylactic reaction may begin with a tingling sensation, itching, or a metallic taste in the mouth. Other symptoms can include hives, a sensation of warmth, wheezing or other difficulty breathing, coughing, swelling of the mouth and throat area, vomiting, diarrhea, cramping, a drop in blood pressure, and loss of consciousness. These symptoms may begin within several minutes to two hours after exposure to the allergen, but life-threatening reactions may get worse over a period of several hours.”
-From “Anaphylaxis” by FAAN http://www.foodallergy.org/section/a
FAAN The Food and Anaphylaxis Network http://www.foodallergy.org
FDA The Food and Drug Administration http://www.fda.gov
