Preventing Food Allergies

The simplest way to prevent an allergic reaction is to avoid the offending food. This is easier said than done, however, and it is important to carefully read food labels and always check with restaurant staff about ingredients and how the food is prepared.

The most common foods to cause allergic reactions in adults are peanuts, tree nuts (almonds, cashews, pistachios, walnuts, pecans, hazelnuts, Brazil nuts, and others), fish, and shellfish. The foods that most commonly cause allergic reactions in young children are milk, eggs, wheat, soy, and peanuts; allergies to foods such as tree nuts, fish, and shellfish are observed as these foods are added to growing children's diets. The majority of children allergic to milk, eggs, soy, and wheat outgrow their Food Allergies over the first several years of life. Allergies to peanuts, tree nuts, fish, and shellfish are less frequently outgrown. For example, only about 20 percent of children allergic to peanuts outgrow their allergy.

To prevent accidental exposure to an allergen, you should memorize the common names of foods you or your child are allergic to, as well as other ways they might be listed on food labels, and then scrutinize all labels. Identifying which foods contain allergens became somewhat easier this year after new rules went into effect requiring that foods containing one or more of the eight most common allergens (all listed above) must have a label clearly stating so.

Other useful precautions:

• If your child has a food allergy, you should be sure to tell all of your child's caregivers about the condition and review with them the plan of treatment to be followed if your child has a reaction.
• If you have an allergy, wear a medical alert bracelet or necklace describing your condition. If your child has the allergy, get a medical alert bracelet for him or her.
• Learn when and how to use an injectable epinephrine device. Carry it with you at all times in case of a severe allergic reaction.

Introducing food to babies

Children in families with allergic members are at a higher risk of developing allergies than children from families without allergic members. As a result, many pediatricians and allergists recommend that allergic parents use certain strategies to attempt to prevent allergies in their young children who are not yet allergic. For example, some physicians suggest that the parents of infants at higher risk delay introducing the foods that commonly cause allergies until the babies are older. The rationale for this approach is that avoidance early in life might reduce the likelihood of sensitization. Most children from families without allergies will not develop allergies even if exposed to these foods at a young age.

A number of studies have attempted to determine if women in families with allergic members can reduce the risk of their babies developing Food Allergies by avoiding the foods during pregnancy. The results of these studies do not support the use of elimination diets during pregnancy, as they do not appear to reduce the child's risk.

Although small amounts of food allergens can be measured in the breast milk of mothers who are ingesting these foods, taking allergenic foods out of the nursing mother's diet has not been shown to prevent the development of food allergy in breastfed children. Nonetheless, many physicians recommend that mothers of children at high risk of developing allergies remove peanuts and tree nuts from their diet while breastfeeding and delay the introduction of solid foods until six months of age.

The American Academy of Pediatrics currently recommends that in children with a strong family history of allergies, the introduction of cow's milk, eggs, and other common food allergens be delayed as follows:

• Cow's milk and dairy products should be delayed until age 1.
• Eggs should not be introduced before 2 years of age.
• Hold off on peanuts, tree nuts, fish, and shellfish until age 3.

It is also reasonable when giving a baby with a family history of allergies a new food to start with a small amount and wait for several minutes to make sure the food is tolerated before giving more. This is especially true for foods that commonly provoke allergic reactions.