Food allergy affects around 7% of children in the UK and appear to have become more common in the last 20 years. We don't know why this is the case, but other types of allergies such as asthma, hayfever and eczema have also become very common and there may be a single explanation for all of this. For example about 1 in 3 children with eczema have a food allergy, whuich suggests a link between the causes of theses 2 problems.

Food allergy occurs when the immune system sees a normally harmless substance such as peanut or egg as a threat, and makes a special type of antibody which attacks the food and causes an allergic reaction. The type os antibody that causes most food allergy is called immunoglobulin E (IgE).

Most allergic reactions to food occur with in 10-15 minutes of eating the specific food, and cause rashes, swelling of the lips or face, and itching which may take several hours to settle down. Some children have a more severe reaction which results in coughing, sneezing, an asthma attack, vomiting or even collapse and unconsciousness. About 2 children each year in the UK tragically die from allergic reactions to food. Unfortunatly it is very difficult to predict which children are more at risk or a severe reaction, but those with nut allergy and those who have both food allergy and asthma seem to be more at risk.

The most common foods to cause allergic reactions in children are cow's milk, egg, nuts, fish and shellfish, soya, wheat, sesame, and kiwi fruit.

It is difficult to avoid some of these foods completely, which has led to strict European labeling laws which state that the above foods and some others must always be labeled clearly if they are present as ingredients in a packaged food. Despite this, children with food allergy have frequent accidents which lead to further allergic reactions. For this reason they are often given an adrenaline injector (Epipen or Anapen) to keep with them, in case they have a severe allergic reaction. When a child dies from a food allergy this often happens within 30-40 minutes, and giving an injection of adrenaline early on can be life-saving.

So how do i know if my child has food allergy?

If your child has eczema which started in the first 2 years of life, or if they have a sibling with food allergy, then they are at increased risk of food allergy and this can be confirmed or excluded by allergy testing.

If your child has any of the symptoms described about within 10-15 minutes of eating a specific food, then this may be a food allergy and they should have an allergy test.

Occasionally children can have a slower form of food allergy which comes on minutes or hours after eating a food,and causes mainly stomach upset or sometimes a flare of eczema. This can also be confirmed or excluded by allergy testing.

And what does allergy testing involve?

There are lots of tests offered by different practitioners for food allergy, however the only ones which have been proven to be reliable are the following:

1. Skin prick testing - this is usually performed on the inner forearm, a drop of allergen solution is placed and a small prick through the drop is made of the skin. The procedure is virtually painless, and its is a very reliable way of confirming or excluding suspected food allergy.
   
2. Specific IgE testing - this involves a blood test to look for IgE antibodies to foods in your child's blood, and is also a good way to confirm suspected food allergy.
   
3. Food challenges - here a portion of the suspected food is given to your child in a safe environment such as a hospital ward. The portion is given in graded doses over a few hours, and this is the best way to completely confirm whether they have food allergy. Food challenges need to be properly supervised in hospital for safety reasons.

The following tests have no proven value for diagnosing food allergy. Excluding foods based on these tests can lead to malnutrition, and ruling out allergies using these tests can be dangerous.

None of these are recommended for diagnosing food allergy

• Vega Testing - measures the electromagnetic fields
• Applied Kinesiology - measures muscle strength
• Auricular Cardiac Reflex Method - measures pulse
• Hair Analysis
• Neutralisation-Provocation Testing
• IgG allergy tests - most of us have IgG antibodies to foods, and this is normal

If your child is unfortunate enough to have a good allergy, then they will receive advice from a dietician on how to avoid the relevant foods, and you will be trained in how to deal with an allergic reaction in case of further accidents. At present we have no cure for food allergy, but very intensive research efforts are ongoing to try to find one.

Source: Imperial College London

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