Is My Child Having a Food Allergy Reaction?
Have you ever wondered if your child is having a food allergy reaction?
Picture this…it’s dinner time and a mother is getting the meal ready for herself and her 7-month-old baby. She brings the food to the table, seats the baby in the high chair, and suctions the baby’s silicone plate to the highchair tray.
An 8 month old fab fellow trying a variety of different solids! Thank you to his parents for sharing.
The baby has been eating solid foods now for about a month and loves to self-feed. She has tried many new foods so far without showing any symptoms of food allergy and is interested in exploring food with her hands and experiencing new flavors, colors, and aromas.
There is no family medical history of food allergies, although the baby has had a tough time with moderate to severe eczema since the age of 2 months.
Her mother introduced tiny amounts of both peanut butter thinned with breastmilk and egg at about 6 months and has continued offering larger portions of both in the baby’s diet a few times a week without noticing any symptoms of an allergic reaction.
This evening, however, she has made some strips of tofu in the air fryer along with some roasted sweet potato sticks and soft steamed broccoli. The baby dives in and starts eating the food right away and begins happily eating.
Soy is among the top 9 food allergens in the United States and a specific food the mother has introduced once or twice before in the form of mashed edamame.
So she is startled when within a minute or two of eating the meal, raised bumps appear on her daughter’s cheeks, as well as what looks like some swelling around and on her lips.
Could this be an allergic reaction to food?
The mother stops eating, unhooks her baby’s safety straps, and pulls her out of the chair. The little girl bats at her face with her hands and starts to whimper, then promptly vomits.
The mother immediately calls the pediatrician, is connected with the doctor on call, and explains the situation, asking for guidance.
The pediatrician asks a series of specific questions about what symptoms the mother has noticed, whether the baby is having trouble breathing (which does not seem to be the case), which foods were eaten right before the reactions occurred, how much of the food was eaten, how much time elapsed between eating the food and experiencing the reaction, and whether the foods had been eaten and tolerated previously.
What is a food allergy?
A food allergy is defined as, “...an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food,” per the Guidelines for the Diagnosis and Management of Food Allergy in the United States (NIAID).
Food allergy includes both IgE-mediated and non-IgE-mediated reactions. Some food allergies are both IgE and non-IgE-mediated.
If any of the below are true about your baby or child, your healthcare provider should consider the diagnosis of food allergy and refer you to an allergist:
Your child experiences anaphylaxis (or a severe allergic reaction in response to a food that involves more than one body system, i.e., the skin, the respiratory system, and/or the gastrointestinal tract)
Your child experiences multiple symptoms within minutes to hours of eating a specific food and/or eating a specific food on more than one occasion
Your child has been diagnosed with moderate to severe eczema
A board-certified allergist will look at the child’s entire clinical picture, discuss any potential need for testing, and consider many factors before making a diagnosis.
Is soy the cause of the allergic reaction?
After discussing the baby’s history and current symptoms with the baby’s mother, the pediatrician thinks she may have potentially identified the food causing the reaction.
If an IgE-mediated food allergy is to blame for the reaction, the foods eaten right before the reaction are to blame.
According to her mother, the baby has had and tolerated sweet potatoes, broccoli, olive oil, and garlic many times before.
However, the last time the mother offered mashed edamame (or mashed soybeans), she noticed that her baby had a few mild hives on her belly when she gave her a bath later that evening. She hadn’t noticed any other symptoms during the meal and thought the hives were due to a virus or perhaps a reaction to a new lotion.
The pediatrician strongly suspects a food allergy to soy after considering that:
It seems the baby has had a reaction to soy more than once
This evening’s reaction happened within minutes of ingesting the food
This reaction included multiple symptoms (hives, swelling of the lips, vomiting)
The baby has moderate to severe eczema (which is the strongest risk factor for food allergies)
She instructs the mother to stop feeding the baby soy and any foods that contain soy and provides a reference to a pediatric allergist.
Food allergies can be scary for new parents...
But I hope it comforts you to hear that severe reactions during infancy are extremely uncommon.
Feeding babies the top allergenic foods early and often during infancy (starting at about 6 months of age, once the signs of readiness for solid foods are present) not only helps reduce the risk of the development of food allergies, but also allows us to identify food allergic babies.
And this is important because when we know food allergies exist in a child, allergists, pediatricians, and healthcare professionals can help create an individual food allergy action plan for the family that helps parents and communities keep food-allergic children safe.
And pediatric dietitians like me can help ensure that food-allergic children still get the nutrients they need to thrive and grow, in spite of their dietary restrictions.
Food allergy prevention starts during infancy
If you’re getting ready to start your baby on solids, download my FREE Baby-Led Feeding Essential Checklist to make sure you have everything you need to get started. You might also want to check out my online course for parents, based on my best-selling book which will walk you through the whole process of starting solids and introducing top allergenic foods using a baby-led approach. The course includes my Safe & Simple 12-Week Meal Plan, which maps out the entire first 12 weeks of your baby’s solid food feeding journey and provides over 30 recipes, weekly shopping lists, tons of balanced baby meals, a complete plan for top allergen introduction, and lots of guidance (with photos) on how to safely serve each food.
And if you're looking for personalized nutrition support for your babies or kids, I am currently accepting new clients in my virtual private practice. Looking forward to meeting you online…