Food Allergy Testing in the Pediatric Population

Within the last decade we have seen an increase in the incidence of food and environmental allergies. Lifestyle choices and dietary habits may lead to the development of food allergies. Symptoms in any part of the body can be triggered by a food. There is evidence that supports a genetic predisposition to development of certain food allergies based on occurrence of allergic reactions in other family members. Studies show that 69 percent of children presenting with allergy symptoms have a significant family history of food allergies. Another study showed that 67 percent of children with parents who both have allergies and 33 percent of those with one allergic parent are likely to develop food allergies. Research shows that food allergies can pass from a mother’s breast milk to her infant and can be expressed as early as two weeks in the newborn as acid reflux. In a recent study it was demonstrated that obese children had higher levels of IgG antibodies then normal weight children. The antibodies are associated with systemic inflammation and have been linked to type 2 diabetes and atherosclerosis.

Food reactions can be non-immune or immune mediated. Non-immune allergy-like reactions are called “sensitivities” and we are still unsure about the mechanism behind the response. In an immune-mediated allergic reaction there is an exaggerated immune inflammatory response. The two most common antibodies associated with food allergies are called IgE and IgG. IgE responses are immediate and normally present with symptoms such as difficulty breathing or hives. IgG are delayed reaction responses that can take hours to days to present. The IgG antibody binds to certain proteins from food and can cause a multitude of diverse reactions. Food reactions can vary from minor irritation to severe behavioral disturbances.

Common IgG allergic symptoms in the pediatric population include: nasal and sinus congestion, constipation or diarrhea, acid reflux, hyperactivity, inattention, and rashes. Diseases commonly associated with food allergies are chronic sinusitis and rhinitis, asthma, ADHD, irritable bowel, and atopic dermatitis. Foods that are eaten frequently can trigger an immune inflammatory response over time. In many cases particular foods are hidden in the ingredient list of processed packaged foods unbeknownst to the patient/family.

The most common allergens in the pediatric population are: dairy, gluten (wheat, spelt, rye, barley, kamut), chicken eggs, citrus, and peanuts.

The most reliable way to identify food allergies is to eliminate all potential food allergens from the child’s diet for a minimum of two weeks. In many cases a longer period of elimination might be needed if symptoms have not resolved. After symptoms have cleared then foods are challenged one by one back into the diet every two to three days. The child is observed for any allergic reaction. The drawback with this method is the difficulty to consistently remove the foods from the diet in the home, with other caregivers, and in school. Furthermore, delayed food reactions can take a few days before they present which can extend the reintroduction phase for weeks.

The traditional method of skin testing is more reliable for immediate anaphylactic IgE reactions to foods. The alternative to determine delayed IgG food reactions is blood testing. A test is now available for the pediatric population that just involves a needle prick for a small sample of blood. Results are received and interpreted by the physician within two weeks of sampling. Based on the level of the reaction, the child will need to at minimum rotate certain foods in the diet up to complete avoidance of the problematic foods for six months to a year. Once the allergies are eliminated, good gut health can be restored and future reintroduction can occur. Food allergy testing is available at Federal Way Naturopathy.

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