How to cut risk of food al­lergy


GIV­ING ba­bies al­ler­genic foods such as peanut but­ter, eggs and dairy prod­ucts will re­duce their risk of de­vel­op­ing al­ler­gies later in life, ac­cord­ing to a re­spected im­mu­nol­o­gist.

Amid ris­ing rates of food al­ler­gies world­wide, Jane Peake says mis­in­for­ma­tion and anx­i­ety has made some par­ents hes­i­tant to in­tro­duce the foods to their chil­dren too early.

“Their knee­jerk re­sponse when they’re scared about se­vere al­ler­gic re­ac­tions is not to give the chil­dren the al­lergy foods. And in fact, that’s the op­po­site of what we’re rec­om­mend­ing. Par­ents are ad­vised to start to in­tro­duce solid foods be­tween four and six months when their baby is ready.

“Once a baby is eat­ing a range of solids, foods com­monly as­so­ci­ated with al­lergy should then be tried. Some par­ents wait un­til their child is 12 months or older be­fore they start in­tro­duc­ing com­mon al­ler­genic foods but by this time, it could be too late.”

Dr Peake, di­rec­tor of the Queens­land Pae­di­atric Im­munol­ogy and Al­lergy Ser­vice at the Lady Ci­lento Chil­dren’s Hos­pi­tal, said re­search showed that in­tro­duc­ing com­mon al­ler­genic foods in the first year of life could pre­vent al­ler­gies.

IT started with a lit­tle cough. “My throat hurts,” said my son, tears welling in his eyes. Then he fought for breath, gasp­ing and wheez­ing. He was hav­ing ana­phy­laxis, hav­ing just eaten less than a quar­ter of a tea­spoon of wal­nut.

Luck­ily, we were in hos­pi­tal, hav­ing a food chal­lenge with doc­tors on hand. Two shots of adrenaline later, he sta­bilised.

My son has food al­ler­gies. For him — and thou­sands of other chil­dren — the only way to know how they will re­act to a food al­ler­gen is to have a chal­lenge in hos­pi­tal. While his re­ac­tion to wal­nut was alarm­ing, we now know how vig­i­lant we need to be.

Pre­vi­ous skin-prick tests had been in­con­clu­sive. And he has had other food chal­lenges in hos­pi­tal which he passed: av­o­cado, al­monds and chia seeds to name a few.

While some may de­scribe this as a First World prob­lem, the stress of food al­ler­gies weighs heav­ily on suf­fer­ers and their car­ers. About 10 per cent of chil­dren up to one year old and 8 per cent of those up to five suf­fer se­vere food al­ler­gies.

Hos­pi­tal ad­mis­sions for se­vere al­ler­gic re­ac­tions have in­creased five­fold in the past decade.

Is there any other lifethreat­en­ing con­di­tion that af­fects such a large pro­por­tion of our chil­dren? Yet, as the world marks Food Al­lergy Aware­ness Week, the Her­ald Sun re­ports that chil­dren with life-threat­en­ing al­ler­gies are wait­ing at least two years for in­hos­pi­tal food chal­lenges. And a short­age of al­lergy spe­cial­ists means there are long waits to even get an ini­tial ap­point­ment.

The re­lief of hav­ing an al­ler­gen crossed off the list of banned food means the heavy re­stric­tions on my son’s life are a lit­tle looser.

Imag­ine a Sat­ur­day morn­ing in Mel­bourne with­out a cof­fee at the lo­cal cafe. But be­cause my son passed his al­mond food chal­lenge, we can now go to a cafe and have a hot cho­co­late be­cause the risk of con­tam­i­na­tion with al­mond milk is no longer an is­sue. And smashed avo doesn’t frighten me any­more.

Al­lergy spe­cial­ist Pro­fes­sor Brad Frankum says the long de­lays in in­hos­pi­tal food chal­lenges add to the anx­i­ety of pa­tients who are too

scared to eat out or even go to a su­per­mar­ket for fear of an ana­phy­lac­tic re­ac­tion. Maria Said, from Al­lergy & Ana­phy­laxis Aus­tralia, says: “There are hun­dreds, if not thou­sands, on wait­ing lists in each state.”

In my son’s case, we have been told to ex­pect a three-year wait be­tween ap­point­ments for his next food chal­lenge. By that time, he will be al­most an adult.

So why is there not more fund­ing to deal with this lifethreat­en­ing con­di­tion which af­fects so many? As state and fed­eral elec­tions loom, why aren’t politi­cians promis­ing to put more money into treat­ing the epi­demic of al­ler­gies among our chil­dren?

And as wait­lists blow out, a na­tional short­age of EpiPens due to man­u­fac­tur­ing prob­lems is caus­ing trauma for those at risk of ana­phy­laxis. Sev­eral times a week, I see par­ents post­ing pleas on­line for help find­ing a chemist that is stock­ing an EpiPen that is not out of date; oth­ers say they are car­ry­ing out-of-date EpiPens be­cause they can’t fill their pre­scrip­tions. But how many EpiPens are be­ing wrongly pre­scribed just be­cause long wait­ing lists mean a child has been un­able to do a food chal­lenge to rule an al­lergy in or out?

The Royal Chil­dren’s Hos­pi­tal says it has the ca­pac­ity to test 86 chil­dren a week with food chal­lenges, but there are still about 1000 chil­dren wait­ing for tests. Chil­dren are pri­ori­tised, with those al­ler­gic to sta­ples like milk, eggs and wheat given a higher pri­or­ity.

But par­ents in a na­tional on­line al­lergy sup­port group say they have been told that chal­lenges for other food al­ler­gens are un­likely to be done at all — be­cause there isn’t enough fund­ing. Some par­ents say they have re­sorted to do­ing their child’s food chal­lenges un­su­per­vised in a hos­pi­tal carpark — at least they are close to the Emer­gency Depart­ment if some­thing bad hap­pens.

“We have been told be­fore to do a chal­lenge in the hos­pi­tal carpark or at home with mul­ti­ple EpiPens at the ready,” says one mother.

Af­ter what hap­pened to my son, I won’t do that.

But why should he — or thou­sands of oth­ers — have to wait years to see if they can eat some­thing that may or may not be harm­less?

It’s time our politi­cians served up more fund­ing for al­lergy treat­ment.

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