Constipation, diarrhea, hives, rashes, eczema, dark circles around the eyes, sneezing, runny nose, coughing and wheezing, ear infections, poor weight gain, irritability, anxiety, fatigue, headaches, crying, hyperactivity, gas, vomiting, and even anaphylaxis. These are all signs that something is definitely wrong. You’ve seen the signs, but how do you figure out the cause of your child’s problems?
Food Allergies
Food allergies are generally much easier to understand than sensitivities. True allergies are considered an IgE food reaction and happen shortly after exposure. Allergic reactions occur when the body overreacts to an allergen by creating antibodies to attack the substance. These antibodies are found in the lungs, skin, and mucus membranes (including gut, eyes, nose, and throat). This causes mast cells to release histamines that cause reactions like hives, diarrhea, vomiting, and anaphylaxis.
Reactions generally become more severe the more one is exposed to the allergen, and avoidance of the food will be necessary for a lifetime. Often, an Epi pen will be required for children with severe anaphylactic allergies, to prevent full closure of the airway.
Common Allergens
The most common food allergens include peanuts, tree nuts, shellfish, wheat, soy, dairy, egg, and fish. Even the smallest amount of exposure is enough to cause a reaction. Your pediatrician or an allergist can run a simple blood test to detect IgE antibodies to various foods.
Food Sensitivities
Food sensitivities are much more difficult to diagnose because reactions can occur within 24 hours to seven days after ingestion. This makes pinpointing the culprit or culprits much more challenging. In reaction to a food sensitivity, IgG antibodies are created. When a food that one is sensitive to is eaten, there is an IgG antibody response that combines with the food in the blood stream.
Here, macrophages (a type of white blood cell that destroys foreign invaders and dead cells) become overloaded and cause a localized inflammatory response.
This process takes time and accounts for the delayed reactivity. Usually, the offending food or foods are those most frequently eaten.
Leaky Gut
Unfortunately, the inflammatory response can destroy the integrity of the gut allowing larger-than-normal food particles into circulation, creating additional sensitivities. This process is often referred to as leaky gut syndrome. Generally, when the offending food(s) are eliminated, the IgG antibodies will decline and will often fully disappear after six months to a year. For children with large amounts of sensitivities it may be difficult to remove all offending foods. In this case, a rotation diet that uses safe foods combined with the least reactive foods in a four-day rotation plan can help lower the IgG response and relieve symptoms.
Celiac Disease
I would be remiss if I didn’t mention celiac disease when discussing pediatric food allergies and sensitivities. This is an autoimmune disease in which the body attacks gluten, the protein found in many grains, including wheat, kamut, spelt, rye, bulgar, and oats.
Not only is gluten found in grain products, including breads, cereals, crackers, pastas, cakes, and cookies, but it may also be found hidden in sauces, gravies, soups, cheese spreads, dips, dressings, margarines, sweets, canned meats, mustard, and almost all packaged and processed foods. Gluten is often used in food manufacturing because it is a sticky protein that binds ingredients together.
Celiac Symptoms
While most people consider diarrhea the hallmark sign of Celiac disease, other symptoms include depression, constipation, irritable bowel syndrome, growth issues, hives, brain fog, nausea and vomiting, constantly getting sick, dairy intolerance, sugar cravings, and other food reactions.
Destruction of the Small Intestine
Since celiac disease is autoimmune and can cause destruction of the small intestine, it is essential to avoid gluten for a lifetime. The good news is that there are plenty of safe, gluten-free grains, including rice, quinoa, buckwheat, amaranth, tapioca, corn, and teff. It has become easier and easier to find gluten-free products at grocery stores, and to find restaurants with gluten-free menus.
Diagnosis may be made with a blood test looking for antibodies and is then confirmed by endoscopy to look for damage to the intestine. Once one stops consuming gluten, however, antibody levels will diminish and blood tests will be negative. Similarly, the intestines will heal and lead to a negative endoscopy test.
Gluten Sensitivity and Wheat Allergies
Some children may also have gluten sensitivity, which provokes reactions without having antibodies. Gluten restriction will help to prevent further symptoms. Other children may not actually have celiac disease, but may have a wheat allergy that may be confirmed with a blood test for wheat IgE antibodies.
How to Adjust
The most difficult part of food allergies, sensitivities, intolerances, and celiac disease is the emotional impact on the child and the whole family. It takes time to adjust and realize that the food or foods must be avoided. Allowing the child to pick new ‘safe’ foods to try and making a game out of the process can really help with the adjustment. It is also important to plan ahead to have safe food alternatives for your child for school, birthday parties, family events, and other food-oriented activities. It is hard for children to understand why they cannot eat what the other kids are eating. They may feel left out and hurt. This can be worsened if they experience the same thing at home. So having the whole family avoid the offending foods can be quite helpful for children. Involving the child in both grocery shopping and cooking can help to teach them about their dietary needs.
Make the experience positive and not a punishment by allowing them to make some fun choices and to experiment with foods that may interest them.
The first couple of months are generally the most difficult; things get much easier once the transition period is over. Keeping a positive attitude about everything makes a huge difference. Oftentimes it is helpful to visit a nutritionist for help finding and eliminating problem foods, as well as finding appropriate alternative options.
Jessica Pizano is the owner of Fit to You, LLC, which offers personalized training programs and nutrition/health counseling. Her concentrations include general fitness, weight loss, food allergies/sensitivities, post-rehabilitative work, training/nutrition for medical conditions, obesity intervention, pre- and post-natal exercise and nutrition, and Pilates. A certified personal trainer and a corrective exercise specialist through the National Academy of Sports Medicine, she is also certified in mat Pilates through PHI Pilates and earned her Clinical Exercise Specialist and Longevity Wellness Specialist through the American Council on Exercise. She completed her training to practice health coaching at the Institute for Integrative Nutrition and is certified as a holistic health practitioner through the American Association of Drugless Practitioners. She is currently completing a master’s degree in human nutrition at the University of Bridgeport. Currently, Jessica practices personal training and nutrition counseling at her studio in Avon.