Pediatric food allergies are becoming increasingly more common, says Phoenix pediatrician Theresa Lococo, M.D.  One in 25 school age children currently are affected, and the numbers appear to be on the rise.

But it’s a daunting task for parents to keep children safe at all times, especially during the summer season when consistency among caregivers can vanish.

Children may attend summer programs with seasonal staff. Or a child’s regular sitter may not always be available, requiring a patchwork of care. This can increase the chances that a child may accidentally ingest problematic foods.

Research published in the July 2012 issue of Pediatrics looked at 512 infants diagnosed with or at risk for having an allergy to milk or eggs.

A high rate of allergic reactions occurred. Study findings found that the incidents often were attributable to a lack of vigilance in checking ingredients and supervising children. Errors made in reading ingredient labels and in preparing foods safely by caregivers suggest that more education is needed to avoid reactions.

Eleven percent of all reactions were due to non-accidental exposures to milk, eggs, and peanut products. Almost half of allergic reactions were due to food served by caregivers other than a child’s parents. Study authors concluded that there is a need to educate all caregivers, including other relatives and teachers.

Through careful planning, teamwork and education, parents of children with allergies can best protect their children from life-threatening allergic reactions, says Lococo, who is in practice with Pediatric Associates, P.C. and is a member of the Arizona Chapter of the American Academy of Pediatrics. She stresses the importance of notifying all caregivers of a child’s allergies, preferably in writing.

“A Food Allergy Action Plan is a great way to do this,” adds Lococo. “This documentation reviews the child’s allergies and possible symptoms, along with what action should be taken in the case of allergen exposure.”

Study findings also showed that only 30 percent of reactions with severe symptoms were treated with epinephrine, or an EpiPen, an injectible form of the drug. The researchers note that knowledge on when to use an EpiPen was lacking. 

Lococo says that an EpiPen should be used for significant respiratory (shortness of breath, hoarseness, wheezing) or cardiovascular (confusion, rapid heart rate, pale skin, fainting) symptoms or if more than one area of the body seems to be involved.

All caregivers should understand which symptoms warrant treatment with epinephrine and should be assured about the safe and proper use of the drug.

Parents need to review their allergy plan with all caregivers, as well as the proper use of the EpiPen, says Lococo. Caregivers should be instructed that if they are concerned of anaphylaxis, they should not be afraid or to hesitate to use an EpiPen, and then call 911 for medical attention.

Lococo suggests that parents check the Food Allergy and Anaphylaxis Network (FAAN) for a sample action plan. And depending on their ages, include the kids themselves in the plan, too:

• Teach a child about their allergies.
• Remind them to never share food or eat food that may contain a potential allergen.
• Ask them to notify an adult immediately if they eat something that may contain an allergen.

Signs of a life-threatening allergic reaction (anaphylaxis) can be varied and subtle, says Lococo. They can include some of the following symptoms:

•  Shortness of breath
• Wheezing
• Hoarseness
• Hives, itching, swelling or numbness
• Abdominal pain
• Anxiety or confusion
• Loss of consciousness
• Fast heart rate
• Weak pulse

Given the subtle nature of many of these signs, says Lococo, caregivers can miss the early signs of anaphylaxis or hesitate due to fear of being incorrect.  ”Unfortunately, she adds, ” this can mean the difference between life and death.

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