Modern medicine offers hope for prevention of food allergies in children

Dramatic rise in allergic diseases today

Wednesday, June 5 2019

“There has been a dramatic rise in allergic diseases both in South Africa and globally in recent years; so much so that we are finding ourselves in the midst of what we may call an ‘allergy epidemic’ today.”

This is according to Dr Thulja Trikamjee, a specialist paediatrician and allergologist who practices at Netcare Sunninghill Hospital in Johannesburg and has a sub-specialty Certificate in Paediatric Allergy, a Diploma in Allergy, as well as the Union of European Medical Specialists Allergy and Immunology Certificate.

Dr Trikamjee says that individuals today have a higher risk than ever before of suffering from some form of allergy. According to the Allergy Foundation of South Africa, a baby without any family history of allergies now has a 15% risk of developing an allergic condition within their first few years of life.

Pic: Dr Thulja Trikamjee, a specialist paediatrician and allergologist who practices at Netcare Sunninghill Hospital in Johannesburg, says there has been tremendous advances in our understanding of allergies, and in their management in recent years.

“This is not all: the Allergy Foundation further notes that if one parent has an allergy, then the child’s risk increases to between 40 and 50%; and if both parents are allergic, the risk is as great as 60 to 80%. A child who has siblings with allergies also has a significantly increased risk of developing allergies.

“This highlights just how considerable the challenge posed by allergies has become both in South Africa and internationally. While this is so, there have been tremendous advances in our understanding of allergies, and in their management in recent years,” adds Dr Trikamjee.

What can you do to help your children?
Dr Trikamjee says there are ways to lower the risks of your children developing allergies, advising that allergy prevention should begin when a mother first finds out that she is pregnant.

“As the foetus develops, so too does the baby’s immune system. As the baby develops its own antibodies, exposure to potential allergens at this time can assist in preventing them from developing allergies to these substances,” she observes.

“Unbeknownst to most mothers, when they eat something, tiny little food proteins from the food pass through the umbilical cord to the foetus. If this continues through pregnancy, the baby’s immune system starts to recognise these food proteins. This process continues after birth and after the baby starts eating solids.”

So what steps should mothers take after finding out that they are pregnant? Dr Trikamjee advises the following:

  • Eat a healthy balanced diet, including food from all of the major food groups.
  • Do not cut out or reduce your consumption of any specific allergenic foods, such as dairy, egg, seafood and nuts, unless you have a confirmed allergy to any of these food items.
  • Avoid smoking tobacco and drinking alcohol during pregnancy.
  • Consider increasing your intake of oily fish, or taking an omega supplement.
  • Introduce solids, and allergenic foods in particular, to your baby at an early stage. Between four and six months has been found to be the most beneficial.

Dr Trikamjee says that there may be some benefit to taking probiotics in the last trimester, but this is still being researched and has yet to be proven by medical science.

“From the perspective of a child’s immune system, natural birth is considered preferable over caesarean section. Natural birth is not always possible, however, and mums should discuss their particular medical histories and preferences with their obstetrician.”

The power of breastmilk
“Breastmilk contains numerous immune factors and properties, which can assist in allergy prevention, as well as protect babies from infections. For this reason we recommend that newborns are breastfed up until at least four months of age if possible,” advises Dr Trikamjee.

“Unless you have a confirmed allergy to a specific food or foods, try to ensure that you do not avoid any foods or food groups, both during pregnancy and while breastfeeding, as this will continue to expose your baby to trace amounts of food proteins via your breastmilk.”

What foods can cause an allergic reaction?
Dr Trikamjee points out that people can potentially have an allergic reaction to any foods, and says that she sees an increasing number of patients who suffer reactions that would have previously been considered uncommon, and even rare.

There are, however, some main allergenic food groups that cause the majority of reactions in children. These include cow’s milk, hen’s eggs, peanuts, tree nuts, wheat, soya and seafood.

How do I know that my child is allergic?
“There are many symptoms with which an allergic reaction can present. Often, when it comes to food, the reaction will occur the first time your child eats a specific food,” says Dr Trikamjee.

Symptoms to look out for include the following:

  • Hives
  • Stomach upset
  • Vomiting
  • Diarrhoea or bloody stools
  • Difficulty breathing
  • Change in consciousness or activity

How are food allergies diagnosed?
“Medicine is an ever-evolving science, as are the fields of allergies and immunology, which are progressing rapidly. This means that there are new and novel ways to diagnose and treat food allergies today. This is one of the reasons why it is so important to see an allergy specialist if you or your child are suffering from an allergy or related condition,” says Dr Trikamjee.

“Many of the panel tests that were used for allergy diagnosis previously have today been replaced with more accurate and specific tests, which are more efficient in diagnosing whether your child is truly allergic, or whether they are able to tolerate a certain food or other substance.

Can children outgrow their allergies?
“Parents should be aware that most children outgrow their allergies. For example, a large proportion of children outgrow milk, egg and many nut allergies. An allergy specialist will be able to guide you through the process to the point where your child is able to safely overcome their food allergy.”

“In conclusion, as much as food allergies are on the rise, so too is our knowledge on this subject, and the management and treatment of food allergies has drastically improved over the last decade. Gone are the days when children have to spend their lives in fear of accidental exposure an allergic food or substance,” concludes Dr Trikamjee.


Diagnosing and testing for food allergies

  • The allergologist will take a detailed history including the diet and foods your child is eating, and the foods that have caused any reaction.
  • Based on the history, the allergologist will then decide on targeted allergy tests that should be done in order to determine exactly to which foods your child is allergic.

Allergy tests
Tests for allergies can either be performed on the skin, or by drawing blood.

Skin prick tests

  • A liquid containing the allergen, or a protein extract is placed on your child’s forearm.
  • The skin is then pierced with a small sterile lancet – this is not a needle that goes through the skin and therefore will not draw blood and does not hurt.
  • The doctor will then wait 10 to 15 minutes before analysing the reaction on the skin.
  • This reaction is measured in millimetres and gives an idea of how sensitive your child is to the food substance that was tested.

Specific IgE testing

  • For this test, blood is drawn and sent to a pathology laboratory.
  • Your child’s blood will be exposed to the allergen proteins, and a laboratory analyst with experience in allergy tests will assess how many Immunoglobulin E (IgE) antibodies that are reactive to the allergen your child has.

There are advantages and disadvantages to both tests, and an allergist will usually decide which is the most appropriate to use, based on your child’s age, reaction and background.

About Dr Thulja Trikamjee
Dr Trikamjee practises at Netcare Sunninghill Hospital, and is currently a consultant at the University of Cape Town Lung Institute. She is a member of the Allergy Society of South Africa (ALLSA), the American Academy of Asthma, Allergy and Immunology (AAAI), and the only African-elected board member of the European Academy of Allergy and Clinical Immunology (EAACI).

To find out more about the services offered through Netcare hospitals and other of the Group’s facilities, please contact Netcare’s customer service centre either by email at [email protected] or phone 0860 NETCARE (0860 638 2273). Note that the centre operates Mondays to Fridays from 08:00 to 16:30.

For more information on this media release, contact MNA at the contact details listed below.

Issued by:           Martina Nicholson Associates (MNA) on behalf of Netcare Sunninghill Hospital
Contact:               Martina Nicholson, Graeme Swinney, Meggan Saville or Estene Lotriet Vorster              
Telephone:        (011) 469 3016
Email:                   [email protected], [email protected], [email protected] or [email protected]