Kids and Living with Food Allergies

Girl WatermelonSIGNS AND SYMPTOMS

A food allergy usually occurs in the first two years of life, says Dr. Ellis, a CHOC Allergy and Immunology Specialist. “It’s important to know that allergic reactions to food typically occur immediately or within two hours of eating the food,” Dr. Ellis explains. “The child might have skin issues like hives (itchy red spots) or develop itchy skin, or the child might throw up. All the organ systems can be involved. The child might wheeze or become short of breath. In severe cases, the cardiovascular  system can be involved and the child could have a drop in blood pressure, feel light headed and faint.”

MANAGING FOOD ALLERGIES
There is no cure for food allergies and the best way to avoid getting sick is avoiding the food. “You have to find out what the child is allergic to. This comes from the family history and then we take a blood test or a skin test to confirm what the family has told the doctor,” says Dr. Ellis. With a serious reaction, an adult should inject the child with epinephrine (adrenaline that reverses the symptoms) and call 9-1-1. “Always have an epinephrine auto-injector. Learn how to read food labels and be careful at high-risk eating areas such as buffets, ice cream parlors and Asian restaurants.”

FOOD FOR THOUGHT
Any food can cause an allergy but a small number of foods are most commonly associated with food allergies. In fact, eight foods/food types account for 90 percent of all allergic reactions. They are: milk, eggs, peanuts, tree nuts (such as walnuts and almonds), soy, wheat, fish and shellfish. Even trace amounts of a food allergen can cause a reaction, including a severe or life-threatening reaction. Peanuts, tree nuts and fish are the most common causes of severe reactions, says Dr. Ellis.

FAST FACTS

  • Estimated number of American children and adults with food allergies: 15 million
  • Annual cost to the U.S. economy related to children’s food allergies: Almost $25 Billion
  • Percentage of children under the age of six with food allergies: 6 – 8

View the full feature on Kids and Living with Food Allergies

Dr. Mark Ellis
Dr. Mark Ellis
CHOC Allergy and Immunology Specialist

PHYSICIAN FOCUS: DR. MARK ELLIS

Dr. Ellis completed his residency at the University of Arizona Health Sciences Center in Tucson and a fellowship in Allergy-Immunology at the University of California, Irvine, Medical Center. Dr. Ellis is chief of the CHOC Children’s Specialists Allergy & Immunology Division and is the Director of the Allergy, Asthma & Immunology program at CHOC. Dr. Ellis specializes in the treatment and management of allergies and asthma. He is a principal investigator for many clinical research studies for adults and children concerning new treatments for asthma and allergies.

Dr. Ellis’ philosophy of care: “I like to identify the problem and educate the family on ways to prevent disease.”

EDUCATION:
Tulane University School of Medicine in New Orleans

BOARD CERTIFICATIONS:
Pediatrics
Allergy and Immunology

More about Dr. Mark Ellis

This article was featured in the Orange County Register on April 7, 2014, and was written by Amy Bentley.

Food Allergy Resources for Families

Having a child with a food allergy can be challenging at times, but with care and menu planning, these kids can lead happy and healthy lives free of allergic reactions.food_allergy_families

“These kids can live a normal life and with proper education, this problem is very manageable,” says Dr. Mark. Ellis, director of the allergy, asthma and immunology program at CHOC Children’s.

Dr. Ellis says that food allergies are becoming more common, but while many hypotheses about the increase exist, none are supported by the medical research.

CHOC offers families many educational resources to help handle food allergies, including nutritional support and dietary advice.  A CHOC dietitian can ensure the child’s diet is nutritionally sound, Dr. Ellis says. Patients can also visit Food Allergy Research & Education (FARE), a nonprofit organization that offers food allergy information.

Even parents of children without known food allergies should know the symptoms of an allergic attack. The American Academy of Pediatrics offers this list of the most common symptoms:

  • Skin problems
  • Hives (red spots that look like mosquito bites)
  • Itchy skin rashes (eczema, also called atopic dermatitis)
  • Swelling
  • Breathing problems
  • Sneezing or wheezing
  • Throat tightness
  • Stomach symptoms
  • Nausea
  • Vomiting
  • Diarrhea
  • Circulation symptoms
  • Pale skin
  • Light-headedness
  • Loss of consciousness

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Making Sense of Asthma Medication

The number of children with asthma continues to rise, but the evolution of asthma medication means most attacks can now be prevented before they start.

While rescue medication is still important, the standard practice today is to prescribe inhaled corticosteroids, usually taken once or twice daily. These preventive controller medications reduce the swelling inside the airways, minimizing attacks over time._MG_6020

When deciding whether to prescribe a corticosteroid, a child’s physician will typically use the rule of two: if a patient uses rescue medication more than twice a week, wakes up at night due to asthma more than twice a month, or refills their rescue inhaler more than twice a year, then controller medication should be used, according to Dr. Mark Ellis, a CHOC Children’s asthma specialist. Controller medication can be started in children as young as 12 months of age.

“We start inhaled corticosteroids whenever we think the benefits outweigh the risks,” Dr. Ellis says.

Corticosteroids are not addictive and have very little risk for long-term side effects. Dr. Ellis says children may experience slowed growth by up to a quarter inch the first year and a quarter inch the second year. However after two years, a child’s growth will catch up to normal levels. Your child’s physician will make sure your child is taking the lowest dose possible to minimize any effects.

Corticosteroids are not to be confused with anabolic steroids, which are sometimes used by athletes to increase performance and bulk up muscle.

For hard-to-control asthma, corticosteroids are occasionally combined with another medication – long-acting bronchodilators – in drugs such as Advair and Symbicort. These combination medications are considered safe, Dr. Ellis says, but the Federal Drug Administration has warned that long-acting bronchodilators, such as Serevent and Foradil, should not be used alone.

In addition to corticosteroids, rescue inhalers and nebulizers should still be used when an attack happens. Some children may feel shaky or have an increased heart rate afterward, but the effects are not harmful and should go away quickly.

CHOC is involved in a number of asthma research projects, including one study led by Dr. Ellis on using antibodies to cause an attack on the cells that inflame airways. Several medications are also being tested for safety and effectiveness in children.

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