Discussions of food allergy are about immune responses to proteins in food. Food allergy is most often recognized in infants. The problem disappears from the medical view in older children and adolescents. Since every person has antibodies in their blood to some food proteins, you can argue that everyone has immune responses to food. You could then argue that food proteins routinely find their way into tissues and blood where these immune responses occur. If this is true, everyone, young and old, must feel this activity at some time, and some children become ill as this immune activity occurs. The unanswered questions are: how many children become ill, how often and with what consequences?

Food Allergy is Common  During the first year of life, the infant diet is the most powerful determinant of the growth and development of the child and food allergy is the most common health problem. Many studies show that breast feeding is best and that the feeding of solid foods is best delayed  4 to 6 months to reduce the risk of food allergy. 

Food allergy in infancy is expressed as crying, colic, vomiting, diarrhea, rashes, eczema and cold-like respiratory congestion. Some infants with food allergy become seriously ill and fail to thrive unless their allergy is recognized and corrected. Infants who develop food allergy in their first year may "outgrow" the first effects but tend to grow into children with more pervasive health, behavior and learning problems unless their diet is properly managed.

There are different types of food allergy. The immediate or type 1 food allergy pattern is easily recognized because it involves quick and   dramatic symptoms. Hay fever is the most common type 1 allergy and can be diagnosed by allergy skin tests. Some food allergy is also type 1 and shows up on  skin tests. The child who develops hives 30 minutes after eating strawberries has a type 1 reaction. A child who wheezes 20 minutes after eating peanut butter has a type 1 reaction and a potentially dangerous one. An infant cries, squirms, and vomits 15 minutes after ingesting a new milk-based formula has type 1 reaction triggered in the stomach.

Delayed patterns of food allergy are not so obvious and generally go unrecognized. Allergy skin tests do not show this problem nor do IgE antibody tests such as RAST or ELIZA.  Delayed patterns of food allergy are responsible for causing common but ill-defined illness patterns in children. A cluster of physical, behavioral, and learning problems is typical of many children we see. A child may present with chronic nose congestion, cheek and ear flushing, a history of recurrent ear infections and tonsillitis, associated with infrequent attacks of abdominal pain and episodes of hyperactivity with temper tantrums. Another child may present with recurrent "flu", fatigue, lymph node swelling and appear to be depressed.

Special Note to Parents  Another call from an unhappy mother reminded us that there is a problem with identifying health problems as "food allergy". The call was from a well-educated, sincere, conscientious mother who had a very difficult son, now 5 years of age. She had managed physical and behavioral problems with careful diet management for two years and had identified several foods that caused symptoms in her son. She took great pains to keep him away from the problem foods. She went to an allergist, hoping that he could help her  identify food and environmental factors that might be bothering him.

According to her account, the allergist was rude to her, denied that her experience with her son's food reactivity had any validity and found no skin reactions with the few foods that he skin-tested. He went on to claim that there was only "one flawed study in the 70's" that showed any connection between food and behavior. This mother soon went down the street to the local naturopath who was more sympathetic with her concerns about her son's food reactivity and offered some helpful advice about managing his diet.

The scientific issues surrounding food allergy are dealt with in detail in several locations at this web site and we encourage you to follow the links, print out the texts so that you can come to your own conclusions about this very complicated subject. Here are the main points that you need to know:

1. Skin tests are very limited in their diagnostic range and only detect one type of allergic mechanism. You cannot rely on the skin test to show the wide range of food allergic reactions.

2. Any allergist who suggests that the skin test is a definitive and final test for food allergy  is misleading you.

3. Do not expect all allergists to be willing or able to help you identify food problems and revise your child's diet. Only a few allergists are interested in  and knowledgeable about food allergy and its management. Proper diet revision requires understanding of food choices, nutrition and eating behaviors.

4. Be prepared to make your own decisions and to manage your child according to your own observations. Become an expert yourself.

Other reports from parents remind us that "alternative" methods of diagnosing and treating "food sensitivity" may lead to confusion, frustration and un-necessary expense. Many have reported that they left their physicians in frustration and went to other practitioners who used a variety of tests to diagnosis food problems, prescribed diet revision and many other treatments. Most alert parents recognized benefits by changing their children's diets but were not sure about all the other treatments offered. Our advice is simple - most often the dramatic improvement in children with hidden food allergy occurs with proper diet revision. We are not aware of any test or treatments that replace the intelligent parents' application of common sense. (See the bad and bizarre for a quick review of invalid tests).

The Complex Presentation-Delayed Pattern Food Allergy

Delayed  patterns of food allergy  tend to be whole-body diseases and a lottery selection of disturbances may evolve over many years. In many older children, we can trace the illness pattern back to early infancy with slow, intermittent emergence of symptoms over several years. In other children the illness begins abruptly and progresses rapidly without prior symptoms. A multi-system and polysymptomatic pattern of illness that defies a single diagnosis means food allergy until proven otherwise. Wise parents will reject psychiatric diagnoses of their children's illness and seek help elsewhere.  See Children and Prescription Drugs

The illness may be mild and include nose congestion, headache, indigestion, flatulence, aching, stiffness and fatigue. The illness may be severe and present as intractable asthma, chronic diarrhea, failure to thrive, skin diseases, arthritis, urinary problems, hyperactivity, or learning disability. One child may have chronic nose congestion, cheek and ear flushing and  history of recurrent ear infections, tonsillitis, associated with infrequent attacks of abdominal pain and episodes of hyperactivity with temper tantrums. Another child may present with recurrent "flu", fatigue, lymph node swelling, loss of appetite and sleep disturbances.

The proper diagnosis of these mysterious illnesses is "delayed pattern or Type III food allergy". If  you are lucky and your doctor recognizes this pattern, (s)he should suggest diet revision - perhaps beginning with the exclusion of packaged and processed foods, milk, and dairy products from your child's diet. You would keep a daily food-intake-symptom journal with a return appointment in three weeks to review the results of your efforts. If the initial changes are not successful in resolving the problem, Alpha Nutrition would be the next logical step. With your physician's help, an ongoing healthy state should be achieved. if you are not lucky and your physician does not support diet revision you will have to be responsible and conduct diet revision on your own. You will need to prepare by studying the Alpha Nutrition manual and you may want to read books that are available through the library and book store.

The diagnosis of delayed pattern food allergy is  based on the history of illness and physical examination. Laboratory tests have not proved very helpful in making this diagnosis and skin tests, used to uncover the allergens in hay fever, also do not help in the diagnosis of delayed pattern food allergy.

The tutorial, Food Allergy in Children gives you a quick lesson in this important topic. We devote a whole website to explaining  food allergy. The topic is well explained in the book, Feeding Children. Advanced readers will want to read the Book of Allergy and Immunology.

Start Tutorial Food Allergy in Children

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