Frequently Asked Questions (FAQs)
1. What is a food allergy?
If someone has a food allergy to a certain food, that means when that person is exposed to the food allergen (the food that he/she is allergic to), his/her immune system treats the food allergen like a harmful substance, such as poison, bacteria or virus, and has an exaggerated immune response to the food allergen. The food allergy reaction can be mild to very severe. It can take substantial exposure or very little exposure to have an allergic reaction.
2. What is anaphylaxis?
Anaphylaxis is a multi-system reaction to an allergen. Anaphylaxis can be fatal if it isn't treated immediately. When someone has an anaphylactic reaction, they can have symptoms in different parts of the body at the same time, including rashes, swelling of the lips and throat, difficulty breathing and a rapid fall in blood pressure and loss of consciousness.
Anaphylaxis is treated with an injection of adrenaline (epinephrine), such as an EpiPen.
Often those with a severe allergy will take their medication with them wherever they go. It is also important for adults who are in charge of children who severe allergies to recognize the symptoms of a food allergy and know how to use the EpiPen when needed. It can be a matter of life or death.
Symptoms can appear within seconds, minutes, hours or even days after someone has come in contact with the food they are allergic to. Sometimes it’s hard to tell if a reaction is anaphylactic because the symptoms may be mild at first, misleading someone to treat it as such. It’s better to be cautious and not to underestimate the danger.
Anaphylaxis can be caused by any food, but most commonly by peanuts, tree nuts, sesame seeds, milk, eggs, shellfish and fish.
3. What’s the difference between food intolerance and food allergy?
A food allergy is an immune system response to a certain food, treating the food like a dangerous substance to the body. Food intolerance is not an immune system response and is not life-threatening.
Usually, someone with a food intolerance lacks a particular enzyme. For example, lactose intolerance is a problem with digesting lactose sugar in milk, caused by a deficiency in lactase, an enzyme produced by a small intestine that breaks down lactose. Allergic reaction is an immune system response to either one or both proteins in milk, casein and whey. Symptoms of lactose intolerance are inconsistent and are limited to some discomfort of the stomach, such as gas, bloating, maybe diarrhea and are not dangerous. The symptoms of an allergic reaction to milk protein are consistently reproducible and occur quickly after consuming milk and may include wheezing, vomiting and hives.
4. What are the symptoms of a food allergy reaction?
The symptoms of a food allergy reaction can be mild, or they can be severe, depending on a person’s allergy level and the amount of exposure to the food allergen. Symptoms of a food allergy reaction can change over time. Did you know that you could possibly eat something your whole life with little or no problem, and then suddenly have a severe allergic reaction to the same food?
The most common symptoms of an allergic reaction include:
- Abdominal pain
- Difficulty swallowing
- Dry throat and tongue
- Itching of the lips, mouth, tongue, throat, eyes, skin, or any area
- Lightheadedness or fainting
- Nasal congestion
- Not being able to speak clearly
- Runny or blocked nose
- Patches of itchy, scaly skin (atopic dermatitis); skin may peel or blister
- Swelling (angioedema), especially of the eyelids, face, lips, and tongue
- Shortness of breath
- Stomach cramps
- Thready pulse
5. How much and what type of exposure will cause an allergic reaction?
The amount of exposure to a food that would trigger an allergic reaction depends on the individual. There are several ways someone who is allergic may be exposed to a food allergen, including:
- Ingestion (eating the food)
- Oral contact (kissing a person who has eaten the food)
- Physical contact (touching the food)
Ingestion (eating the food): Most people who are allergic will have a reaction from ingestion of the offending food. This poses the most risk to the onset of an allergic reaction and can be the most dangerous. Even if someone is very careful and tries to avoid the food allergen, he or she can still eat it accidentally, which can trigger an allergic reaction. Sometimes eating only a trace of the food allergen can trigger an allergic reaction. That is why accurate ingredient labeling and thorough reading of the ingredient label of food products are very important.
Oral Contact (kissing a person who has eaten the food)
Kissing someone on the mouth or having oral contact with someone who has just eaten something you are allergic to certainly poses a serious risk of ingesting the food allergen and can trigger an allergic reaction. A study at NY’s Mount Sinai School of Medicine (2006) showed that simply brushing and rinsing your teeth after someone just ate a food allergen does not fully remove the food allergen. However, after four hours of not eating the offending food, the allergen eventually goes away. Researchers advise that it is best that partners of those with food allergies also avoid the same foods.
Physical contact (touching the food): Some people can have reactions from some type of physical contact with the food allergen such as touching the food. Usually, the reaction will be localized to where the contact occurred. Itching, swelling, hives, or redness may occur. Though it is unlikely that this type of contact will trigger a serious reaction in most food allergy cases, it can still occur with those people who have a severe allergy. Satellite reactions (reactions in other parts of the body, not just where the contact with food allergen occurred) and the onset of anaphylaxis can even occur.
A person with food allergies should wash any part of the body with soap and water immediately after it comes into contact with an allergen or an allergen contaminated surface. Allergens from the contaminated hands of any person can be easily transferred through touch to other body parts, objects or foods, creating an unsafe environment for an allergic individual. Frequent hand-washing with soap and water, particularly after eating or handling food, is the most effective way to keep hands and surroundings clean from food allergens.
6. What is Oral Allergy Syndrome?
Oral Allergy Syndrome is a term used to describe itchy or scratchy mouth symptoms caused by raw fruits or vegetables in people who also have hay fever. Symptoms are typically limited to the mouth. This reaction is caused by an allergic response to the pollen that crosses over to similar proteins in the foods. Most people affected by oral allergy syndrome can eat cooked fruits or vegetables because the proteins are sensitive to heating. The condition is also known as pollen-food syndrome. Symptoms resolve usually within minutes after the food is swallowed or removed from mouth, and treatment typically is not necessary. However, sometimes oral allergy syndrome can foretell the onset of a more severe reaction in which the term "oral allergy syndrome" no longer applies.
7. Is Celiac a kind of food allergy?
No. Celiac is not a kind of food allergy. It is a condition that damages the lining of the small intestine due to ingestion of gluten and affects the ability to absorb nutrients that are important for staying healthy. Celiac is not a food allergy, but the same care of strict avoiding a certain food (in this case, gluten) is essential. Gluten is found in wheat, barley, and rye. Please visit the Celiac Disease Foundation for more information.
8. Is having a food allergy an illness? How does someone get a food allergy?
No, a food allergy is not an illness, however, it is a health condition which is covered by the American Disabilities Act, Section 504.
Not much is known why food allergies develop in some people and not others. Genetics plays a role. Someone is more likely to develop a food allergy if they have a parent or sibling with an allergy to anything, food, the environment, or any other substance. Young children are more likely to develop food allergies than adults, although allergies can develop at any age. Some people outgrow childhood allergies, some people never outgrow their allergies, and some develop allergies when they become adults. Some experts believe that the lifestyle and cleanliness of a society may impact the incidence of food allergies.
9. Is there a cure for food allergies?
There is no cure for food allergies at this time, so the only way to prevent a reaction is to avoid the food that a person is allergic to. Strict avoidance is key to managing food allergies. Strict avoidance includes minimizing contamination of the environment of someone with a food allergy, and thus it takes a community to manage food allergies.
10. What type of medication is needed when someone has a food allergy? Why does a person sometimes carry a fanny pack everywhere he or she goes?
If someone has a severe food allergy, the doctor will likely prescribe antihistamines, such as Benadryl, and/or a single-dose injectable EpiPen containing adrenaline. People who suffer from dangerous allergies must carry the EpiPen, as it is the only life-saving medication for someone who is having a severe allergic reaction. In an allergic reaction, every minute counts and medical response should not be delayed. Sometimes it takes only a few minutes for the symptoms to escalate to a life-threatening situation. Doctors advise people who have anaphylaxis or other possible severe symptoms to never go anywhere without their life-saving medication. Many people who have food allergies carry their emergency medication with them in a fanny pack.
11. What snack/food should I send to school for my child if there is a classmate with a food allergy?
It is possible that a letter may be sent out by a school nurse, a teacher or a principal to all the families in the class notifying parents about presence of specific life-threatening food allergies, without identifying a child. It is up to a parent of a child to disclose more details about his/her child’s condition if they wish. The letter from the school will outline what snack is permitted or what allergens are restricted in the classroom. It may outline ways you can help maintain an inclusive and safe environment for all kids throughout a year (e.g. hand-washing after breakfast).
12. Will there be a list of safe snacks given out to the parents to help make informative choices without putting a child with food allergies at risk?
A team consisting of a school nurse, a class teacher and a parent of a child with food allergies have an option to create a list of safe snacks and make it available to the parents as a guide. See the "Food Allergy Quick Guide" on the left panel for ingredients to avoid.
13. What precautions should we and our children take to make play-dates and social gatherings safe and inclusive for children with allergies?
If you are planning to serve food, let parents know ahead of time the type of food you will be serving. Serve food using clean utensils to an allergic child first to avoid cross-contamination. It is helpful to teach children good hand-washing hygiene before and after meals and snacks .Save labels from the food packaging that can be a great source of allergen-containing information to parents/children. Never be intimidated to ask a parent of a child with food allergies about ways you can make an event fun and inclusive. Likely, they will volunteer to bring food or help make it with you. When you show caring and respect for differences, your children will learn tolerance by example.
14. What should I know if I am in charge of a child with food allergies?
It is important that you or the child has all emergency medications with them, such as an EpiPen and/or Benadryl. Ask parents before they leave to show you how to use an EpiPen. Ask to have a phone number they can be reached at and know what the child is allergic to. Always read ingredients before offering food. Practice good hand-washing and wiping surfaces with disposable wipes or tissues. If ever in doubt or if you need more information, please speak to parents of an allergic child. They know their child best.
15. We love baking and sharing food with all our friends during holidays, birthdays and special occasions, but we do not want to leave out anyone from the experience or make it unsafe. Are there alternative options that we can select from instead of food?
There are options to celebrate any occasion without focusing on food. Whether it is in the school setting, a party place or your home, you can select from non-food items and activities. In a school setting your child may like to create non-food party favors, do crafts, create art projects, read or gift a book, play games, make puppets, act out a favorite story or sing favorite songs. Outside the school setting your child may like to participate in/attend a theatrical performance or a sports game, gather for a movie, go bowling, create or decorate pottery, visit a museum, go ice skating, have a picnic in a park, enjoy water or pool activities, play music or dance with friends. Whatever you or your child selects, keep in mind the child’s age and adequate adult supervision/involvement.
Sources: American Academy of Asthma, Allergy, and Immunology; Celiac Disease Foundation; FAAN; Food Allergy Initiative; Journal of Allergy and Clinical Immunology; National Center for Biotechnology, a division of the National Library of Medicine at the National Institutes of Health; National Institute of Allergy and Infectious Diseases, division of U.S. Department of Health and Human Services, National Institutes for Health; New York State Department of Health, New York State Education Department, New York State Health Services Center
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