Allergy clinic Q’s debunked by Dr Diab Haddad

Dr Haddad our resident Paediatrician has worked with Grow with Iris since 2020 in the very early days. Here he answers some of the most frequent questions he gets asked in his allergy clinic.

There is increasing awareness of the role various types of allergies play as a cause of ill health in infants and children. With that, the number of children, following some sort of food avoidance, has dramatically increased. As many parents would know, it is difficult, at the best of times, to get children to take an adequate diet which meets their nutritional needs. To attempt to achieve this, while still having to follow the various restrictions frequently imposed on the diets of children with suspected food allergies, can become an impossible task.

While there are plenty of products offered as alternatives to the specific food to be avoided, there has always been an issue with the adequacy of such alternatives in terms of nutritional value, palatability and content of other potential food allergens, which is relevant in cases of multiple food avoidance. As a paediatrician who ran one of the busiest paediatric allergy services in Surrey, I wasn’t short of real life examples of these difficulties. Thus when Amy and Sophie told me about their plan to work on coming up with a solution and creating a product that could meet these needs, I didn’t need much convincing.

One rather overwhelmingly persuasive factor for me was the motive behind this project and the passion with which its two founders were pursuing it. As a mum, Amy had personally experienced the difficulties mentioned above almost on a daily basis as she shopped around for suitable food products for her daughter Iris, who had proven multiple food allergies.

“I just don’t want other parents to go through this any more” declared Amy.

Her determination and optimism were only matched by her friend Sophie who shared with Amy her experience and enthusiasm. I thus agreed without hesitation, when asked to provide medical advice at the different stages of the project. Throughout I felt the overriding imperative has continued to be the product safety, nutritional adequacy, palatability and suitability for children.

Imposing food restrictions unnecessarily serves no good purpose and can lead to harm. The diagnosis of a food allergy should be made only after adequate evaluation by health care professionals with experience in this field.

Below are some of the common queries parents often have about food allergies in children:

• How Common is food allergy in children?

The highest prevalence of food allergy is among infants and toddlers when the prevalence reaches 6-8% of 1-2 year olds. It then drops to 3 to 4% among older children and adults. Not all “reactions” to food are allergic in nature. Some children and adults may develop symptoms consistently after consuming certain foods because of other types (non-allergic) of intolerance to these foods. Cases of lactose intolerance or reactions to foods containing high concentrations of certain substances (such as histamine or which acts like histamine) belong to this category.

• Can Children grow out of their food allergies?

The figures quoted above clearly show that more than half to two thirds of young children diagnosed with food allergy will eventually grow out of their allergies. The chances of this are highest for cow’s milk and egg allergies but even young children with nut allergy stand a reasonable chance of growing out of their allergy. This is why it is important to be followed up by health care professionals who can undertake the appropriate repeat evaluation in a safe manner. Please note that you should not “test” your child yourselves to see if they have grown out of any type of allergy without the health care professional indicating that this is safe to do.

• Will allergic reactions get worse with time?

There is no evidence this is the case. The severity of allergic reactions depend on multiple factors including the amount and form of the food eaten, as well as the state of health of the child on the day among a host of other factors that vary from child to child and from one type of allergy to another. Generally repeat reactions can be of the same severity as the first reaction, milder or worse. The health care professional will assess the various risk factors for severe allergic reactions and accordingly decide if measures need to be put in place to deal with potential severe reactions in each individual case.

• Apart from avoidance of the offending food, are there any other options for treatment?

There are currently programmes of “desensitisation” in place as well as under investigations. Unfortunately most of these do not offer “cure” of the allergy. However they may increase the threshold of food needed to trigger a reaction. In some cases this may be helpful and can give the child and family more freedom to lead normal lives. Such programmes are not suitable for all children and it is important to discuss this with your health care professional.

• My child had a “positive” allergy test, does that mean they have to avoid these foods?

A positive allergy test of any type does equate being allergic to the food tested. It does raise the possibility and the health care professional will need to assess the magnitude of the reaction and the history as well as at times obtain further tests before being able to conclude whether a positive allergy test to a food signifies genuine allergy or not. Equally sometimes a child with an established diagnosis of food allergy may test negative to that food. Thus accurate diagnosis of food allergy requires careful assessment of the history as well as the allergy tests by a health care professional with expertise in this field.

For further information, check out our FAQ’s. If you have any specific questions for Dr Haddad, please do email us at hello@growwithiris.com