By Michaela Gibson Morris/NEMS Daily Journal
Food allergies aren’t caused by peanuts alone.
“Peanut gets a lot more attention,” said Tupelo allergist Dr. Matt Oswalt. It’s the most common of the IgE-mediated food allergies, which can cause the life-threatening, anaphylactic reactions, but it isn’t alone. Fish, shellfish, tree nuts, milk, soy, eggs and wheat round the top eight culprits for food allergies.
“Kids can have dramatic reactions to any of those foods,” Oswalt said.
Anaphylactic reactions can affect the whole body – causing hives, wheezing, vomiting, diarrhea, difficulty breathing and low blood pressure.
Research published in the Pediatrics medical journal found that 8 percent prevalence of food allergies among U.S. children. The survey found higher prevalence of peanut and fin fish allergies than previously published studies.
“I think it’s probably more common than people thought,” Oswalt said.
The survey gathered data on 38,000 children about food allergies and their reactions. Multiple food allergies were reported in 2.4 percent of the children.
Out of the children who had food allergies, 38 percent had a severe reaction, most commonly to peanuts, which are technically a legume, or tree nuts, such as cashews and almonds.
Allergies to peanuts, tree nuts like cashews and almonds, fish and shellfish typically develop in older children and adults, and they are not outgrown, Oswalt said.
Allergies to soy, wheat, egg and milk tend to evolve much earlier, but children can outgrow them. However, the more severe the reaction, the less likely the allergy will completely resolve.
Skin and blood tests have gotten more reliable, but doctors need to know what symptoms people have to put the whole picture together.
“Even if they are sensitive, they may have no problems,” Oswalt said. “Sensitivity means nothing without history.”
For kids with food allergies, there are no shots to desensitize them like there are for mold, grasses, trees and animal dander.
“The safest thing is strict avoidance,” Oswalt said.
It takes a lot of work and label reading on parents’ parts to keep those foods away from children with food allergies. Avoiding peanuts has gotten easier, but it can be challenging especially if the child has more than one allergy.
“We’re pretty much not eating any processed food,” said Crystal Heatherly of Tupelo, whose 8-year-old son Bryce has multiple food allergies.
Most parents of children with food allergies end up scouring specialty sections of grocery stores and health food stores for safe foods. But it comes at an increased cost.
“I pay $5 for two cups of ‘cheese,’” said Amelia Murphree of Tupelo, whose nearly 3-year-old son Robert has multiple food allergies.
Families with children under age 5 can get assistance through WIC, if they qualify. Once kids are older than 5, families are on their own.
“Insurance is not required to cover elemental formulas and medical food,” Murphree said.
Murphree, Heatherly and several other families have banned together to form FACE IT Tupelo support group, which is affiliated with the national Food Allergy and Anaphylaxis Network.
In addition to trading tips on living with food allergies, the support group has organized fun for the kids like a Food Free egg hunt. Next they are planning a Trunk or Treat with stickers, little toys and other non-edible treats.
“Our culture revolves around food,” Murphree said, but for these kids, fun has to come apart from food.
It’s important to Murphree and Heatherly that their kids attend regular school and learn to navigate the real world.
“My kid doesn’t belong in a bubble,” said Murphree, who serves on the national advisory council for Food Allergy and Anaphylaxis Network.
Mississippi was one of the first states in the nation to develop voluntary guidelines for working with children with food allergies. The public schools develop plans to work around food allergies the same way they work with students who have asthma, diabetes or a disability, but parents play a crucial role as advocates in that process.
“Most schools have gotten away from serving peanuts,” Oswalt said. “A lot of schools are going peanut-free,” asking students not to bring peanut products to school because so many children are highly sensitive to the peanuts.
“It’s not worth someone dying over peanut butter,” Oswalt said. “It’s an easy food to avoid.”
It gets trickier when you start adding other allergies into the mix. Simply having a peanut-free table for kids with allergies in the lunch room may not be enough because kids can have serious allergies to other things.
“It needs to be taken on a case by case basis,” considering the particular allergies and medical history of the children, Oswalt said. “If a kid has nearly died from milk, you don’t want it next to them.”
The Murphree family was in trouble from the beginning; they just didn’t know why.
“Robert came out throwing up,” Murphree said. “His first day in the hospital, he was projectile vomiting.”
The Murphrees and their doctors went through rounds of treatment for acid reflux. When Robert was 41⁄2 months, he was diagnosed with food allergies by a pediatric gastroenterologist.
Because she was breastfeeding, Murphree went two weeks on a diet eliminating the top eight likely allergens waiting for Robert’s tests to come back.
“I lived on lettuce, oil and vinegar,” Murphree said.
During that time, Robert got better gradually. In a week and a half, he was no longer projectile vomiting.
Within a month, skin and blood tests verified that Robert was very allergic to egg, as well as milk, peanuts, tree nuts, fish, shellfish, sweet potatoes and strawberries.
At nearly 3, Robert can tell people he’s allergic, and he doesn’t seem too bothered that he can’t have a doughnut on the way to day care or a cupcake at a birthday party.
“We’re the lucky ones,” Murphree said. “Robert has never known anything different.”
Her daycare has been very cooperative, helping her pore over the menu for safe foods, keeping a cabinet of safe alternatives and watching closely for reactions.
“I’d rather he eat what the other kids do, if he can safely,” Murphree said.
Sometimes there have been sticky situations, like having to help other parents understand why they can’t send treats with peanut butter or eggs to school.
“I’m not trying to take it away from other people,” Murphree said. “I just can’t have it around my kid.”
Bryce Heatherly had no sign of food allergies until he was 5.
The first sign came as Bryce complained his throat and stomach were hurting as he drank a glass of milk.
“We told him to drink it anyway,” Heatherly remembers. “We thought he was just trying to get out of drinking milk.”
Then after eating egg salad sandwiches at Grandma’s, he wouldn’t stop throwing up.
They eliminated milk, suspecting he was lactose intolerant. They found he had eosinophilic esophagitis, an inflammation of the esophagus connected to seasonal allergies and asthma.
He developed eczema, an itchy, scratchy skin condition often associated with allergy, and anemia.
Finally, all the pieces added up to food allergies. Bryce’s initial tests showed he was allergic to milk, soy, corn, egg and brewer’s yeast.
“It was hard to give up Cheetos, ice cream, cheese and yogurt,” said Bryce. “Now I don’t like sweets.”
The family adapted and through some ups and downs, but had started slowly testing the parameters of what he could and could not eat without a reaction. Then Bryce had a big reactions breaking out in hives and whelps.
This time, the allergy testing came back with sensitivity to 26 different things including milk, eggs, soy, corn, fish, oats, rice, tomatoes, rye, gluten, broccoli, chicken, pork, beef and mustard.
Ironically, peanuts are on Bryce’s safe list.
“Peanut butter is his main source of protein,” Heatherly said.
Food allergies like Bryce’s are particularly tricky. So many of the gluten-free products rely heavily on rice flour, making them off limits for Bryce. A trip out of town has to be carefully plotted to make sure they have adequate food packed or access to Wendy’s restaurant, where the french fries are safe for Bryce.
The family recently found a gluten-free bread, but it wasn’t available locally, so it cost $30 for three loaves with shipping.
But when combined with some non-dairy butter and cheese, it’s a tasty treat for Bryce.
“It really tastes like grilled cheese,” Heatherly said. “He remembers what grilled cheese tastes like.”
Beyond the expense of the special foods, it’s the lurking uncertainty that bothers Heatherly.
“It’s scary because you never know,” Heatherly said. “We went from six to 26 … you have to stay in tune.”
FACE IT: Tupelo – a support group for parents of children with food allergies, meets twice a month on the first Friday and third Monday. The group is also open to those with conditions that require food avoidance. Affiliated with the Food Allergy and Anaphylaxis Network. Contact Amelia at (662) 322-7434 or firstname.lastname@example.org for time and place. Next meeting will be noon, Aug. 5, at the Gloster Creek Village Food Court.
• Food Allergy and Anaphylaxis Network – www.foodallergy.org: National organization offers information on food allergies, advocacy and research.