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Peter LoGalbo, MD of West Nyack was interviewed by the Rockland Journal News on how Food Allergies challenge families

08/08/2011 in news

For the growing number of parents of children with food allergies, simple activities have to be planned to avoid food that could give their kids hives, swollen tongues, or in some cases, cause anaphylaxis, a life-threatening condition.

Cake time at birthday parties is carefully watched. Planning meals is time-consuming. Eating at restaurants is nerve-racking.

"We are living the impossible everyday," said Suzie Fromer, a Tarrytown mom of two boys with multiple food allergies. "Food is everywhere."

Play Doh, for example, contains wheat.

"You have to be vigilant," said Fromer, who also suffered from food allergies as a child. "It's a full-time job for me."

The number of reported food allergies among those under age 18 grew 18 percent from 1997 to 2007, according to the National Center for Health Statistics. A study published last month in the journal of the American Academy of Pediatrics estimated that 5.9 million children — more than previously thought — have food allergies. Cow's milk, eggs, peanuts, tree nuts, soy, wheat, fish, and shellfish are the top allergens.

"In general, if you ask parents, if you ask school nurses and even physicians, we would all say there is a real increase in the last 10 or 20 years," said Dr. Peter LoGalbo, an ENT and Allergy Associates physician in West Nyack. "Nobody really knows why."

One possibility — the hygiene hypothesis — theorizes that immune systems of children in industrialized countries aren't challenged enough with infection, so they are skewed to fight harmless substances.

Even though the prevalence of food allergies is increasing, parents shouldn't assume their child will develop them, said Dr. Subhadra Siegel, a pediatric allergist and immunologist at Maria Fareri Children's Hospital at Westchester Medical Center. She estimates that 3 percent to 8 percent of children have food allergies.
 
Some parents misidentify an "adverse food reaction," like an upset stomach, as an allergy, she said.

"There is so much awareness of food allergy that (with) any kind of symptom, parents try to link it to something the child ate that day," she said.

A food intolerance, such as an upset stomach from lactose intolerance, is different than an immune system response to a food. Confusion and fear about food allergies have prompted some parents to eliminate foods from their child's diet without knowing for sure if they are allergic. That could lead to nutritional deficiencies, and parents should always see an allergist for a diagnosis before drawing conclusions, she said.

Symptoms of a true food allergy include hives, swelling lips, wheezing, and difficulty breathing — severe symptoms that usually occur within 20 minutes of eating or coming into contact with a certain food. Parents should be aware of their family history of  allergies and watch for indications, such as eczema, Siegel said.

Doctors also cautioned against limiting foods based on blood and skin tests.

"There is a very high false positive rate," LoGalbo said. "You can get a positive test, but the person can eat that food and nothing happens. A negative test is more accurate. If the test is negative, you almost certainly are not allergic to the food, whereas if it's positive, there is really only about 50 percent likelihood you are allergic."

Unless children show very high reactions on blood and skin tests, doctors can administer food challenges to find out if they are truly allergic, LoGalbo said. The blood and skin tests also can't predict whether children would have a mild or severe reaction to certain foods, he said.

Parents of children with allergies said sometimes people don't understand the seriousness of food allergies "One of the comments I get that drives me a little crazy is, "Well, when I grew up no one had a food allergy," said Diane French-Lynch of Pearl River, who recently helped start a support group called Food Allergy Families of Rockland. "There is obviously something going on. These kids are having reactions. It's not just based on tests."
 
Her son Cormac, now 2 1/2, had eaten peanut butter a few times without a problem until about about a year ago. Then he touched peanut butter crackers, and rubbed his eyes, which swelled to the size of golf balls.

"There are no clear cut answers: why he got it, if it will go away, if his reaction will get worse," she said. "That's the frustrating part."

She carefully checks product labels to not only make sure they don't contain nuts, but also that they weren't produced in a factory with them. Many packaged foods are off limits. So are bakeries and ice cream parlors. Going to a restaurant is stressful because you have to trust the word of strangers who are preparing the food, she said.

Fromer, the mom from Tarrytown, has a long list of foods her boys, Daniel and Peter Hyman, can't eat. Daniel, 5, gets swollen lips and throat problems from foods including wheat, barley, peanuts, eggs and shellfish, to name a few. Her younger son, Peter, breaks out in hives if milk touches his skin.

The hardest part of having children with allergies is being socially isolated, she said. Rather than let her make her own food arrangements, sometimes parents just don't invite her to birthday parties, she said. "People don't understand they are being hurtful," she said.

Sari Canell's daughter, Hayley, 10, was diagnosed with a number of food allergies when she was 11 months old after she vomited from a tiny piece of cheese. Hayley has outgrown some of the allergies, but still has restrictions.

Canell, a Scarsdale resident,started a support group, and she recently merged with Fromer's support group to form Food Allergy New York.

She said even parents with kids who don't have food allergies should be aware of them because there is a good chance their child will have a friend with a food allergy.

"On a play date or a sleepover, if something were to happen, you would be able to recognize it," Canell said.
 

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