Food allergy symptoms in infants and young children

Within minutes to hours of ingesting allergenic foods, three typical symptoms will appear: skin erythema/wheals, vomiting and diarrhea, sneezing, coughing and wheezing. In severe cases, it can cause laryngeal edema and anaphylactic shock, which is life-threatening. The symptoms of different individuals, or even different episodes of the same individual, vary greatly, and there is no completely unified judgment standard.

Last week, I met a 6-month-old little Nuomi at the child care clinic. My grandma fed her egg yolk for the first time. She just licked half a spoonful. Within 10 minutes, the area around her mouth turned red, and she kept rubbing her nose and face. At first, grandma thought it was the egg yolk that was too dry and stuck. After feeding her two mouthfuls of water, she started coughing. She hurriedly took her to the emergency room, where she was confirmed to be allergic to egg yolk. Fortunately, the intake was small and it disappeared soon after taking the medicine.

The first impression many parents have of allergies is a rash. This is indeed the most common manifestation. Almost 60% of babies with food allergies have skin reactions as their first symptom - some are red around the mouth and cheeks, as if they have just eaten red peppers, and some are raised wheals on the body, which become more swollen the more they are scratched, and are itchy enough to make the baby cry. Babies who are not yet able to speak and cannot express themselves will keep rubbing their heads and eyes, causing their eyelids to turn red and even the areas around their eyes to become swollen. These are all very typical signs.

Oh, by the way, don’t think that allergies are only caused by rashes. Many children’s allergies do not go to the skin at all, but cause moths in the digestive tract. Previously, a mother brought her 10-month-old baby for a physical examination. She said that after switching to ordinary milk powder, the baby vomited every time she drank. At first, she thought it was because she was fed too much and the milk overflowed. Later, the vomiting became more and more frequent, and there was blood in the stool. She did not gain any weight in half a month. It was finally found out that I was allergic to milk protein. After switching to deeply hydrolyzed milk powder, these symptoms disappeared within a week. It should also be mentioned here that there are currently differences in the judgment of this type of atypical gastrointestinal allergy in the academic community: one group believes that as long as it meets the avoidance challenge test criteria of "symptoms appear after eating, disappear after avoidance, and relapse after repeated exposure", it is considered confirmed. ； The other group insists on detecting an increase in specific IgE or a positive skin prick test before making a diagnosis. This is why many parents hold allergen reports that show "all negative" and wonder why their babies feel uncomfortable when they eat certain foods - the immune system of babies under 1 year old is not fully developed, and the false negative and false positive rates of tests are not low, so judgments cannot be made based on reports alone.

What needs to be most vigilant are respiratory-related allergic symptoms, which many parents easily mistake for a cold. I met a 3-year-old baby before. After eating a mouthful of mango, he sneezed non-stop and had a runny nose. His mother thought it was because of the wind and caught a cold, so she gave him some cold medicine. However, half an hour later, the baby started to wheeze, complaining of a sore throat, and his voice became hoarse. When he was sent to the hospital, he was already struggling to breathe. It was diagnosed as a severe allergic reaction. If it were later, he might even suffer from laryngeal edema and suffocation. If your child suddenly develops coughing, wheezing, hoarseness, and tight throat after eating, especially if it is accompanied by swollen lips, pale face, and cold hands and feet, don't hesitate to send him to the emergency room immediately.

Nowadays, many parenting bloggers on the Internet say that "when a baby develops eczema, it means he has a food allergy." This view is actually different from the mainstream understanding of dermatology. There are many causes of eczema, including dry skin, too high ambient temperature, contact with chemical fibers or irritating toiletries. Only about 30% of moderate to severe eczema is related to food allergies. If you stop all complementary foods as soon as eczema develops, it will easily lead to insufficient nutritional intake of the baby and affect the growth and development.

There are also some very hidden atypical symptoms that many parents never think are allergies: For example, after a child eats something, he suddenly becomes very irritable and cries for no reason, or he keeps yawning and is listless. Older children who can talk may say "numbness in the mouth" and "itchy throat". These may be precursors to allergies, so don't take them seriously. Oh, by the way, don’t think that the sooner the symptoms appear, the more serious they will be. I once met a child who was allergic to peanuts. He just rubbed his eyes a little when he first ate them, and it took more than two hours for him to start wheezing. On the contrary, it was much more dangerous than those who developed a rash just after eating them.

My usual advice to parents is that there is no need to memorize the symptom comparison table online. The most suitable judgment method for ordinary families is to keep a food diary: each time you add a new complementary food, add it separately and eat it for 3 consecutive days to observe the reaction. Once the above-mentioned abnormalities occur, stop immediately. After the symptoms completely disappear, try a small amount again. If similar reactions appear twice, you can basically determine that you are allergic to this food. For babies, this method is much more reliable than drawing blood for allergen testing.

After all, every baby's body is different. What other people eat without problems may not be tolerated by your own baby, so it's always good to be more careful. When you are really unsure, see a pediatrician or allergist. Don’t make random guesses about food taboos, and don’t just ignore it.