For many kids, the cafeteria at school is space to make new friends and enjoy some downtime between classes. For others, the lunchroom can feel more like a minefield.
It’s an understandable feeling of concern—one shared by parents, teachers, staff and children—rooted in one harrowing fact: today’s children are more allergic than ever before.
It’s true. The number of diagnosed food allergies among children has steadily increased over the past several decades, with approximately two children with food allergies in each classroom today. While not all allergic reactions warrant a hospital visit, some can be life-threatening. In fact, food allergies cause hundreds of deaths each year.
With statistics like these, it’s useful for every parent or guardian to understand the basics of food allergens and how to recognize a reaction. Here to help understand the dangers is Indiana University School of Medicine expert Mark Kaplan, PhD, Billie Lou Wood Professor of Pediatrics and program director of the Pulmonary Inflammation, Asthma and Allergy research group at the Herman B Wells Center for Pediatric Research.
Anyone can have a food allergy.
Food allergies do not have any demographic or ethnic preference. However, the presence of one allergy can indicate that the child has other sensitivities as well—including those to foods, dust, dander or pollen.
“An allergy is an immunological response. A substance enters your body, and the immune system perceives it as threatening,” Kaplan said. “Allergies are like real estate. It’s all about location. If the reaction happens in your intestines, you develop food allergies; if it’s in your lungs, you might develop asthma, and if it’s on your skin, you may develop an itchy rash, called atopic dermatitis.”
Atopic dermatitis, more commonly known as eczema, is significant because it is one of the earliest allergic diseases a child develops. According to Kaplan, atopic dermatitis is thought to be the first sign of the “atopic march,” which indicates that one allergic disease predisposes the child to the development of other allergic diseases, such as food allergy or asthma.
A reaction can occur even if the child doesn’t ingest the allergen.
Allergen sensitivities are as varied as the people who have them. While some children with food allergies should simply avoid eating the allergen, others can react to touching contaminated surfaces, such as tabletops or utensils that are not properly cleaned.
Common allergens, or items that can cause allergic reactions, include peanuts, tree nuts, milk, eggs, soy, shellfish and wheat. A child who is allergic to these items may experience hives, itchiness, and swelling. In severe cases, they may go in to anaphylactic shock, which can be life-threatening.
Stay calm, act quickly.
As a parent, you may come across an unexpected allergic reaction, whether you’re chaperoning a field trip, assisting in the classroom. Schools go to great lengths to provide a safe environment for their students, so they will have valuable resources on hand to help guide you in handling these situations. Be sure to consult the school’s nurse or administrative team for policies and procedures that you should be aware of and ask about known sensitivities among the children under your supervision.
“It’s important to stay calm and use the medication most appropriate for the response,” Kaplan said. “For milder reactions such as hives or minor swelling, an over-the-counter antihistamine might be sufficient. But for severe swelling or anaphylactic shock, rapid administration of epinephrine is important. With severe reactions, an emergency room visit is likely required.”
Right now, there is no cure, but …
Kaplan said that the best and most common method of prevention is avoidance. Sadly, allergic reactions happen every day and some allergies can last a lifetime. But that may not be the case for long.
IU School of Medicine researchers in Kaplan’s group have made significant discoveries that could lead to new types of treatment or prevention of allergic diseases. In fact, a collaboration between Kaplan’s lab and scientists at Notre Dame University recently led to the development of a novel inhibitor that suppresses allergic reactions to peanut—one of the most common allergens among today’s children. They published their findings in March 2019.
Additional studies from the research group are identifying biomarkers that will help to assess risk in children. While some studies examine the cellular mechanisms that signal immune responses to allergens, others are uncovering the environmental factors that may facilitate allergen sensitivity—such as cooking oils or the use of baby wipes.
With the help of the Wells Center, IU School of Medicine and the Department of Pediatrics hope to improve the quality of life for sick children in Indiana and beyond.
To learn more about the atopic march, allergies and active related research, visit the Pulmonary Inflammation, Asthma and Allergic Diseases research page.