Food allergies are quite common in Hong Kong. About five percent of infants suffer from food allergies. Hong Kong children with food allergies typically exhibit symptoms before the age of two, often when they try new foods. Common allergenic foods are milk, eggs, peanuts, and seafood. Some seafood allergies are discovered at an older age, possibly when the person is a teenager.
If you notice a child having any serious allergic reactions, like hives, swelling in the face or mouth, or vomiting right after eating, it is best to seek medical help immediately. If a child’s eczema repeatedly flares up and is not controlled with medication, I also advise seeing a doctor. Additionally, if there are signs of bronchial sensitivity related to diet, acid reflux, or chronic gastrointestinal discomfort, it is crucial to consult a doctor.
Q2. What kind of allergy test is most suitable for children?
Depending on the child’s various symptoms, we can provide different tests. We may offer skin prick tests or more comprehensive blood tests. We may also send the patient’s blood samples to the laboratory to arrange special combined tests, such as the Basophil Activation Test. In certain cases, the doctor may arrange for the patient to directly try the allergenic food in food challenge tests.
Q3. Are the impacts of food allergies limited to dietary choices?
In the most severe cases of food allergies, people can be allergic to more than five different categories of food, including seafood, nuts, and eggs. When allergies involve such a variety of foods, it becomes more than just a matter of food selection. It can significantly disrupt family life, affecting daily routines and activities. Caregivers often experience anxiety about allergies, like peanut allergies, which some parents consider as unpredictable threats that could strike at any time. This worry is particularly heightened during activities like travelling and dining out. It is important to discuss these concerns with a doctor, who can offer assistance with managing daily life and making necessary arrangements.
Q4. What are the new treatment methods for food allergies?
There are many advanced methods to help or guide patients to overcome food allergies early. Through the food ladder approach, doctors and dietitians work together to help children with food allergies gradually consume allergenic foods. We know that foods at different temperatures or using different cooking methods can have varying levels of allergenic strengths and chances of triggering an allergic reaction. Therefore, we can arrange a dietary plan for children, making changes every three or six months, and incorporate various food challenge tests. For example, with eggs, the process may start with incorporating can start from baking, then move to boiling, the process may start w allowing children to gradually be able to eat eggs.
Whether it is peanuts, eggs, milk, or others, desensitisation can be achievable. We are also attempting the food ladder method with fish allergies. When the patient can tolerate it, we cautiously introduce the food and gradually increase the amount. After reaching a certain level, the patient might overcome the allergy.
As for Oral Immunotherapy (OIT), it requires patients to precisely follow the entire treatment regimen because they are at a higher risk of reactions. OIT is a formal desensitisation programme that may take some time, especially in the first six months. During this period, doctors will carefully measure the amount and determin the cooking methods of the food that patients can consume. Through frequent consultations, patients will be able to consume controlled quantities of highly allergenic foods.
Q5. My child is only one year old. Is it safe to undergo food desensitisation?
The food desensitisation process inevitably carries some risks. Currently, if the patient is older, doctors may prescribe Omalizumab to prevent related allergic or anaphylactic reactions. In recent years, this injection has been approved for use in children as young as one year old. Therefore, during the process, the amount of allergenic foods can be gradually increased, and this is also a recognised desensitisation treatment.
Q6. My first child has food allergies, and I am expecting a second child. How can I prevent food allergies in my second child?
Parents should not worry too much. Although the child has a higher chance of developing food allergies, one should relax and nurture the foetus during pregnancy. In general, expectant mothers do not need to follow a special diet and can eat normally. After the baby is born, it is advisable to see a doctor as early as possible. Your doctor will provide guidance based on your family’s allergy history and suggest some preventive measures. For instance, early intervention and diet monitoring can help reduce the risk of allergies. Studies show that introducing semi-solid and solid foods early may have a preventive effect on children with a family history of allergies. Therefore, the first introduction of solid foods could be done as early as four months, rather than the usual six months.
For families with a history of severe allergies, we may recommend introducing highly allergenic foods to young children earlier. This approach is quite different from the past. Previously, it was commonly advised to avoid such foods and delay their introduction. Nowadays, it is recommended to introduce highly allergenic foods early when the child’s immune system is not fully developed and there is a chance to build better tolerance. Even highly allergenic foods like peanuts can be given. If parents have these concerns, they can consult a doctor to find the most suitable way to address their child’s food allergy issues.
Q7. Do food allergies persist even after growing up?
This depends on the type of food allergy. Allergies to peanuts, fish, and seafood may persist into adulthood. However, some patients with allergies to milk, eggs, and even peanuts in certain cases may experience improvement as they grow up. With advances in medical research, both diagnosis and treatment methods have become much more advanced. We can help many families, allowing children with food allergies to eat a broader range of foods. Therefore, we hope parents will understand the importance of early diagnosis and treatment for their children, increasing the chances of achieving food desensitisation.
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