What should parents “know and know” when caring for children with food allergies?

　　Xinhua News Agency, Beijing, August 16 - Title: care of children with food allergy, parents "should be aware of," What?

　　Xinhua News Agency reporter Tian Xiaohang

　　It’s okay to eat cakes, but custards are whipped up; as soon as they drink milk, they vomit and have diarrhea... The three meals a day for children with food allergies make parents feel anxious.

　　Will food allergies accompany children for life? What tests are needed to confirm the diagnosis? If allergenic food cannot be eaten, how to ensure nutrition? At the 14th Concord International Summit Forum on Allergic Diseases held recently, a number of allergy specialists and pediatric experts explained to parents how to take care of children with food allergies.

High hair, "trouble", but not "stable"

　　The incidence of food allergies is increasing year by year in the world, especially in the younger population. According to Sha Li, chief physician of the Allergy Department of Children's Hospital of the Capital Institute of Pediatrics, about 8% of children in Western countries are affected by food allergies. A single-center cross-sectional study in my country shows that the prevalence of food allergies in children has risen to 7.7%.

　　Food allergies are "very troublesome", and can cause skin, gastrointestinal, respiratory symptoms and even life-threatening symptoms of suffocation and shock, which seriously affect the quality of life of children. Most food allergies in childhood are related to eight types of food, including milk, eggs, fish, soybeans, peanuts, wheat, crustaceans, and nuts.

　　According to Wen Liping, deputy chief physician of the Allergy Department of Peking Union Medical College Hospital, children's food allergies include IgE-mediated, non-IgE-mediated, and mixed types. Among them, IgE-mediated food allergy is an acute type. Family genetic history, skin barrier disorder, cesarean section, short breastfeeding time, excessive cleansing of the environment, and early use of antibiotics are all risk factors leading to IgE-mediated food allergy.

　　However, parents do not need to be too anxious. “Children’s food allergies are not a'minified version' of adults, but are always changing.” Wen Liping said, children’s food allergens are mainly eggs, milk, wheat, and peanuts, and most of them can be gradually tolerated with age. This is also the main reason why the prevalence of food allergy in adults is lower than that in children.

　　Experts also suggest that food intolerance does not involve an immune response and is not a food allergy. Parents often mistake the symptoms of food intolerance as food allergies, which only increases worry. Whether it is food allergies or what kind of food allergies need to be diagnosed in the hospital.

There are not too many "precision" detections, but prevention at all

　　The symptoms of food allergies look no different from other allergic diseases, so how can they be diagnosed and how should they be treated?

　　"Some parents require the hospital to do as many tests as possible for their children. This is a misunderstanding." Wen Liping said that the key to food allergy testing is accuracy and not too many, and it must be consistent with the clinical history. Some unproven tests, such as allergen-specific IgG detection, bioresonance/bioelectric detection, cytotoxicity test, etc., not only cannot be used for the evaluation of food allergies, but also interfere with the diagnosis and aggravate parents' anxiety.

　　According to experts, the correct detection method for food allergy is skin prick test and serum-specific IgE detection. However, these two tests are not perfect, and there is a problem of cross-allergic reactions. For example, someone who eats shrimp and crab is not allergic, but because of dust mite allergy, his shrimp and crab skin test will be positive.

　　How to diagnose accurately? Wen Liping said, first check for suspicious foods based on medical history, and conduct prick tests on fresh foods if necessary. When clinical history collection and auxiliary examinations are insufficient for diagnosis, oral provocation test is required. If the diagnosis is still not possible, a double-blind food challenge test is necessary. However, this "gold standard" for the diagnosis of food allergy also has high risks. It must be carried out under close supervision under the premise of strict management, standardized procedures, and equipment and personnel meeting the requirements.

　　Unfortunately, experts said that although the latest food desensitization treatments have seen some effects, they have not been widely used in clinical practice. Food allergies cannot be cured at present and are still being prevented.

Patient education is crucial, but it’s not just patients who are “taught”

　　The 5-year-old boy Ni had a serious milk allergy since he was a child. He suffered anaphylactic shock after going to a restaurant and drinking a small bowl of fish soup and was admitted to the ICU. Although the parents had told the restaurant before the meal that their children were allergic to milk, the restaurant did not realize that a small amount of "three-flower evaporated milk" added to the fish soup would become the "prime culprit" in inducing children's allergies.

　　"Patient education is the top priority to prevent food allergies." Wen Liping said that food allergy is not only a problem that parents or doctors need to understand, but also a problem that needs to be mobilized and paid attention to by the whole people.

　　She said that it is necessary to educate children to "share toys but not food"; schools and kindergartens should regularly verify children's allergens with parents and prepare first aid medicine. It is necessary to educate adolescent patients and their families to read food labels, clarify whether it contains allergenic ingredients, and pay attention to cross-reactions; understand the precautions for food cooking, and clarify how foods processed will not cause allergies; reduce eating out; learn to use epinephrine pen.

　　How to ensure the nutrition of children with allergies if they cannot eat certain foods? Hu Yan, deputy head of the Child Health Care Group of the Pediatrics Branch of the Chinese Medical Association, said that strict food avoidance and symptomatic treatment are usually necessary to relieve symptoms after diagnosis. After that, for foods that provide nutrients necessary for growth and development, it is necessary to look for alternatives, such as choosing hypoallergenic formulas for infants and young children with milk protein allergies. As infants grow older, add complementary foods reasonably, and do not excessively limit the intake of complementary foods; except for foods that have clearly contained allergens, the introduction time of other complementary foods is the same as that of normal babies. A reasonable combination of dietary nutrition, supplementation of nutrients and growth monitoring when necessary.

　　Hu Yan, for example, said that because a variety of food proteins can be passed on to infants and young children through breast milk, mothers should avoid certain foods for infants with food allergies who are breastfed from 0 to 6 months of age and do not blindly stop breast milk. If the baby is diagnosed with a milk protein allergy, the mother must avoid milk and its products and pay attention to calcium supplementation. For infants with milk protein allergies from 0 to 6 months of age who have mild to moderate symptoms, deep hydrolysis formula is preferred for feeding; severe, multiple food allergies or severe gastrointestinal symptoms food allergies, The amino acid formula should be selected for feeding.