ANDREA CANTY M.D.
MICHAEL KEATING M.D.
CHRIS VAILLANCOURT M.D.
PHONE 696-0587 dr.a.canty@nb.aibn.com
PHONE 696-6544 dr.m.keating@an.aibn.com
PHONE 696-6544dr.c.vaillancourt@nb.aibn.com
ASTHMA & ALLERGY
707 MILLIDGE AVE
SAINT JOHN, N.B. E2K 2N7
FOOD ALLERGIES
Food allergy is defined as a convincing history of immediate reactions following food
ingestion beginning within 2-4 hours of ingestion and usually lasting less than 8 to 12
hours with generally objectives symptoms such as hives, swelling and vomiting or
wheeziness. The exception is the case of Oral Allergy Syndrome when symptoms are
just in the mouth or throat.
There are eight common foods that cause approximately 90% of all allergic reactions to
foods. They are peanuts, tree nuts, eggs, cow’s milk, soybean, fish, wheat and shellfish
(shrimp, crab, lobster, scallops). There are at least 160 other foods that cause the other
10% of allergic reactions to food.
PREGNANCY
Based on present knowledge (September 2007) there is no special diet recommended for
the pregnant or lactating mother to conclusively reduce allergies in the infant.
INFANCY
High-risk infants with a well defined increased risk of developing allergic disease (at
least one parent or sibling with documented allergic disease) should be exclusively
breast-fed and avoid solids for 4-6 months. Most important is avoidance of tobacco
smoke during pregnancy and infancy.
PEANUTS
Studies show that a child has a 1-2% chance of having a peanut allergy if the parent is
allergic and 7% chance if a sibling has it. The majority of people who have peanut
allergies give a history of highest level of sensitivity as teenagers and young adults. It is
estimated that 10 Canadian die each year of an anaphylactic reaction to peanuts.
Fortunately, new research suggest that 1 in 5 people with peanut allergies may outgrow
this affliction. Children with peanut allergies should be retested on a regular basis every
year. As little as 1/1000 of peanut can trigger anaphylaxis but more commonly 1 or 2
peanuts are required. Foods that may contain peanuts, are cookies, crackers, chips, cereal
and baked goods as well as Asian foods that are cooked in unrefined peanut oil. Children
who outgrow their food allergies to milk, eggs, soy and wheat, will often outgrow their
peanut allergy as well. Some paediatricians are recommending no milk until 1 year, eggs
2 years and peanuts 3 years. But these recommendations are under review.
SEEDS
Sesame, Sunflower and Poppy seeds can cause severe reactions but affect fewer people.
Sesame seeds are more common in the diet, therefore more of the population is exposed
causing cases of this allergy to increase
TREE NUTS
The person is usually counselled to avoid all tree nuts: Almonds, Brazil Nuts, Cashew,
Hickory Nuts, Chestnuts, Filberts, Hazel Nuts, Macadamia Nuts, Pecans, Pine Nuts,
Pistachios and Walnuts. However, recent research suggests that cashews and pistachios
are related; walnuts pecans and hazelnuts are related, so avoidance of all tree nuts may
not be necessary.
COW’S MILK
This is the most common food allergy in children with a prevalence of 2.5%. Exclusive
breast-feeding is (avoidance of solid foods and cow’s milk for 4-6 months) is highly
recommended. Alternatively, soy formula may be tolerated but there is a high frequency
of concurrent soy allergy, so be prepared to switch. You may need to switch to
extensively hydrolyzed formula (Alimentum or Nutramigen) or, raely, amino acid
formula (EleCare or Neocate). Some research shows that by one year of age, 50% of
infants can tolerate cow’s milk. This increases to 75% by age 2 and 90% by age 3.
Unfortunately, adverse reactions to other foods and/or inhalants may develop in 35-50%
before puberty.
March 08