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Can Children Outgrow Food Allergies?

About two children in every U.S. classroom have a food allergy leaving a large number of families affected by the condition.  Managing a food allergy takes constant effort and with the significant impact on daily activities, it can be overwhelming for many parents.  This may leave them asking when their child will outgrow his or her food allergy.

What Does “Outgrow” Actually Mean?

If someone has outgrown a food allergy, it means that person can now consistently eat the food that once caused an allergic reaction without having any symptoms.  Outgrowing a food allergy happens naturally and does not require a treatment to sustain the tolerance of the food – such as participation in a research study for a potential food allergy treatment.  Some treatments may allow a child to eat the food allergen but requires ongoing ingestion of the food or treatment to maintain this tolerance and this would not be considered a natural resolution of a food allergy.

Which Food Allergies are Commonly Outgrown?

About 85% of children allergic to milk, egg, soy, or wheat will outgrow their food allergy.  In contrast, only about 15-20% of those with peanut, tree nuts, fish or shellfish will be able to eat those foods later in life.  Some children who have a history of an allergic reaction accompanied by high levels of allergen-specific IgE at diagnosis, may be less likely to outgrow their allergy.  While it is impossible to know exactly which child or when the child will outgrow the allergy, some may be lucky enough to outgrow their allergy in the early years of life.  However, it can occur as late as the teenage years, so it is important for parents and older children not to get discouraged.

Monitoring a Food Allergy Over Time

An allergist will often monitor a child’s food allergy by following up with repeat tests at different time intervals.  Decreasing amounts of allergen-specific IgE may be suggestive that a child is outgrowing the food allergy.  The appropriate time to repeat testing is often determined by the age of the child, the food allergen, and other pertinent medical history. Milk, egg, soy, and wheat may be tested more frequently and peanut, tree nut, fish and shellfish tested less often. Test results can be used as a guide to determine when it might be safe to introduce an allergenic food into the diet. If the doctor suspects your child may have outgrown his/her food allergy, an oral food challenge in an allergist’s office will likely be recommended to determine if the food can be safely incorporated into the diet at home.

Steps to Introducing the Food Back into the Diet

Once your child’s doctor has determined a food “safe” and given the green light, reintroduction can begin. A parent may think reintroducing foods will be easy, however, many children have difficulty accepting foods they have never eaten or that have previously caused a reaction.  This may be due to fear of a repeat reaction or an oral aversion if they have gone a long period of time without eating the food.  Here are a few steps that may help the process of reintroducing foods:

  • Explain – Having a conversation with your child about what outgrowing a food allergy really means and explaining the process of how the doctor has deemed the food okay to put back into the diet may help ease your child’s fears. Asking your child’s doctor to explain may provide an additional feeling of safety for your child. In some cases, talking with a therapist may be helpful in working through these challenges.
  • Listen – Allow your child to express his/her emotions about putting the food back into the diet. Show empathy and ask questions to help you better understand the child’s challenges and concerns.
  • Go slow – Showing patience and having realistic expectations will make food reintroduction a more positive experience. Know and understand that small steps, such as licking or taking just one bite of the food, may be more effective for long term progress when incorporating the food back into the diet.
  • Be Positive – Show positive reinforcement when your child interacts with the food. Refrain from being negative, giving ultimatums or showing your frustration with the process.

Asking your doctor or a registered dietitian for a plan or ideas for how to introduce the food can be helpful.  Feeding therapy may be a necessary tool for some children who are unable to move forward on their own.

Eosinophilic Esophagitis (EoE)

Eosinophilic esophagitis (EoE) is defined as a chronic disease and is therefore considered to be a lifelong disorder.  However, patients living with EoE can usually achieve remission and resolution of symptoms with continued medication or dietary management.  Sometimes a combination of these two therapies is recommended particularly in patients who have not had success with symptom resolution with a singular therapy. Dietary management using an elimination diet is often considered more desirable for long term management due to the possible side effects and negative perceptions related to lifelong medication use.  Regardless of therapy choice, EoE can be effectively managed and patients can live a normal life by complying with their treatment choice, following up with their doctor and speaking up if concerns or questions arise.

Food Protein-Induced Enterocolitis Syndrome (FPIES)

While Food Protein-Induced Enterocolitis Syndrome (FPIES) typically appears in the first year of life and can be quite severe, it is not usually a lifelong condition.  Most children outgrow FPIES by 3 years of age but will vary from person to person and may even be different depending on which foods trigger a reaction in your child. Working with a registered dietitian to expand the diet, ensure adequate nutrition, and identify safe foods and textures while avoiding any foods that may trigger a reaction can be especially helpful in managing FPIES. Once your doctor thinks your child might have outgrown his/her FPIES, an oral food challenge will likely be recommended. It is important to continue avoidance of the foods that cause an FPIES reaction until your child’s doctor determines that he/she has outgrown FPIES and ingestion of the food(s) is deemed safe.

Help Until Your Child Outgrows His/Her Food Allergy

Food avoidance and elimination diets are common in IgE-mediated food allergies as well as Eosinophilic Esophagitis and Food Protein-Induced Enterocolitis Syndrome and may put children at increased nutrition risk.  Amino acid-based formulas provide complete nutrition without intact proteins and therefore ensure a very low risk of a reaction.  At 25% lower cost, EquaCare Jr. provides a more affordable hypoallergenic formula option. Learn more by visiting us online or calling 1-833-377-2773.

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