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Aug 21

Think your child has a food allergy or intolerance? Read this before changing their diet – ABC Life

When Jess's first daughter was a baby, it was clear something was wrong.

The little girl struggled to put on weight, she later started vomiting and her parents found blood in her nappies.

But it wasn't easy for 36-year-old Jess from Werribee to navigate the conflicting advice about the cause of those symptoms, despite working in the health system as a midwife herself.

Was it poor breastmilk supply? A cow's milk allergy related to formula?

Healthcare professionals including a maternal health nurse and a lactation consultant threw around different theories. But it wasn't until Jess was referred to the specialist allergy clinic at the Royal Children's Hospital Melbourne that real answers emerged.

It turned out an allergy to multiple foods including dairy, eggs, chicken and fish was to blame. But Jess doubts she would have got to the bottom of her daughter's allergy without rigorous testing by the right specialists.

"The world of allergies is incredibly confusing and there is a lot of misinformation and misdiagnosis," Jess says.

Michaela Lucas, a clinical professor at University of Western Australia and immunologist at Perth Children's Hospital, agrees that "immunology and allergies is a very difficult field to grasp".

She says many Australians incorrectly self-diagnose their children's conditions.

"There is an overrepresentation of allergy, meaning many people report an allergy or think they have an allergy, and on further assessment they don't," says Dr Lucas, who is also a director at the Australasian Society of Clinical Immunology and Allergy (ASCIA).

Misdiagnosis can be a result of scientifically unproved methods of testing such as cytotoxic food testing, kinesiology, Vega testing, electrodermal testing, pulse testing, reflexology and hair analysis, ASCIA warns.

Parents who rely on online parenting forums or 'Dr Google' to make a diagnosis also risk getting it wrong.

One study by YouGov and Liddells found that 22 per cent of Australians report self-diagnosing a food intolerance, sometimes by consulting Dr Google and more than one-third (35 per cent) of those people have never consulted a healthcare professional to diagnose or manage their symptoms.

The key to avoiding misdiagnosis is to seek a professional medical opinion, says Dr Lucas.

But which type?

If your child is showing signs of anaphylaxis (changes in the voice, wheezing, swelling of the tongue or throat, or loss of consciousness or floppiness in an infant), "that's an emergency, and treat that as an emergency by using an EpiPen if prescribed or calling triple-0," says Dr Modak.

But if it's not a medical emergency, your first step is your GP.

Dr Lucas says they can help you figure out whether you're dealing with an allergy an immune system reaction or an intolerance, which is an uncomfortable but unexplained reaction that doesn't have a clear immunological outcome.

Your GP may refer you to a specialist paediatrician.

Dr Modak says if your child shows signs of an immediate-type allergic reaction (i.e. within 15 minutes to two hours), you'll need a referral to a paediatric allergist, who will confirm your child's suspected diagnosis often using a skin prick test.

The allergist may also perform other tests, such as blood tests to measure immunoglobulin E (IgE) antibodies, which may help to confirm or exclude the cause of your allergy.

If you're nervous about the costs, Medicare bulk-billed allergy testing is available (for example, at public children's hospitals).

For help locating a specialist or learning more about allergy testing, see the ASCIA website or the Allergy and Anaphylaxis Australia website.

There are a number of different allergic conditions, ranging from mild to severe.

You might've heard of mums and kids restricting their diets to try to work out the source of an allergy. So should you try it?

The short answer is: not without medical supervision.

Depending on the symptoms, your specialist paediatrician or allergist may recommend a temporary food elimination diet.

And if you're breastfeeding and you have a baby with a suspected delayed allergic reaction to cow's milk, your GP might suggest you eliminate dairy and soy from your own diet for a couple of weeks. (In that case, you may then be referred to a paediatrician to further discuss that diagnosis, and to confirm when to reintroduce dairy, Dr Modak says.)

But experts warn against making these dietary changes without careful medical supervision.

"That can be very dangerous, particularly in children [who need nutrients to grow]," says Dr Lucas.

Keep in mind also that all babies should ideally be exposed to common allergy-causing foods in their first six to 12 months, as this may reduce the chance of developing food allergy.

This means restricting your child's diet without a doctor's say-so can actually do more harm than good.

A specialist, sometimes assisted by a dietitian, will guide your elimination diet and let you know which replacement foods to incorporate.

Having your child's allergy diagnosed and treated can be stressful and difficult, but there is hope: Most children outgrow their food allergies by five to 10 years of age.

For Jess's daughter, it's been long journey including a full elimination diet in consultation with a paediatric dietitian, followed by a restricted, dairy-free diet until three years of age but she's now four and eats a normal diet.

Childhood allergies are difficult to navigate, but Jess believes that persevering to get early and accurate medical help was the best thing she could've done for her daughter.

"So many mums feel like they are failing when in fact it's just inaccurate information," Jess says.

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Think your child has a food allergy or intolerance? Read this before changing their diet - ABC Life

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