Food allergy is a relatively new terminology in Pakistan which is still not understood fully by many. Parents with a food-allergic child may be struggling daily and often without any help or support group. On the other hand, the child can also feel isolated at school and in other social settings.
To make matters worse, family and friends often provide a barrage of unsolicited, unnecessary, and sometimes downright incorrect advice such as:
“Kuch nahi hota, tumhara wehem hai ke allergy hay”.
Their advice can sometimes even be dangerous and life-threatening such as,
“Thora thora nuts waghera khilatay raho, he will outgrow it this way.”
As a parent of a child who has food allergies, I request other parents to be kind and considerate even if they don’t understand the problem. In fact, I urge them to ask genuine questions and be open to facts in order to understand what food allergies and intolerances really are. Also, friends, family and relatives need to respect the parents’ judgment on what is best for their child.
Is it a food allergy or intolerance?
A food allergy is a rapid and potentially serious response by one’s immune system to an allergen, that is, the food triggering the allergic response. It can trigger classic allergy symptoms such as a rash, wheezing and itching while more serious cases may cause swelling of the tongue and constriction of the airways (anaphylaxis).
Children can be allergic to milk, soya, eggs, peanuts, tree nuts, seafood, food colours, food additives and preservatives, certain cooking oils, certain vegetables and fruits; and so forth.
Food intolerances are more common than food allergies. The symptoms of food intolerance tend to appear slowly, often many hours after eating the problem food. Typical symptoms can include bloating, stomach cramps and even vomiting. It is possible to be intolerant to several different foods which can make it more difficult to identify which food(s) is/are causing the problem.
Most importantly, food intolerances are never life-threatening but they can present the same or similar symptoms as other digestive disorders such as inflammatory bowel disease, gastrointestinal obstructions or irritable bowel syndrome (IBS).
One of the most commonly found food intolerance is lactose intolerance, also known as dairy intolerance, which occurs when your body can’t digest lactose, present in milk and dairy products such as yoghurts and soft cheeses. The main symptoms of lactose intolerance are diarrhoea and stomach pain. In most cases, a general physician can diagnose lactose intolerance by looking at the patient’s symptoms and medical history.
Diagnosing food allergies and intolerances in Pakistan
According to a research, around one or two people out of every 100 in the UK have a food allergy but food intolerance is more common. Similarly, while food intolerances are likely to be more common than allergies in Pakistan, unfortunately, people here lack understanding of these conditions. And many people choose to deny it even when they are diagnosed with a particular allergy/intolerance.
It seems that they’d rather live with a discomforting, if not painful, condition rather than seek help for it!
In case of a food allergy, symptoms may appear within seconds or minutes of eating the food or there may be a delayed response up to 24 hours after consuming the allergen. While food allergies can be easily diagnosed through medical tests, the National Institute of Health in Islamabad is the only institute that offers relatively extensive testing for allergies in Pakistan.
In extreme cases, food allergies can be life-threatening and cause an anaphylactic reaction; even a tiny trace of the food can cause a reaction. Signs and symptoms include swelling of the lip, eyelid, cheek, ear; rash behind ears, on face, neck or whole body; increased heart rate (the heart races in severe allergies), difficulty in breathing, long sighs during sleep, urticaria (itching), redness and itching in the conjunctiva (eyes) and so forth.
Management of food allergy and intolerance
- Sometimes it is not easy to identify which food is causing the problem and the only reliable way of identifying a food intolerance is through an exclusion diet, where the patient eliminates certain foods from his/her diet one at a time to see if there’s any change. If a particular food is identified as a trigger, they will have to stop consuming it for a while and perhaps, re-introduce it at a later stage since food intolerances can go away with time. If symptoms re-appear after re-introduction, the patient will just have to give up the food for life.In the case of a food allergy, the patient will simply have to avoid the food they are allergic to. At times, patients have been known to consume the cooked form of certain foods without any problem while the raw form causes reactions, for example, in case of certain fruits and vegetables.
- While avoiding whole foods like dairy, eggs, wheat and so forth is easier, it is also important to remember that these foods can be used in preparing other foods as well for example, cakes and cookies.
If you have a food allergy/intolerance, ALWAYS read food labels carefully and learn where your problem food may be used as an ingredient in other foods.
- Anaphylaxis is an emergency condition that needs professional medical attention right away. Epinephrine auto injector is a life-saving injection and parents of all food-allergic children must keep it at hand. Unfortunately, this auto injector is not available in Pakistan but one can get it from UAE, Canada, US or UK.
- After lifesaving measures and epinephrine are given, the child may receive antihistamines, such as diphenhydramine and corticosteroids, such as prednisone, to further reduce symptoms.
- It is essential for the school to be taken on board when dealing with an allergic child. The teachers should be well informed of your child’s health issues and required measures for his/her safety. These may include not allowing food to be shared from the child’s lunch box in order to avoid introducing an allergen from another child’s hands; and not allowing the child to eat anything except the snack sent from the home.
Ideally, children with known food allergies should wear a medical ID tag, wrist band and/or badge to keep those around him/her aware. These are commercially available abroad but not in Pakistan.
It is normal and understandable for a child with allergies/intolerances to feel isolated or excluded in social settings as he/she may not be able to enjoy the food, cakes and candies that other kids are enjoying. It is important to stay strong for your child and you can always give extra (non-allergen) treats to him/her to take to such events!