Ravina Sewani

Practically, a child can be allergic towards any fruit but the most common are apples, pears, cherries, peaches, melons, plums, kiwis. Causes: Proteins present in the fruit that the child is allergic to. Symptoms: Symptoms usually show up minutes after a child has been exposed to a fruit that (s)he is allergic to. Sometimes, the symptoms might show up after a few hours.The symptoms include:<ul><li>Nasal congestion, runny nose, sneezing or dry cough</li><li>Eczema (a dry, itchy rash) or hives (reddish, swollen, itchy areas on the skin)</li><li>Redness of the skin around the mouth or eyes</li><li>Itchy mouth, ear canal or lip swelling, odd taste in the mouth</li><li>Nausea or vomiting, diarrhoea or stomach pain</li><li>Drop in blood pressure</li><li>Severe reactions include loss of consciousness, chest pain, turning pale, shortness of breath, trouble swallowing, or anaphylaxis</li></ul> Diagnosis:<ul><li>The first thing is to not self-diagnose. Always rely on a healthcare expert's diagnosis.</li><li>A healthcare expert will examine your child's symptoms, his/her health history, and conduct other tests if required, to confirm whether your child has an allergy towards particular foods or not.</li><li>The doctor might get a blood test or a skin prick test done for your child.</li></ul> Foods to avoid:<ul><li>Fresh fruit to which the child is allergic.</li><li>Fresh fruit juice.</li><li>Desserts or food dishes which contain the fruit to which your child is allergic.</li><li>Fruit flavoured packed foods.</li></ul> Treating allergies:<ul><li>The best way to prevent allergies of any sort in children is to avoid the source of the allergen.</li><li>In allergies, paediatricians usually prescribe antihistamine medicines for mild allergic reactions. Whereas for severe allergic reactions like anaphylaxis, your child’s paediatrician will prescribe an adrenaline auto-injector (AAI).</li></ul> Precautions:<ul><li>Develop a habit of reading the food labels for ingredients and allergy information.</li><li>Teach your child to mention about the allergy whenever (s)he goes to visit someone.</li><li>Inform your child’s school about your child’s allergy. You can also give the medicines prescribed by your child’s doctor to the school which they can use in case of sudden allergic reactions.</li><li>Be careful about the possibility of cross-contact; especially when visiting a restaurant.</li><li>Always keep the allergy medication handy for your child.</li></ul>

Not every child will have an allergy towards the same fruit. Every child's immune system reacts differently towards different fruits. The allergic reaction, however, is more or less the same towards any kind of fruit.

Fruit allergies

Cereal allergies are caused due to immune reactions against proteins present in cereals. Cereals are grains from the grass family like wheat, rice, oats, maize, barley, corn, and millet. Wheat allergy is the most common allergy among all. There are certain pseudo cereals like buckwheat, quinoa, chia seeds which belong to the non-grass family. Allergic reactions to these are very rare.Children who have eczema are at a greater risk of developing rice allergy.Children with an allergy to fruits like peach have more chances of developing allergic reactions against corn kernels.Gluten sensitive children are at a risk of developing allergic reactions to one or more cereals. Before ruling out other cereals on this basis, it is advisable to consult with your child’s paediatrician.Celiac disease is commonly misunderstood with cereal allergy because it shows similar symptoms like cereal allergy.Always keep the allergy medications handy; especially carry adrenaline auto injectors like EpiPen in case of history of severe allergic reactions or asthma. Gluten sensitivity and wheat allergy:<ul><li>Gluten sensitivity and wheat allergy are different. Gluten sensitivity results from a protein (gluten) present in wheat, rye, or barley. It is not life threatening like wheat allergy. This is called Non-Celiac Gluten Sensitivity (NCGS). It is diagnosed when the doctors are sure that the child neither has wheat allergy nor celiac disease.</li><li>Celiac disease is a serious form of gluten sensitivity and is a life-threatening autoimmune disease. Celiac disease causes inflammation of the small intestine due to adverse reaction to gluten. If this disease is not timely diagnosed, it can cause health issues due to malnutrition.</li><li>Wheat allergy, on the other hand, results from an immune response triggered due to any of the many proteins present in wheat. The allergic reactions to wheat range from mild to severe. Severe life-threatening allergic reactions are known as ‘anaphylaxis’ and require immediate medical attention. Anaphylaxis is a less common reaction of wheat allergy.</li></ul> Symptoms:<ul><li>Nasal congestion, runny nose, sneezing or dry cough</li><li>Eczema (a dry, itchy rash) or hives (reddish, swollen, itchy areas on the skin)</li><li>Redness of the skin around the mouth or eyes</li><li>Itchy mouth, ear canal or lip swelling, odd taste in the mouth</li><li>Nausea or vomiting, diarrhoea or stomach pain</li><li>Severe reactions include loss of consciousness, chest pain, turning pale, shortness of breath, trouble swallowing, or anaphylaxis.</li></ul> Diagnosis:<ul><li>Diagnosis of wheat allergy is difficult as few of its symptoms overlap with that of celiac disease and gluten sensitivity. Hence, it is of utmost importance that you get your child diagnosed by a healthcare expert.</li><li>For diagnosis, the paediatrician will evaluate your child's medical/family history, existing conditions like asthma, eczema and other food allergies; along with a skin prick test, blood test or Oral Food Challenge.</li></ul> Precautions and Treatments:<ul><li>Your child must avoid consuming all wheat based foods and products; but can still enjoy rye and barley products unlike in gluten sensitivity.</li><li>Develop a habit of reading the food labels for ingredients and allergy information.</li><li>Teach your child to mention about the allergy whenever he/she goes to visit someone.</li><li>Inform your child’s school about your child’s allergy to soy. You can also give the medicines prescribed by your doctor to the school which they can use in case of sudden allergic reactions.</li><li>Your child’s paediatrician might prescribe antihistamine medicines to fight against allergic reactions due to soy. Always give medications for allergy under proper guidance of the doctor.</li><li>Always keep the allergy medication handy for your child.</li></ul> Sources of wheat:<ul><li>Bread, pastas, cookies, baking mixes</li><li>Note that if your child is only allergic to wheat and is not gluten-sensitive, then you can give him/her other grains like rice, corn, quinoa, oats, rye, barley.</li><li>Also, buckwheat is not associated with wheat even though it sounds like a type of wheat so you can opt for that as well.</li></ul>

Among all the cereal allergies, the most common one is the allergy to wheat.

Cereal allergy

In an egg allergy, the body mistakes the egg proteins as a threat which triggers the immune system to produce an allergic reaction to those proteins. An allergic reaction to the proteins in egg white or yolk or both is possible.Studies have shown that 2 out of 100 children are allergic to egg but around 70% of them outgrow the allergy by the time they reach adulthood.Egg proteins are found in raw, boiled/parboiled, poached, baked, or powdered form of eggs.It is advisable to avoid egg-based foods as it is difficult to completely separate the white from the yolk. Traces of yolk might be present in a few commercially available 'egg-white products'.Children with egg allergy can be safely vaccinated for MMR and Flu vaccine.Eggs can be introduced into your child’s diet by a scientific approach called “egg ladder”. Egg Ladder is a specific scientific food chart designed for the easy reintroduction of eggs in the diet and to induce egg tolerance to combat egg allergy. Symptoms:<ul><li>Nasal congestion, runny nose, sneezing or dry cough</li><li>Eczema (a dry, itchy rash) or hives (reddish, swollen, itchy areas on the skin)</li><li>Redness of the skin around the mouth or eyes</li><li>Itchy mouth, ear canal or lip swelling, odd taste in the mouth</li><li>Nausea or vomiting, diarrhoea or stomach pain</li><li>Severe reactions include loss of consciousness, chest pain, turning pale, shortness of breath, trouble swallowing, or anaphylaxis.</li></ul> Diagnosis:<ul><li>The first thing is to not self-diagnose and assume your child to be allergic to eggs. Always rely on a healthcare expert's opinion before avoiding egg-based products.</li><li>A healthcare expert will examine your child's symptoms, his/her health history, and conduct other tests if required, to confirm whether your child has an egg allergy or not.</li><li>Egg allergy has very mild symptoms and is not known to cause severe reactions.</li></ul> Foods to avoid:<ul><li>In breastfed infants, the egg proteins from mother’s diet may transmit to the baby via breast milk and cause an egg allergy to develop an egg allergy.</li><li>Eggs from birds like quails, duck, geese, turkey as well if your child has an egg allergy need to be avoided.</li></ul> Other foods to avoid:<ul><li>Mayo or mayonnaise</li><li>Nougat</li><li>Marshmallows</li><li>Ice cream</li><li>Parents are usually also concerned about giving baked foods to children who have milk or egg allergies. Research indicates that 70%of children allergic to milk or egg can tolerate baked food as high temperature baking can destroy the allergens in milk and egg. Introduction of baked food is known to increase the tolerance to whole forms of milk/egg.</li><li>Always consult your child’s paediatrician to look for alternate sources of nutrition as avoiding milk and egg based foods may develop nutritional deficiency.</li></ul> Treating allergies:<ul><li>The best way to prevent allergies of any sort in children is to avoid the source of the allergen.</li><li>In allergies, paediatricians usually prescribe antihistamine medicines for mild allergic reactions. Whereas for severe allergic reactions like anaphylaxis, your child’s paediatrician will prescribe an adrenaline auto-injector (AAI).</li></ul> Precautions:<ul><li>Develop a habit of reading the food labels for ingredients and allergy information.</li><li>Teach your child to mention about the allergy whenever (s)he goes to visit someone.</li><li>Inform your child’s school about your child’s allergy. You can also give the medicines prescribed by your child’s doctor to the school which they can use in case of sudden allergic reactions.</li><li>Be careful about the possibility of cross-contact; especially when visiting a restaurant.</li><li>Always keep the allergy medication handy for your child.</li></ul> Egg allergy and vaccines:There are several contradictions revolving around developing egg allergies due to a few vaccines like the MMR vaccine, influenza vaccine and yellow fever vaccine. If your child is diagnosed with egg allergy, it is best to consult your child’s paediatrician and then get your child vaccinated.

Egg allergy is one of the most common allergies among all.

Egg Allergy

Wheat allergy is an allergic reaction to foods containing wheat. Allergic reactions can be caused by eating wheat and also, in some cases, by inhaling wheat flour. Wheat is found in many foods, including some you might not suspect, such as soy sauce, ice cream and hot dogs. Wheat allergy sometimes is confused with celiac disease, but these conditions differ. Wheat allergy occurs when your body produces antibodies to proteins found in wheat. In celiac disease, a specific protein in wheat — gluten — causes a different kind of abnormal immune system reaction. Symptoms of wheat allergy:<ul><li>Swelling, itching or irritation of the mouth or throat</li><li>Hives, itchy rash or swelling of the skin</li><li>Nasal congestion</li><li>Headache</li><li>Difficulty breathing</li><li>Cramps, nausea or vomiting</li><li>Diarrhoea</li><li>Anaphylaxis</li></ul> Causes:Exposure to a wheat protein triggers the body's immune system for an allergic reaction. Your child can develop an allergy to any of the four classes of wheat proteins — albumin, globulin, gliadin and gluten. Sources of wheat proteins:<ul><li>Breads and bread crumbs</li><li>Cakes, muffins and cookies</li><li>Breakfast cereals</li><li>Pasta</li><li>Semolina</li><li>Soy sauce</li><li>Meat products, such as hot dogs</li><li>Dairy products, such as ice cream</li><li>Natural flavourings</li><li>Modified food starch</li><li>Vegetable gum</li><li>Cosmetics</li></ul> Risk factors:<ul><li>Family history: The chances of your child being allergic to wheat are higher if there is someone in the family who is allergic to wheat.</li><li>Age: Wheat allergy is most common in babies and toddlers, who have immature immune and digestive systems.</li></ul> Difference between Wheat Allergy and Celiac Disease:Wheat allergy involves an allergic response to any of the four proteins in wheat. Whereas, celiac disease is caused by gluten (a type of wheat protein). Celiac disease does not cause an immune response but rather causes a problem with the absorption of food in the intestines. Diagnosis:Symptoms of wheat allergy and celiac disease are overlapping hence an allergist can determine whether an allergy is present or not. You will be required to give your child's medical history, family's medical history combined with a skin-prick or a blood test. Prevention:<ul><li>Develop a habit of reading the food labels for ingredients and allergy information.</li><li>Teach your child to mention about the allergy whenever (s)he goes to visit someone.</li><li>Inform your child’s school about your child’s allergy. You can also give the medicines prescribed by your child’s doctor to the school which they can use in case of sudden allergic reactions.</li><li>Be careful about the possibility of cross-contact; especially when visiting a restaurant.</li><li>Always keep the allergy medication handy for your child.</li></ul> Treatment:<ul><li>The best way to prevent allergies of any sort in children is to avoid the source of the allergen.</li><li>In allergies, paediatricians usually prescribe antihistamine medicines for mild allergic reactions. Whereas for severe allergic reactions like anaphylaxis, your child’s paediatrician will prescribe an adrenaline auto-injector (AAI).</li></ul>

Some children can develop allergic reactions towards wheat and need to be fed on a different cereal.

Wheat allergy

Allergy to soy is developed due to the trigger of immune response against the soy proteins which the body considers as threat.Allergic reactions to soy are usually mild and the anaphylactic reaction from soy is very rare.Studies also show that many children outgrow soy allergy in later life but it is better to stay careful. Symptoms:<ul><li>Nasal congestion, runny nose, sneezing or dry cough</li><li>Eczema (a dry, itchy rash) or hives (reddish, swollen, itchy areas on the skin)</li><li>Redness of the skin around the mouth or eyes</li><li>Itchy mouth, ear canal or lip swelling, odd taste in the mouth</li><li>Nausea or vomiting, diarrhoea or stomach pain</li><li>Severe reactions include loss of consciousness, chest pain, turning pale, shortness of breath, trouble swallowing, or anaphylaxis.</li></ul> Diagnosis:Get your child diagnosed by a doctor. The doctor might examine your child’s medical history as well your family history. The doctor might also suggest one of the tests - skin prick test, blood tests or an Oral Food Challenge to confirm whether your child has an allergy to soy or not. Precautions and treatments:<ul><li>Develop a habit of reading the food labels for ingredients and allergy information.</li><li>Teach your child to mention about the allergy whenever he/she goes to visit someone.</li><li>Inform your child’s school about your child’s allergy to soy. You can also give the medicines prescribed by your doctor to the school which they can use in case of sudden allergic reactions.</li><li>Be careful about the possibility of cross-contact; especially when visiting a restaurant.</li><li>Your child’s paediatrician might prescribe antihistamine medicines to fight against allergic reactions due to soy. Always give medications for allergy under proper guidance of the doctor.</li><li>Always keep the allergy medication handy for your child.</li></ul> Foods to avoid in case of soy allergy:<ul><li>Cold-pressed, expelled or extruded soy oil, Natto, Soy cheese, Soy milk, Soy yogurt, Soy sauce, Tofu</li><li>Some of the formula milk contains soy or soy derivatives so it is advisable to consult with your child’s paediatrician before deciding any formula milk for your child.</li><li>Some children can tolerate highly refined soy oil.</li><li>Soy is also a hidden ingredient is some of the pet foods and beauty products like soaps and moisturisers.</li></ul>

Soy, like peanut belongs to the legume family but a child who has a peanut allergy will not necessarily be allergic against soy and vice versa.

Soy allergy

Peanut allergy triggers an immune response towards the proteins present in peanuts. It is one of the most common food allergies.Peanuts grow underground and are different from tree nuts.Please note that having a peanut allergy does not mean being allergic towards all nuts.Peanut allergy is usually developed in early childhood but can develop later in life as well. Diagnosis:Never self-assume that your child has peanut allergy. Always get your child diagnosed by a healthcare expert. The doctor may recommend that your child undertake tests like skin prick test, blood test or food challenge. It is important that these tests are performed under medical supervision as these tests might trigger an allergic reaction. Who is at risk?<ul><li>Family history: Your child has a higher risk of developing peanut allergy if it runs in your family.</li><li>Existing allergy: Having one food allergy may sometimes lead to some other food allergy to develop.</li></ul> Symptoms of peanut allergy:<ul><li>Itching</li><li>Rashes</li><li>Vomiting</li><li>Diarrhoea</li><li>Swelling of the lips or tongue or face</li><li>Throat constriction</li><li>Difficulty in breathing</li><li>Peanut allergy may sometimes also cause a life-threatening reaction called anaphylaxis which constricts the airway passage and requires immediate medical attention.</li></ul> Myths about peanut allergy:1. Myth: Peanut allergy is more common than other food allergies in children.Fact: No, Peanut allergy is not 'the' most common food allergy. Egg and milk are more common food allergies. 2. Myth: Peanut allergy is only developed in childhood and then stays on for life.Fact: Even though it is common in childhood, peanut allergy can develop at any age. A small percentage of children tend to outgrow peanut allergy but in most cases, it is permanent. 3. Myth: The allergic reaction develops immediately and of same intensity every time.Fact: In most cases, the reactions begin within minutes but in some cases, the allergic reaction might take a few hours as well. Also, the intensity of the allergic reaction is also not the same every time. 4. Myth: I can diagnose my child’s food allergies myself.Fact: While you can gauge your child’s allergic symptoms, they should always be diagnosed by healthcare expert. Commercial home test kits for self-diagnosis are not recommended as they may not be of the required standards. 5. Myth: If a dish or a food product does not list peanut, then it is safe.Fact: No, you must clarify and always pay close attention to the ingredients in a food product or a dish which is served to your child. Teach your child to develop the same practice as well. 6. Myth: Peanut allergy can be cured permanently.Fact: Researches are going on but there are no permanent cures for peanut allergy as of now. 7. Myth: Consumption of trace amounts of peanut-based food won't cause any problem.Fact: No, even a trace amount of peanut-based food can cause a severe reaction. Prevention:<ul><li>Studies suggest that if infants are introduced to peanut-based food then the chances of developing the allergy later are less. But such steps should always be taken under proper guidance of your child’s paediatrician.</li><li>Introducing peanuts in your baby’s diet:</li><li>If your child has any other food allergy already, it is better to first consult your child’s paediatrician and then introduce peanuts under doctor’s guidance.</li><li>You can introduce peanuts in your baby’s diet when your child starts eating solid food. Introduce peanuts in the form of a puree and not as whole. Observe for 10 to 30 minutes after feeding for any allergic reactions. If you find something wrong, consult your child’s paediatrician soon.</li></ul> Steps to take after reaction against peanuts get triggered:<ul><li>If your child has mistakenly consumed a food containing peanuts, the immune reaction gets triggered a few minutes to an hour.</li><li>The immune reaction varies every time and varies from child to child.</li><li>These immune reactions range from mild (itching or rashes) to severe life-threatening ones (breathing trouble or 'Anaphylaxis').</li><li>When your child shows mild reaction: Give your child doctor recommended medicines and take him/her to the doctor once your child starts feeling better.</li><li>When the reaction is severe: Give the medications recommended for such a condition as soon as possible and seek medical attention immediately.</li><li>Always keeps medications of allergies handy for your child.</li></ul> Therapies or treatments commonly used to treat peanut allergies:<ul><li>Antihistamine medicines for mild allergic reactions</li><li>Use Adrenaline auto-injectors (AAI) for severe allergic reaction like anaphylaxis. It is an injector pen that releases a prescribed dosage of adrenaline into the blood.</li><li>Always keep AAI handy because only AAIs can be used in treating severe cases of allergy reaction. Learn how to properly use an AAI on your child. These injector pens are usually used on the outer mid-thigh muscle.</li></ul> Following few alternative therapies are being tried as a long-term cure:<ul><li>Skin patch: It is a small adhesive patch which can be used topically on skin. It releases peanut proteins in small amounts into the blood. These are used to protect against accidental cases of exposure or consumption of peanuts.</li><li>Oral Immunotherapy (OIT): In this therapy, peanut protein based foods are given in small amounts to children known to have peanut allergy. Gradually the amount of such foods is progressively increased to develop tolerance against peanut proteins. Note: Do not go for this therapy without consulting your child’s paediatrician as this method can have serious consequences.</li></ul> Outgrowing peanut allergy:<ul><li>It is very rare that children would outgrow their peanut allergies as peanut allergies tend to stay on for life.</li><li>Peanut and other nut allergies:</li><li>Peanuts are legumes so it is rare that children with peanut allergy would develop allergies to tree nuts (eg. walnuts, almonds).</li><li>Sometimes, children with peanut allergies might develop allergies to other legumes like lupin or sesame.</li></ul> Foods to avoid or things to take care of if the child has peanut allergy:<ul><li>Develop a habit of reading the food labels for ingredients and allergy information.</li><li>Teach your child to mention about the allergy whenever he/she goes to visit someone.</li><li>Be careful about the possibility of cross-contact; especially when visiting a restaurant.</li></ul> Check the labels/ingredients of:<ul><li>Ice creams, candy, nougat, pancakes, egg rolls, and salad dressing</li><li>Sauces such as pesto, gravy, chilli / hot sauce, and enchilada sauce</li><li>If there is equipment sharing between peanuts and other nuts, be careful about the same.</li><li>Food or drinks such as hot chocolate, cookies, pudding, pies or other baked foods</li><li>Vegetarian food labelled as meat substitutes</li><li>Pet food (cross-contact risk) or compost used as fertiliser may also contain peanut shells (cross-contact risk).</li></ul>

Peanut allergies tend to stay on for life so it is very important to stay conscious and aware all the time.

Peanut allergy

Milk allergy, also known as Cow Milk’s Protein Allergy (CMPA), is an immune response triggered against the proteins present in the milk, which the body perceives as a threat and mounts a reaction.Even though milk allergy is one of the top food allergies, your little one is less likely to develop a severe reaction. Symptoms:<ul><li>Nasal congestion, runny nose, sneezing or dry cough</li><li>Eczema (a dry, itchy rash) or hives (reddish, swollen, itchy areas on the skin)</li><li>Redness of the skin around the mouth or eyes</li><li>Itchy mouth, ear canal or lip swelling, odd taste in the mouth</li><li>Nausea or vomiting, diarrhoea or stomach pain</li><li>Severe reactions include loss of consciousness, chest pain, turning pale, shortness of breath, trouble swallowing, or anaphylaxis.</li></ul> Diagnosis:<ul><li>Always get your child diagnosed by a healthcare expert and never on your own. Never self-assume that your child has a peanut allergy. Commercial home test kits for self-diagnosis are not recommended as they may not be of the required standards.</li><li>Your child’s paediatrician may recommend that your child undertake tests like skin prick test, blood test or food/drug challenge. These tests must be performed under medical supervision as these tests might trigger an allergic reaction. Along with these tests, your child’s paediatrician will also examine your child's medical/family history, existing conditions like asthma and eczema.</li></ul> Cow Milk Protein Allergy can be present in two forms:Breast-fed children can develop CMPA before they turn 6 months and rarely after they are a year old. Most children either outgrow this allergy, and some learn to tolerate this. Children with eczema, asthma or hay fever have a higher likelihood of developing CMPA.&nbsp;Children develop CMPA due to one of these reasons&nbsp;– formula milk containing cow milk’s proteins, breastfeeding mother consuming cow milk, or a child consuming cow milk.&nbsp;Cow milk's allergy can be present in two forms:<ul><li>An 'immediate response' from minutes to hours and a 'delayed' type onset over hours to days. The “delayed” type is more common in children.</li><li>Fortunately, most children outgrow cow milk’s allergy in their early childhood.</li><li>Keep in mind that well-boiled or heated milk does not alter the structure of CMP or make it any less allergic.</li></ul> To alleviate CMPA, a breastfeeding mother should cut off products containing CMP from her diet until the child is weaned off from breastfeeding altogether. For formula milk, your child’s doctor may prescribe a hydrolysed formula that breaks the proteins. The majority of the children with CMPA can tolerate baked food due to different ingredients binding together. A doctor may advise you to introduce baked milk under medical supervision to improve your child's CMPA. If your child can tolerate it, a 'milk ladder' may then be recommended. A milk ladder is a structured approach to reintroduce milk protein products and is tailor-made for each child. Please make sure to inform your child's school, caregivers, or places frequently visited by your child's milk allergy and the possible alternatives in the diet. Milk allergy and lactose intolerance:<ul><li>Milk allergy is entirely different from milk intolerance.</li><li>Milk (lactose) intolerance triggers abdominal symptoms like diarrhoea, gas, or cramps due to the absence/deficiency of an enzyme called Lactase that helps digestion of milk sugar called 'Lactose'. Lactose intolerance can occur at any age but more commonly seen in babies and young children following infections, medications, or inflammatory bowel conditions.</li></ul> Alternative to cow’s milk:<ul><li>Consult your child’s paediatrician before selecting any alternative of milk for your child.</li><li>Milk from other mammals like sheep, goats, buffalo may also cause allergic reactions as they share similar proteins with cow's milk at varying levels.</li><li>Amino Acid-based Formulas (AAF) are recommended for children with a severe sensitivity to milk proteins.</li><li>It is not recommended to give other types of milk like rice milk, almond milk, soy milk to babies as it is not safe to use in children during the weaning period.</li><li>Formula based on soy proteins may be advised for infants over 6 months of age.</li></ul> Foods to avoid:<ul><li>If your child has CMPA, it is recommended to avoid milk proteins. As milk proteins may be found in the following food/food products, you must identify the variants.</li><li>Dairy products like yoghurt or curd, pudding, cheese, cottage cheese, sour cream, cream, custard, butter, ghee, whey, etc.</li><li>Particular food or drugs containing casein or its variants, lactose, lactulose, lactalbumin, lactoalbumin phosphate, lactoferrin, and cow's milk proteins.</li></ul> Other potential sources are:<ul><li>Chocolate, candies, nougat</li><li>Ice creams</li><li>Bakery products</li><li>Some medications/supplements</li><li>Artificial butter flavour</li></ul> Cow milk’s ladder:<ul><li>Milk Ladder is a guide to gradually introduce cow milk proteins in children who have a milk allergy. This is a reintroduction.</li><li>The first step of the ladder is to introduce baked products, progressing to less-treated milk products. It ends with a more allergenic form of cow's milk protein.</li><li>It is observed that few children can tolerate baked or well-heated milk.</li><li>The milk ladder may have eggs, soy or wheat. If your child is allergic to any other food, it is advisable to consult your child’s paediatrician for alternate options.</li></ul>

Milk allergy is one of the most common food allergies.

Milk Allergies in Babies

Nut allergy is usually caused by peanuts. Peanuts grow underground. Peanut allergy can sometimes trigger life-threatening reactions. The proteins found in nuts are considered dangerous by the body and in response the body triggers an immune reaction against those proteins. Peanut allergies generally stay on for life but in very rare cases, children may outgrow these allergies. Peanut allergies are severe hence even trace amounts of peanut could trigger an immune reaction posing a threat to your child.Nut allergies are also very rarely caused by tree nuts grown above ground. Common tree nuts are Almonds, Brazil nuts, Cashews, Hazelnuts, Macadamia nuts, Pecans, Pine nuts, Pistachio, Walnuts, etc. If your child has a nut allergy, it is advisable to consult your child’s paediatrician before giving him/her coconut based foods. This is because coconut belongs to tree nuts family. Symptoms:<ul><li>Nasal congestion, runny nose, sneezing or dry cough</li><li>Eczema (a dry, itchy rash) or hives (reddish, swollen, itchy areas on the skin)</li><li>Redness of the skin around the mouth or eyes</li><li>Itchy mouth, ear canal or lip swelling, odd taste in the mouth</li><li>Nausea or vomiting, diarrhoea or stomach pain</li><li>Severe reactions include loss of consciousness, chest pain, turning pale, shortness of breath, trouble swallowing, or anaphylaxis.</li></ul> Diagnosis:<ul><li>Always get the diagnosis done by an expert. The doctor may recommend that your child undertake tests like skin prick test, blood test or food challenge. It is important that these tests are performed under medical supervision as these tests might trigger an allergic reaction.</li><li>Your child may develop allergies if there is a history of allergies in your family.</li></ul> Precautions:<ul><li>Always keep a habit of reading the food labels for the ingredients.</li><li>It is advisable to avoid all kinds of nuts if your child has developed allergy to one of the nuts. This is because there are risks of cross-contact and even trace amount of the nut your child is allergic to can lead to severe allergic reactions. Consult your child’s paediatrician for the same.</li><li>Inform your child's school or caretakers of the nut allergy so that they have an emergency response kit or you can provide the emergency kit to the school.</li><li>Keep an anti-allergic medicine prescribed by your child’s paediatrician handy in case of mild triggers.</li></ul> Foods to avoid:<ul><li>Cross-contact is common in the case of nut allergy so always be careful of the foods your child consumes.</li><li>Be careful of the following foods as nuts could be a hidden ingredient in them:</li><li>Cereals, breakfast bars, snacks like crackers, cookies, cakes, pastries, energy or protein bars, pancakes, egg rolls</li><li>Beverages like flavoured hot chocolate, flavoured coffee</li><li>Desserts like ice creams, frozen yogurts, chocolates, candy, fudge</li><li>Cheese, butter or oil from tree nuts or other nuts</li><li>Even personal hygiene products like shampoos, lotions, perfumes, and soaps may contain extracts from nuts</li><li>Pet food, bird seeds, compost used as fertiliser may contain peanut shells</li></ul>

Nut allergies can be of two types: tree nut allergies or underground nut allergies.

Nut allergy

Common spices allergies are of mustard, garlic, and coriander. Out of these, allergic reactions to mustard are the most common.Common seed allergies are of sesame, poppy and sunflower seeds.Allergy to mustard causes reactions in skin, lungs, and digestive tracts and affects sinuses as well.In the case of seeds and spices, there are two possibilities – true allergic reaction and non-allergic response. Hence it becomes important to distinguish between the two. True allergy is caused by an immune response to the proteins present in the spices or seeds and can be life-threatening.Non-allergic responses are rashes, teary eyes, runny nose, burning sensation in the mouth, and coughing after inhalation. This is usually self-resolving. Symptoms:<ul><li>Nasal congestion, runny nose, sneezing or dry cough</li><li>Eczema (a dry, itchy rash) or hives (reddish, swollen, itchy areas on the skin)</li><li>Redness of the skin around the mouth or eyes</li><li>Itchy mouth, ear canal or lip swelling, odd taste in the mouth</li><li>Nausea or vomiting, diarrhoea or stomach pain</li><li>Severe reactions include loss of consciousness, chest pain, turning pale, shortness of breath, trouble swallowing, or anaphylaxis.</li></ul> Diagnosis:Get your child diagnosed by a healthcare expert. For diagnosis, the paediatrician will evaluate your child's medical/family history, existing conditions like asthma, eczema and other food allergies; along with a skin prick test, blood test or Oral Food Challenge. Precautions and treatments:<ul><li>Your healthcare expert may prescribe adrenaline auto-injector for children with a history of anaphylaxis. The paediatrician might also prescribe just medicines if the allergic reactions of your child are mild.</li><li>Avoid foods containing the seeds or spices to which your child is allergic.</li><li>Keep a habit of reading the food labels for ingredients.</li><li>Inform your child’s school about your child’s allergy problem.</li><li>Mustard may be used as a whole, in powdered/paste form or as a sauce in sandwiches and sesame may be used as whole seeds, as oil, or in cosmetics, and pharmaceutical products. Hence, be careful about these products.</li></ul>

Read the article to know what to look out for in case your child has seed allergy.

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