In a time when food allergies are rising among kids, there’s one sign parents should look for to determine whether their baby may be at risk: eczema.
“’Should I or shouldn’t I introduce foods with peanuts’ is one the most common questions new parents have,” said Adriana Andreae, MD, PhD, a pediatrician and allergist at University of Utah Health and Intermountain Primary Children’s Hospital.
“If there’s a family history of food allergies, or if parents suspect their baby has significant eczema, we’ll want to bring them in and do testing to be sure they’re safe before introducing these foods.”
Food allergies develop when a person inhales, touches or eats an allergen, or a food protein, and the immune system makes an antibody against that allergen, according to the National Institutes of Health. Future contact with that allergen can result in mild to severe reactions, like a rash or anaphylaxis.
Food allergies have risen significantly in the past four decades, as have other “allergic” diseases like eczema and asthma, as they share a common mechanism, Dr. Andreae said. There is no known explanation for this, but hypotheses include changes in our body’s need to fight diseases that are no longer encountered in many parts of the world, changes in the diversity of the proteins we consume in processed foods, and the gut’s changing microbiome due to environmental and nutritional factors.
There is research-based guidance on how to reduce kids’ risk of developing food allergies. The 2015 LEAP study by the National Institute of Allergy and Infectious Diseases found giving babies foods containing peanut in their first year of life drastically reduced their risk of developing a peanut allergy by age 5.
The study also suggested that sensitivities to peanuts actually can begin through skin contact instead of through eating.
That’s where eczema comes in.
Eczema is part of the allergic/atopic diseases category. Children with eczema may have a first contact with food allergens through the skin, such as coming in contact with peanut butter, or even household dust in homes that frequently consume peanut butter, Dr. Andreae said. That can lead the immune system to respond to that allergen as a danger when eaten.
“The way and route a that food allergen is presented to the immune system helps determine whether it is recognized by the body as a problem or danger, or if it leads to tolerance,” Dr. Andreae said.
Parents whose baby has significant eczema should discuss it with a provider at their well child checks, which are recommended several times in the first year of life. Pediatricians often can consult with the parents about next steps for safe food introduction. If needed, they can refer the family to an allergist for testing.
“If a child has no allergies, then we recommend introducing them to a diet rich in fruits and vegetables and whole grains in age-appropriate forms, having the child practice feeding themselves when they’re able to sit up, and participating in family meals,” Dr. Andreae said.
For more information, visit intermountainhealth.org.
About Intermountain Health
Headquartered in Utah with locations in six states and additional operations across the western U.S., Intermountain Health is a not-for-profit system of 34 hospitals, approximately 400 clinics, medical groups with some 4,600 employed physicians and advanced care providers, a health plans division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For up-to-date information and announcements, please see the Intermountain Health newsroom at https://intermountainhealthcare.org/news.
