Two years ago, Frances Malone handed her daughter Peyton a little triangle of a peanut butter and jelly sandwich at a daycare party. Within minutes, the two year old broke out in hives, stopped breathing and was rushed to the hospital in an ambulance.
“It was terrifying,” says the Richmond mother of two, who has no family history of allergies. “I kept thinking thank God the ambulance came so fast.”
With food allergies on the rise, parents and doctors are struggling to understand what causes them and how to prevent them. Research from the U.S. Centers for Disease Control and Prevention shows that food allergies in children increased 18 percent between 1997 and 2007. One in twelve kids has a food allergy, according to a 2018 Northwestern University study. That’s about two kids in every classroom, the study said.
“There is an epidemic in food allergies,” says Dr. Kari Nadeau, one of the authors of the Northwestern study. “On any given day, you could have an accidental ingestion that could lead to a fatal event. It’s a huge burden for the child, the family and all of society.”
The rate of milk and peanut allergies, for instance, is doubling every 10 years, says Nadeau. One of the most puzzling aspects of the surge in food allergies is that 75 percent of cases occur in children with no prior family diagnosis.
“We really don’t know what is causing the rise in food allergies,” says Dr. Tina Sindher, an allergist with Stanford Health Care. “But we know that many of them are severe enough that they will impact the child’s quality of life.”
Three months ago, Kelly Oseka Marquez, of Antioch, started feeding her baby, Colette, a little bit of peanut butter in her oatmeal. The first time, Colette had no reaction. The second time, she didn’t want to eat it. The third time changed everything. The six-month-old’s face swelled up. She started crying and scratching at her eyes while a bright red rash spread across her tiny body. Her big sister Annabelle, 3, has no allergies.
“I was totally clueless,” says Marquez, who called an advice nurse and gave the baby Benadryl. “It was scary at the time, but it’s even more scary once you realize you never know how severe a reaction will be. You realize you may have to save your child’s life someday.”
The problem is so widespread that some schools now have banned all food from their classrooms, not just common allergens such as nuts, milk, eggs, fish, shellfish, soy and wheat.
Malone says allergies have changed the family’s relationship to food. Peyton’s 9-year-old brother, Caden, is allergic to eggs, though he can usually eat baked goods made with eggs. But eggs are easier to avoid than nuts.
“The reason nuts are so hard is so many things contain traces of peanuts and tree nuts,” says Malone, 29. “So we have to read the labels on everything we feed her. And we never go anywhere without the Benadryl and the EpiPen.”
There are many theories about what is driving the increase in food allergies. One of the most popular is the “hygiene hypothesis,” which suggests that we have limited our children’s exposure to dirt too much. Others blame the overuse of antibiotics, too much processed food in our diet, which weakens the gut microbiome, and a lack of vitamin D, which undermines the immune system.
“It could be that we have cleaned the world too much,” says Sindher, “We don’t let our kids get out there and get dirty anymore.”
For the record, parents who “cleaned” their baby’s pacifier by sucking on it after it fell on the floor cut their infant’s risk of developing allergies, according to a Swiss study. And babies who grow up with a family dog are four to five times less likely to develop an allergy than those who don’t, doctors say.
“The dog goes in and out,” says Nadeau, director of the Sean N. Parker Center for Allergy and Asthma Research at Stanford, “like an ambassador from the world of dirt.”
Another key variable could be the increase in dry skin in children, experts say, which may be caused by the use of harsh chemical detergents. Children may then become exposed to food particles through broken patches of skin, and the body may misinterpret these foods as a threat.
“It’s likely not any one thing that causes food allergies but rather a lot of things piling on top of each other,” says Nadeau, adding that food allergies are not something many children will outgrow. About 4 percent of adults have a food allergy, she notes, and in many cases it’s a food they have previously tolerated.
The lack of certainty unsettles a lot of parents.
“It’s extremely overwhelming when your kid gets a food allergy diagnosis. Your world feels like it just got a hundred times smaller,” says Marquez, 37, “It’s scary not knowing if something you did may have caused the allergy.”
There are many different ways to cope, from total avoidance to trying to slowly increase tolerance over time through oral immunotherapy. Marquez plans to start Colette, who is now nine months old, on the therapy once she turns one.
Like many families grappling with food allergies, there is a lot of fear in the Marquez household. They worry about going out to eat, which they used to love to do.
Colette’s allergy is still confusing for Annabelle, who once rolled around on the floor with her sister while eating peanut butter puffs. That was before Marquez decided to forbid nuts in the house.
“It’s a frightening world you truly aren’t aware exists until you are unwittingly thrown into it,” says Marquez, “It’s tough to know what may lie ahead.”