Wesley Burks, MD

Wesley Burks, MD, chief of the Duke Division of Pediatric Allergy and Immunology, discusses food allergies in children and what parents should do if they suspect their child has an allergy.

What is the most common allergy?

The house dust mite is the most common allergy.

In the United States the most common food allergies are milk, egg, and peanut, with peanut allergy being the most serious.

Why do food allergies seem so prevalent today?

One theory that has developed about the increasing prevalence of allergies is called the hygiene hypothesis.

This theory states that exposure to allergens in the environment early in life reduces the risk of developing allergies by boosting immune system activity.

Conversely, early exposure to a relatively clean environment would sway the immune system toward allergy-promoting responses. Clean environments are simply part of our modern society, but a super clean environment is really not necessary.

It’s okay to get infections, to retrieve food from a relatively clean floor, and to let your children play in the dirt.

What course of action should parents take if they suspect a food allergy?

Atopic dermatitis, or skin rash, in the first six months of life might indicate the presence of a food allergy. Be aware of when symptoms develop, and talk with your pediatrician.

It is uncommon for a child to have a life-ending allergic reaction before adolescence. It is not clear why adolescents more commonly have these reactions, so that question is being studied. It could be hormonal factors, risk-taking behavior (that is, an adolescent eating a food that he knows he’s allergic to) or other factors we do not understand now.

How can you tell if your child has an allergy or if recurrent infections are the root of the problem?

If a child is having recurrent symptoms (more than eight times a year) of wheezing, runny nose, itchy watery eyes, or sneezing, parents should talk to their pediatrician.

If a fever is present with these symptoms, the likely diagnosis is infection, not an allergy.

Should parents avoid giving babies certain foods?

If there is a history of food allergies in the family, we recommend that a mother breastfeed and not introduce any solid foods to a baby until he or she is at least four months old.