By: Daniel DiGiacomo, MD, MPH, FAAP
If your child lives with
asthma, you know about some things that can make symptoms worse. For example, air pollution, tobacco smoke, plant pollen or outdoor physical activity can trigger a flare up.
For some kids, food, drink or ingredients in medicine can set off asthma symptoms. Here's what to know if your child has a food allergy and asthma.
Are allergies and asthma linked?
A family history of any type of
allergy increases the risk that a child may develop
asthma. Having asthma can affect how your child reacts if they have a food allergy reaction. They may have more severe symptoms, and more symptoms to watch for, if their
asthma is not controlled.
If your child has asthma and a food allergy, it can be hard to know what is causing their symptoms. Like asthma, an allergic reaction can affect your child's ability to breathe. A severe allergic reaction can happen even if their asthma is
under control.
It's important to work with your child's doctor to make sure they have an
Allergy and Anaphylaxis Emergency Plan. An emergency dose of
epinephrine should always be available, including with the child care provider and at school.
Epinephrine: emergency treatment of allergic reactions to food
For anyone experiencing
anaphylaxis,
epinephrine should be given right away followed by a call to 911.
Can food additives trigger asthma or allergic reactions?
In addition to food allergies, some parents wonder whether ingredients added to foods—known as additives—might also play a role in asthma symptoms.
There are very few reports linking additives and asthma flare-ups. The evidence of this link is not strong. And it's important to keep in mind that other types of allergic reactions that are not related to asthma can occur with food additives.
When to consider food additives as a cause of allergy and/or asthma
Asthma or allergy symptoms that repeatedly occur after eating a food and an obvious cause has not been found
Symptoms when eating commercially prepared food, but the food is tolerated when made at home
Reactions to seemingly unrelated foods
These ingredients may be added to improve the nutritional value, flavor or color or as a preservative. Only a few additives are clearly known to cause allergic reactions or worsening asthma. Here are a few to look out for.
Do sulfites make asthma worse?
Sulfites can occur naturally or the ingredient may be added to some processed food and drinks. As a preservative, sulfites help keep food or medication fresh. Sulfites can also improve the color or taste of food.
Both natural and added sulfites have been linked to worsening asthma symptoms and are known to cause asthma flare-ups. The chance of a reaction depends on the type of food, level and form of sulfite. The Food and Drug Administration requires levels above 10 parts per million be labeled as containing sulfites on the product label.
There have been
reports of allergic reactions—mostly among people with severe uncontrolled asthma—associated with sulfites. Watch for sulfites in food and drinks such as:
Sulfites go by many different names and may be an ingredient in medicine. When reading labels, look for ingredients such as:
Sodium bisulfite
Potassium bisulfite
Sodium metabisulfite
Potassium metabisulfite
Sodium sulfite
If you think your child may be sensitive to sulfites, talk with your doctor or pharmacist.
Do salicylates aggravate asthma symptoms?
There are some individuals with asthma who have a severe sensitivity to acetyl salicylates (including aspirin). This may result in asthma attacks or other allergic symptoms.
Salicylates are found naturally in many foods, such as plant-based foods, spices and flavorings. There is little evidence that avoiding salicylate in your child's diet will improve their asthma symptoms. If you believe your child may be sensitive to salicylates, talk with your doctor.
Other additives suspected of making asthma or allergies worse
Various additives have been loosely linked to asthma and allergic reactions.
Those linked to asthma include ingredients such as red dyes, sodium benzoate and flavors such as spearmint, peppermint and menthol. They have not been definitively shown to worsen asthma other than in individual reports.
Other types of allergic reactions like
anaphylaxis can occur with food additives. For example, these ingredients may include carmine, annatto, guar gum, erythritol, gelatin, psyllium, lupine, carrageenan, pectin and most spices.
If your child has asthma, a nutritious diet goes a long way to ensure their asthma is controlled and to support healthy lungs. Your child's doctor can help you address your concerns and be there to provide nutrition and dietary advice.
Remember
It can be hard to sort through information about your child's health online. Before making big changes to your child's diet, talk with your child's doctor about your concerns. They can work with you to find out if any food, medicines or other products are causing problems for your child. They can also make sure your child has the best plan to avoid severe asthma attacks or allergic reactions.
More resources
About Dr. DiGiacomo
Daniel DiGiacomo, MD, MPH, FAAP, is a Pediatric Allergist/Immunologist at K. Hovnanian Children's Hospital at Jersey Shore University Medical Center. He completed his pediatrics residency at Children's National Medical Center and fellowship training at Massachusetts General Hospital in Boston. Dr. DiGiacomo, a member of the American Academy of Pediatrics (AAP) Sections on Allergy and Immunology and Epidemiology, Public Health and Evidence, has a clinical interest in infant food allergy. He enjoys spending time at the beach with his family during his time off, and is an avid New York sports fan.
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