10 of your allergy questions answered - November 2023

I get a lot of DMs through various social media platforms and thought I would share some of the questions I have been asked and their answers.

1 - What are the different classes of allergy?

There are 4 different classes of allergy, these can help to define the cause and symptoms of an allergy.

- 1 - Class I are classic IgE mediated reactions. These allergies cover most of what we think of on the topic, including asthma, allergic asthma, food allergy, rhinitis, hayfever and dermatitis.

- 2 - Class II cytotoxic (poisonous to cells) reactions mediated by IgG or IgM antibodies. This includes hemolytic anemias, drug toxicity and normal infections.

- 3 - Class III are mediated by immune complexes. You can read more about these on the Complement Activation-Related Pseudo-Allergy page.

- 4 - Class IV are delayed reaction mediated by a cellular response. These are usually contact allergies and allergies to medications.

These are not to be confused with allergy grades, which are usually linked to the severity of reaction. You can read more about those in a previous allergy questions post.

2 - Can I eat my baby's allergens if I am breastfeeding?

For parents whose children have no family history of allergies, it’s beneficial to consume a diverse array of foods while breastfeeding. This practice can expose infants to potential food allergens in a safe manner, without triggering allergic reactions. The rise in food allergies may be linked to several factors, including the lack of early exposure to various foods.

Families with a history of food allergies should proceed with caution, but still, eating a wide range of foods in moderation can offer a protective effect.

Previously the prevailing advice was that food allergens couldn’t be transferred through breast milk. However, current understanding suggests otherwise. Considering that substances like drugs and alcohol can affect the baby through breast milk, it’s reasonable to conclude that food allergens might also be transmitted in this way.

This is definitely a topic to discuss with your doctor or health visitor and always ensure that if you are cutting food from your diet that you are getting enough iron and calcium in your diet from other sources.

3 - How do I wean a baby with allergies?

It’s important not to postpone introducing solid foods to a baby due to concerns about food allergies. Early exposure to common allergens can actually decrease the likelihood of developing allergies.

Ensure that your child avoids any known allergens, but also provide them with a diverse diet. Maintaining a food diary could be helpful to track any delayed allergic responses.

Introducing new foods individually can assist in pinpointing which ones may be problematic.

Excellent resources for weaning are Anaphylaxis Campaign and BSACI.

Consulting with your doctor is crucial for guidance and support regarding your baby’s diet.

4 - How do I wean a baby with food intolerances?

When it comes to weaning a baby with food intolerances, the approach is very similar to that of food allergies. The key distinction is that food intolerances are often temporary and can be outgrown, especially in young babies whose immune systems are still developing.

As babies mature, they may become more tolerant of foods that previously caused them discomfort. This is particularly true for egg and milk intolerances, which are commonly outgrown.

With your doctor’s guidance, it’s advisable to keep track of the foods your baby is intolerant to and periodically retest them as your child grows. This can help determine if the intolerance persists or if it has been outgrown, allowing for a broader diet over time.

5 - Are vegan foods suitable for people with dairy and egg allergies?

Vegan and allergen free are two different claims. There is a lot of EU legislation surrounding allergen labelling (see the next question below), but there is no legal definition of the term vegan.

The Food and Drink Federation have some good comparison guidance, but essentially vegan food is not suitable for allergy sufferers unless it makes additional "free-from" claims.

6 - Where can I find information on allergy laws in the EU?

In the UK you can find out more information on EU allergen labelling laws from the Food Standards Agency. This is especially useful for businesses that provide food.

You can find the specific EU legislation from 2011, Regulation (EU) No 1169/2011 of the European Parliament and of the Council on the European Union Website.

The Food Standards Agency also has a section of the website which gives information on how to report a "food crime", like poor hygiene or labelling. Businesses that provide food can sometimes have poor hygiene or incorrect allergen labelling and this can be reported through either the local authority or Trading Standards.

7 - Can you get allergies after receiving an organ donation?

This is a rare occurrence, but very well documented. When an organ from a donor who has allergies is transplanted into a recipient without allergies, the recipient’s immune system on rare occasion may adopt the donor’s allergic responses. This is thought to be related to the transfer of immune cells from the donor that are specific to the allergen.

The possible reason behind this is that hematopoietic (stem cells which are components of blood) cells may also be transferred with solid organ transplantation.

Asthma and allergic rhinitis (hayfever) have also been recorded on rare occasion after organ donation from a donor with these conditions.

8 - How did I develop allergies after an illness?

Allergies can sometimes develop after illness. It’s believed that this happens because the immune system, after fighting off bacteria or viruses, becomes hyperactive and mistakenly targets common food proteins. This phenomenon has been observed in pregnant individuals and those with immune disorders as well.

Such allergies related to illness may subside once full recovery from the illness is achieved or may gradually improve over time.

9 - What is the significance of knowing the specific allergen you are allergic to?

Multiple allergies are becoming more common and this often leads people to impose a strict restrictive diet on themselves. This can result in a poor diet lacking in essential nutrients and frustration over a lack of eating options. Knowing your specific allergen gives you more information on which foods are the most likely to be causing your reactions can bring more options back into your diet.

This is why food diaries continue to be an important tool in diagnosis of your allergies – noting the times reactions took place and what medications were taken are a necessary starting point for a proper diagnosis.

There is more information on food diaries HERE.

10 - In the kitchen can I deal with allergens like I would unseen bacteria and viruses?

Absolutely not! A very clean kitchen can still lead to severe allergic reactions if additional precautions are not taken.

Bacteria and viruses are easily killed with a variety of cleaning solutions, heating, cooking or freezing. Once dead they are no longer able to cause infection or harm.

Allergens on the other hand are often hardy structural proteins which will not be destroyed by a chemical spray, heat or freezing, they need to be physically removed by scrubbing or wiping and this is usually not an option if food is incorrectly handled and cross-contaminated.

Additional things to consider if you are catering for people with allergies are

Food Storage - physical contact with another food
Cooking Food - cooking food in the same fryer
Shared Food Prep - preparing food in the same area
Lack of hand washing - preparing allergy food after touching other foods

All of these scenarios can cause cross-contamination and the possibility of an allergic reaction, especially those with severe anaphylaxis.

If you enjoyed reading these allergy questions answered you can read the previous allergy questions page HERE.

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