Taking the fear out of food for kids with allergies

Having an allergic reaction to food can be scary for anyone but witnessing your young child have one can be downright terrifying. Tina Hoang will never forget when her daughter, Layla, had her first severe reaction at only eight months old. They were on a flight home from their first family vacation when a morsel from Tina’s meal landed on Layla’s face. Layla’s cheek became extremely inflamed and she went into distress. The airline crew considered an emergency landing, but an on-call doctor provided crucial guidance by phone. Upon landing, paramedics treated Layla for a severe allergic reaction to nuts. Tina and her husband, Bryan, hadn't even known Layla had a nut allergy, let alone a life-threatening one.

Layla’s family learned she has several allergies, including dairy and mustard, along with anaphylactic allergies to peanuts, walnuts and pecans. "I remember feeling very overwhelmed," says Tina. She worried about how restrictive Layla’s life would be and how she would keep Layla safe. "I would look at Layla and think about how multiple anaphylactic allergies would require a lifetime of extreme caution," she says.

Unfortunately, Layla’s allergy is not unique. There are almost 500,000 children in Canada with food allergies, and only around 250 allergists in Canada who treat patients of all ages. Thankfully, there are life-changing treatments and trials available to help allergic kids, and the SickKids Food Allergy and Anaphylaxis Program (FAAP) is leading the charge.

Tina reached out to Dr. Julia Upton, an award-winning allergist at SickKids and co-lead of FAAP. Layla soon joined an oral immunotherapy (OIT) study Upton was working on, which exposes children to very low amounts of their allergens under careful supervision to gradually build up a tolerance. "OIT causes desensitization," explains Upton. "This means the amount of nuts that can be safely ingested greatly increases over time. If started very young, at less than a few years of age, OIT might help the chances of outgrowing the food allergy. It helps take the fear out of food."

Over time with OIT, Layla’s tolerance increased, and while it doesn’t mean she’s free to enjoy nuts, both she and her parents don’t constantly worry about accidental exposure anymore. "We are so happy with her progress," says Tina. "Layla’s now a confident kindergartener who is able to navigate the classroom without too much fear and is able to advocate for herself. We remain very careful but the study helped open up a new world for Layla where social and classroom integration is less scary." This means she can sit at the same table as her friends for lunch and her family feels more comfortable at social events and travelling.

OIT is just one therapy that SickKids is pioneering while pushing for wider availability of innovative treatments and diagnostic tools. "Broadly, we are focussing on improving diagnosis so that children who are not actually allergic can eat the food routinely," says Upton. "Diagnosis is tricky because blood and skin allergy testing is not 100 per cent predictive of allergy. We are studying better diagnostic tests and have clinics which confirm or delabel allergies." The FAAP at SickKids also studies multiple treatments and approaches with and without medications. A big part of the program's efforts is in patient and physician education about food allergy prevention, diagnosis, management and anaphylaxis.

This work is critical as "food allergies affect laws, schools, travel, food handling, manufacturing and so many areas of our lives, whether or not we personally have a food allergy," says Upton. 

And of course, the research advances mean the world to families like Layla’s. "SickKids has given us hope," affirms Tina. "Being part of this research has made us feel empowered. We truly feel blessed that we had the opportunity to be supported by Dr. Upton and her amazing team. We are hopeful that there will be continued progress to help children with severe food allergies have a better quality of life."

Learn more about the SickKids Food Allergy and Anaphylaxis Program and how to make a donation to support its life-saving work.

Layla’s treatment is supervised by SickKids specialists. If your child has food allergies, please do not try any of the treatments mentioned in this article without the careful supervision of an experienced doctor.