A review of food reactions in children from inhalation was recently published in an issue of Allergy and Asthma Proceedings.
As an introduction, the authors remind readers we are able to smell foods because of tiny aerosolized particles of food. In some children, even this tiny amount of exposure can lead to allergic symptoms.
The foods most commonly implicated in this mischief are: fish, nuts, legumes, grains and cow milk.
Up to 10 percent of children allergic to fish will have some type of allergic response to seafood odors or fumes. Typically, this is eye itching, sneezing or wheezing.
Of interest, shellfish were much less likely to cause inhalation problems than “swimming” fish.
The incidence of airborne nut allergy was smaller with three percent of children with tree nut allergy reacting to the smell, and one percent of peanut-allergic children reacting. (Even though peanut is a legume, it was studied in the nut category because there are so many children with peanut allergy.)
Again, common symptoms seen were eye itch, sneezing and wheezing. But some children suffer hives and even anaphylaxis from nut odor inhalation.
The most common legumes to cause inhalation allergy are soy, chick peas, peanut-like lupines and green beans. The spectrum of symptoms: eye itch, sneezing and wheezing, but also intense itching in the mouth and throat in some children.
The cereal grains most likely to cause problems are rice, buckwheat and wheat. Buckwheat is more common a cause than expected because many children have ongoing exposure from buckwheat chaff being used in stuffed animals.
And while cow milk is a common cause for inhalation allergy, some children are sensitized from powdered formulas being mixed in their presence.
Also, as mentioned in a previous newsletter, some asthma inhalers contain small amounts of milk protein as a stabilizer.