Understanding Food Allergies in Children
If your child has a food allergy, it can often be a scary and challenging diagnosis to navigate safely. If your child goes to school or daycare, it can feel even harder to ensure that your child avoids any food allergens and resulting reactions. That is why understanding food allergies in children is important for not just parents of children with food allergies, but also for any caregivers, teachers, coaches, or anyone else that may be responsible for your child throughout the day. With proper awareness and education, it is possible for your child to properly manage their food allergy and remain healthy and safe whether at home, school, or other activities.
What Are Food Allergies in Children?
A food allergy can be a serious and potentially life-threatening condition. It happens when your body’s immune system, which is usually responsible for detecting germs and fighting infections, accidentally mistakes a food as an invader—and attacks. This overreaction of the body’s immune system releases histamines and other chemicals that can result in your child experiencing mild to severe symptoms such as hives, itching, vomiting, diarrhea, difficulty breathing, and more.
Food Allergy vs. Food Intolerance: What’s the Difference?
It is important to distinguish between a food allergy and a food intolerance. While a food allergy is the result of an inappropriate response of the body’s immune system that can range from mild to severe and life-threatening, food intolerance does not affect the body’s immune system at all. Instead, food intolerance is when the body is unable to properly digest a specific food and irritates the digestive system. Symptoms of food intolerance may include gas, cramps, diarrhea, irritability, and headaches.
What Are Some Common Food Allergens?
While any food could trigger an allergic reaction in a child, the following nine foods are responsible for 90% of reactions in kids:
Milk
Eggs
Peanut
Soy
Wheat
Tree Nut (such as walnuts, almonds, etc.)
Shellfish (such as shrimp, clams, etc.)
Fish
Sesame
How Do I Know My Child Has a Food Allergy?
Recognizing Food Allergies in Children: Signs & Symptoms
Symptoms of an allergic reaction may develop within minutes of to a couple hours after exposure to a certain food. Symptoms may affect one or several areas of the body and can range from mild to severe and, in some cases, life-threatening. It is important to understand the different types of symptoms of a food allergy so that appropriate and prompt intervention and treatment can be initiated.
Mild Symptoms May Include:
Itchy/runny nose
Sneezing
Itchy mouth
Hives
Itchy skin
Mild nausea or discomfort
Severe Symptoms May Include:
Shortness of breath/difficulty breathing
Wheezing
Cough
Throat tightness/hoarseness/difficulty swallowing
Swelling of the tongue or lips
Hives, widespread skin redness
Vomiting
Diarrhea
Feeling of impending doom, anxiety, or confusion
Lightheadedness
Loss of consciousness
Children may experience a mild reaction or a severe reaction when allergic to a food. A mild reaction is when one mild symptom is present that affects one area of the body. A severe reaction is when any severe symptom is present OR when mild symptoms affect more than one area of the body (such as hives with nausea). Sometimes, a severe reaction can progress rapidly to a condition called anaphylaxis. Anaphylaxis is a serious, life-threatening allergic reaction involving the whole body. The child may have difficulty breathing and may pass out. It is considered a medical emergency that must be treated with a drug called epinephrine.
Recognizing Food Allergies in Infants and Young Children
Infants and young children can have allergies to milk and soy that may present differently. Symptoms of these food allergies may include colic (fussiness), blood in stool, and poor growth. Your child’s pediatrician may recommend you switch your baby’s formula to a soy formula or breastmilk if a milk allergy is suspected. If your child also has symptoms with soy formula, then an easily digested hypoallergenic formula may be recommended. In infants, symptoms of a milk or soy allergy may resemble other medical conditions, so it is important to always consult your child’s pediatrician for advice.
While food allergies cannot be prevented, they can at times be delayed in infants by breastfeeding for the first six months and avoiding solid foods until your child is at least six months old.
How Are Food Allergies in Children Diagnosed?
In order to diagnose a food allergy in your child, your pediatrician will ask for your child’s medical history including any symptoms and any family history of allergies or conditions like eczema and asthma. They may then refer your child to an allergist who may perform special tests such as a skin test or blood tests.
During a skin test, food allergens are introduced just below the skin surface and any resulting skin reaction is measured. Blood tests measure immunoglobulin E (IgE) antibodies to specific foods. If the results of these tests are unclear, then a food challenge may be recommended. During a food challenge, increasing amounts of the food allergen are eaten while under close medical supervision. If the entire amount of food can be eaten without a reaction, then there is no food allergy present. A food challenge may also be used to determine if a child has outgrown a food allergy.
What Treatment Options Are Available for Children With Food Allergies?
A child with a food allergy will be prescribed an epinephrine auto-injector (or, EpiPen) to carry with them at all times. Epinephrine auto-injectors are easy to carry, easy to use, and contain the prescription medicine epinephrine. It is important that your child always has two epinephrine auto-injectors with them in case one does not work or a second dose is needed before emergency responders arrive.
Your child’s pediatrician may also give you an allergy action plan, such as the Food Allergy and Anaphylaxis Emergency Care Plan (see Figure 1 below) developed by Food Allergy Research & Education (FARE). These plans typically include information about how to prepare, recognize, and treat an allergic reaction. This care plan should be shared with anyone who may be responsible for your child such as relatives, school staff, and coaches. Also be sure that caregivers always have easy access to epinephrine and know how to give it. You might also consider your child wear a medical alert bracelet to easily alert others of their food allergy.
In the Event of a Severe Allergic Reaction:
Time matters: Immediately use the epinephrine auto-injector if your child develops a severe reaction with any severe symptoms present or if mild symptoms affect more than one area of the body (such as hives with vomiting).
Call 911 and go to the emergency room. Your child may require further treatment and continued medical supervision even if they seem better as a “second wave” of serious symptoms can return.
See my blog First Aid: Allergic Reactions/Anaphylaxis in Children for a more in-depth step-by-step guide on how to treat both mild and severe allergic reactions.
How to Keep Your Child Safe With Food Allergies
Carefully read food labels every time before feeding a food to your child to make sure it does not contain the allergen as an ingredient. It’s important to do this even if your child has safely eaten it before as ingredients and manufacturing processes can change. The most common allergens should be clearly labeled, but less common allergens may be included under vague ingredients such as “natural flavors.”
Be aware of potential cross-contamination risks that may not be properly indicated on the label. Cross-contamination can occur when the manufacturer uses the same tools and equipment with multiple different foods, one of which your child may be allergic to. If you are unsure of a food’s risk of cross-contamination, you can look on the company website or contact the company directly and ask.
When dining away from home, it is important that any adult in charge and anyone preparing the food knows about the food allergy and what to avoid. Your child may carry an allergy card with this information that can be given to servers in restaurants and caregivers. Another possibility if you are unsure if the options available when dining away from home are safe for your child is to have them bring their own food that you know is safe.
To learn more about how to keep your child with a food allergy safe at home, at school, when dining out, and more, visit https://www.foodallergy.org/.
Key Points to Remember
Navigating your child’s food allergy can be a scary challenge, but when equipped with the right tools and information, it is possible to do so safely. When your child is diagnosed with a food allergy, it is important to always keep an allergy action plan and two epinephrine auto-injectors handy at all times. All caregivers should be educated on how to recognize a severe allergic reaction and how to administer epinephrine and call 911 in case of an emergency. While it is possible to outgrow a food allergy, allergens should be avoided until re-evaluation with your child’s pediatrician or allergist. Always play it safe: If you’re unsure of a food’s ingredients or the risk of cross-contamination, do NOT give it to your child. Keeping your child safe and healthy with a food allergy can be accomplished with proper education and awareness for you, your child, and other caregivers.
Image obtained from Food Allergy Research and Education website.
