Food allergies in babies and kids. If your child has an allergic reaction to something they eat, symptoms may appear within minutes or develop hours later. Most children with food allergies have mild reactions. If your child is severely allergic, symptoms usually develop right away. One risk factor is having a parent or sibling with an allergy. If you suspect a food allergy, talk to your child’s doctor immediately with no hesitation.

IN THIS ARTICLE

• What is a food allergy? 
• Signs and symptoms of food allergy in babies and children 
• Most common food allergies in children 
• Can I get my baby tested for food allergies? 
• Management and treatment of food allergies 

Food allergies are fairly common in children, and by understanding how food allergies work, you may be able to recognize the early signs. It’s also helpful to know what the top food allergens are and what to do if your child ever has a serious allergic reaction.

What is a food allergy?

A food allergy is the immune system’s overreaction to normally harmless proteins in a particular food. When a child with an allergy eats an offending food, their body produces an antibody called IgE, which is a protein that can detect the food. If your child eats the food again, the antibody tells your child’s immune system to release substances such as histamine to fight the “invader.” These substances cause allergy symptoms, which can be mild or severe.

Food allergies usually begin in the first two years of life, and some are outgrown. At one year of age (when food allergies peak), about 6 to 8 percent of children have a food allergy. After that, the prevalence of allergies falls progressively until late childhood, when about 4 percent of children have a food allergy. Young children with food allergies are more likely than children without allergies to develop asthma later (at four to eight years).

Signs and symptoms of food allergy in babies and children

If your child has an allergic reaction to something they eat, symptoms may appear within minutes, or they may develop hours later. Most children with food allergies have mild reactions, though severe symptoms – which usually develop right away – can be life threatening.

For a severe reaction

If your child has a severe allergic reaction (anaphylaxis), it can be life threatening. Call emergency number or go to emergency room right away. Your child’s airway can close up within minutes, so don’t take time to call the doctor for advice or drive your child to the hospital yourself. You need paramedics on the scene as soon as possible.

Severe symptoms that need immediate medical attention and call for emergency help include:

• Trouble breathing
• Turning blue
• Swelling of the lips or tongue
• Throat tightness or hoarseness in the throat
• Wheezing
• Lightheadedness or fainting
• Chest tightness or pain
• A weak pulse
• Panicky feeling
• Tingling in the hands, feet, mouth, or scalp
• Trouble swallowing, drooling, or suddenly slurred speech

If your child is having a milder reaction, they may have:

• Itchy, watery eyes
• Itchy mouth, nose, and/or ears
• Itching or tightness in the throat
• Itchy skin, red patches, or hives
• Redness around the mouth or eyes
• Flaring of eczema
• Coughing
• Runny or stuffy nose
• Sneezing
• Abdominal pain
• Diarrhea
• Nausea and vomiting
• Odd taste in mouth
• Swelling

If your child has any of these milder symptoms after eating a new food:

• Call 907 if your child develops any severe reactions. (Milder food allergy symptoms can develop into more severe symptoms.)
• Keep an eye on your child, and call the doctor if your child seems to be getting worse, or if hives last longer than 24 hours.
• If your child is at least 12 months old, antihistamines such as cetirizine (Zyrtec) or diphenhydramine (Benadryl) can help with milder reactions, like hives. Ask your child’s doctor or pharmacist for the proper dosage.
• A cool bath may help with itching, but limit it to about 10 minutes so your child doesn’t become chilled.
• If your child consistently has symptoms within two hours of eating a certain food, ask their doctor about getting an evaluation. You may be referred to a pediatric allergist for testing.
• Be prepared in case it happens again. Even if the first reaction was mild, the next one might be severe. Your child’s doctor can provide you with an action plan, including instructions on how to manage an allergic reaction.

What information that parent need to know about food allergy symptoms:

Symptoms involving more than one part of the body are more concerning. If your child’s having stomach problems as well as skin problems, for example, it indicates that they’re having a more severe reaction than one that’s isolated to just their stomach or just their skin.

Chronic or ongoing symptoms can make diagnosis harder. If your child has chronic symptoms – for example, gastrointestinal problems like vomiting or diarrhea – they could be caused by something else and a food allergy. Another example is eczema, which is dry, scaly patches of skin that show up on a child’s face, arms, trunk, or legs.

Children can react to a food even if they’ve eaten it before without any problem. A child with an egg allergy, for instance, might not have a reaction the first few times they eat eggs – but eventually symptoms will appear.

Your child may be exposed to an ingredient when it’s combined with something else. For instance, your child may eat eggs, milk, or ground nuts in a cookie. Also, some children can tolerate an ingredient when it’s baked or cooked into other foods but not when it’s eaten on its own.

More than half of children with milk and egg allergies can tolerate milk and egg that’s been extensively heated in baked foods.

Most common food allergies in children

Any food can cause an allergy, but the most common food allergens for young children are called “highly allergenic” foods. The top eight food allergens account are:

• Cow’s milk. This is the most common food allergy in babies and young children. Most cow’s milk allergies are outgrown.
• Eggs. Egg allergy affects children. Almost many children resolve by age 2, and the majority resolve by adulthood.
• Peanuts. Allergies to peanuts and tree nuts coexist in many cases. While earlier studies found that peanut allergy was persistent, more recent studies suggest that one quarter or more of children allergic to peanuts lose their sensitivity over time.
• Fish. Many children (and adults) have a fish allergy. The most common reported fish allergies, in order of decreasing frequency, are: salmon, tuna, catfish, cod, flounder, halibut, trout, and bass.
• Soy. Many children outgrow their soy allergy by seven years of age. According to one study, almost 70 percent outgrow their allergies by 10 years old.
• Wheat. Wheat allergy affects children, and it’s usually outgrown by age 5. Children with wheat allergies often have other food allergies.

There’s increasing concern about sesame as an allergen, too. Like tree nut allergies, sesame allergies are more likely to persist than some other food allergies.

Can I get my baby tested for food allergies?

Yes, allergy testing is available for babies and kids. If you think your child may have a food allergy, talk with their doctor. The doctor might suggest a food diary to help identify the cause or, if your child is formula-fed, a change in formula.

If you’re referred to a pediatric allergist, they’ll ask detailed questions about your child’s symptoms. The allergist can evaluate your child and help decide if testing is needed.

Testing for allergies may include:

• Skin test. The doctor will prick your child’s skin with something that contains a tiny amount of the suspected allergen(s). (Your child can be tested for several allergens at the same time.) If your child has a reaction – an itchy red bump – it means they might be allergic.
• Blood test. This will test for antibodies that the body makes during an allergic response.
• Food challenge test. In a food challenge test, your child’s doctor gives the suspected food to your child during an office visit and then monitors your child for an allergic reaction. This is considered the most accurate way to diagnose a food allergy.

If the skin test produces a hive or the blood test shows that your child has elevated IgE antibodies to the food, there’s a chance they’re allergic to that specific food. If the tests are negative, your child’s symptoms are less likely to be due to a food allergy, although they may be caused by a food intolerance.

At that point, you may be referred to a pediatric gastroenterologist to pinpoint the cause of the intolerance or to investigate other explanations for your child’s symptoms.

Management and treatment of food allergies

If your child has a food allergy, work with their doctor to come up with a plan. You’ll need to be diligent about avoiding the allergen. You’ll also want to be prepared in case of a severe reaction. And you’ll want to explore your options for treatment.

Avoiding allergens

It’s crucial that you protect your child from being exposed to the food they’re allergic to. Avoiding a particular food is trickier than it sounds. Foods show up in unlikely places, and even a little bit may be enough to trigger a severe reaction. Most people who have a severe reaction have eaten a food they thought was safe.

Learn which foods contain the allergen. Read labels carefully and with more attention . By law, food labels must list the top eight allergens. Nuts, fish, and shellfish must be named specifically. And all the allergens must be listed in plain language. For example, the label has to say “egg” instead of “albumin” or “egg” in parentheses after “albumin.” If you’re unsure about a product’s ingredients, call the manufacturer.

When eating out – in restaurants or at friends’ or relatives’ homes, for example – verify that the food you’ve ordered for your child is free of the allergen.

Tell caregivers about the allergy. Make sure anyone who takes care of your child – babysitters, relatives, daycare workers, teachers – knows about the allergy and which foods are off-limits. Point out the kinds of foods that could hide the substance, and ask caregivers to double-check ingredients. Tell caregivers exactly what to do if your child has an allergic reaction.

You may also want your child to wear a medical bracelet to identify the allergy. If you can’t find it in the country you are at, ask for those who comes for visit.

Depending on your child’s allergy, you may want to consult a dietitian or nutritionist for help making sure that your child’s nutritional needs are being met. (If they’re allergic to milk, for example, you may want suggestions for meeting your child’s calcium needs.)

Treatment for food allergies

EpiPen

Antihistamines such as ceftirizine (Zyrtec) can be helpful for minor allergic reactions, but if your child is in any danger of having a severe reaction, you’ll want to have an EpiPen on hand at all times.

An EpiPen is a device that automatically administers an emergency shot of epinephrine (a medication that stops anaphylaxis) to stop an allergic reaction. Your child’s doctor will prescribe the right EpiPen for your child and show you how to use it. (They may also provide instructional materials or direct you to a how-to video.)

Anyone who takes care of your child should also have access to an EpiPen in case your child needs it. Do not lock it so that they can access it easily.

In some cases – if they’re very responsible – an older child can carry the epinephrine injector themselves. Talk with your child’s doctor about whether this is recommended for your child.

Allergy shots

Allergy shots – allergen immunotherapy – can be beneficial for some children with certain allergies. The child is given injections containing small (and increasing) amounts of the allergen, usually starting on a weekly schedule and then every two weeks, three weeks, and finally four weeks.

The regimen of monthly shots is usually maintained for three to five years, after which allergic symptoms don’t return. These shots are given under the supervision of a doctor and don’t do it by your own.

Oral Immunotherapy (OIT)

Oral immunotherapy is a way of building your child’s immune system tolerance towards an allergen. The process involves giving your child small doses of a food they’re allergic to over time. The initial dosing is done in a doctor’s office (don’t do this at home on your own), and you continue the same dosing – as directed by the doctor – at home between visits.

The doctor will increase the amount of allergen (called “updosing”) over the course of months, and eventually – if it works – your child will become desensitized to the allergen. For maintenance, your child will continue to eat small portions of the food regularly (if they stop eating it, their symptoms may return therefore make sure they keep on eating the foods). The goal is to have your child be able to eat a small amount of the food they’re allergic to without having a severe reaction. Children can receive OIT for several foods at the same time.

Food supplementation

There’s now an FDA-approved treatment for peanut allergies called Palforzia. It’s not a remedy to be used when a child is having an allergic reaction, but a treatment regimen to help reduce the severity of allergic reactions, including anaphylaxis.

The treatment is for children ages 4 through 17 and must be administered under the close supervision of your child’s primary doctor or allergist. The treatment involves three phases of dosing with a powder that’s sprinkled on a small amount of food (applesauce, yogurt, or pudding, for example) for the child to eat. Children must still avoid the allergen after treatment, but if they’re accidentally exposed their reactions will hopefully be less severe.

Key Points About Food Allergy In Children

• A food allergy is when your child’s body has a bad immune reaction to a certain food.
• Most allergies are caused by milk, eggs, wheat, soy, tree nuts, peanuts, fish, and shellfish.
• Symptoms of food allergies may include vomiting, diarrhea, cramps, hives, swelling, eczema, itching, trouble breathing, wheezing, and lowered blood pressure.
• Symptoms of milk or soy intolerance may include colic, blood in your child’s stool, and poor growth.
• The goal of treatment is for your child to stay away from the foods that cause the symptoms. Your child also needs a food allergy treatment plan and epinephrine autoinjectors in case of a severe allergic reaction.

Next Steps

Tips to help you get the most from a visit to your child’s doctor:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

Read more about

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• How to avoid heavy metals in your baby’s food
• Introducing solid foods to your baby
• When and how to introduce a sippy cup
• How much should my baby eat?