In the United States, approximately 1 in 13 children have a food allergy, which can impact both their physical and mental well-being.
“Food allergies can significantly affect both children and their families,” says Dr. Ekta Shah, a pediatrician and allergist at Atrium Health Allergy, Asthma & Immunology. “Navigating food allergies involves lifestyle changes, regular communication with teachers and other caregivers, caution when consuming food outside the home, and education around the signs and symptoms of an allergic reaction.
The most common food allergens in kids
The most common food allergens in children include:
- Eggs
- Fish
- Milk
- Peanuts
- Tree nuts (including walnuts, almonds, hazelnuts, cashews, pecans, pistachios and Brazil nuts)
- Shellfish
- Soy
- Wheat
- Sesame
Of course, these are not the only allergens that children may experience reactions to. It's important to consult with a healthcare professional for personalized advice and management
Food allergies vs. food intolerances in children
It’s helpful to know the difference between food allergies and intolerances.
A food allergy is caused by an immune system reaction to a particular food. Symptoms of a food allergy typically occur within minutes of eating a food and can include:
- Coughing
- Decreased blood pressure
- Diarrhea
- Difficulty breathing
- Hives
- Itching or swelling of the mouth, lips, tongue or throat
- Loss of consciousness
- Nausea and vomiting
- Swelling
- Wheezing
“Food allergies can cause life-threatening reactions in some cases, so it’s important to understand and implement measures to keep your child safe,” says Dr. Shah. “If an allergic reaction is severe or affects multiple systems in the body, it can be life-threatening.”
Call 911 if your child:
- Has trouble breathing or shortness of breath
- Feels like their throat is closing
- Has swelling of their throat, face, tongue or lips
- Has a weak, fast heartbeat
- Has hoarseness or difficulty talking
- Has pale blue skin that’s cool or moist
- Loses consciousness
- Has a seizure
In contrast, food intolerances don’t involve the immune system. Although symptoms can be uncomfortable and similar to those of a food allergy, they aren’t life-threatening. Symptoms of food intolerance generally include abdominal pain, bloating and gas.
What parents can do to keep kids safe
If your child has a food allergy, here’s what you can do to help keep them safe, says Shah:
- Develop and communicate their emergency action plan. Your child’s plan should list the signs and symptoms of their allergic reaction, their emergency treatment plan and their emergency contact information. Share this plan with your child’s school nurse, teacher and other caregivers. Be sure to communicate this plan before social events, such as birthday parties or sleepovers.
- Ensure their medications are available at all times. If your child has a food allergy, be sure they always have antihistamine medications and two epinephrine autoinjectors with them at all times. Talk to your child’s school nurse or teacher about the appropriate use of the auto-injectable epinephrine.
- Teach your child how to take their medications correctly. If your child is in middle school or high school, teach them how to safely use their auto-injectable epinephrine.
- Be cautious when going out to eat. When dining at a restaurant, avoid buffets and fried foods because they may be cross contaminated with common allergens. Tell your server about your child’s food allergy before placing your order.
- Create a food allergy card. Consider typing and printing a food allergy card you can give to restaurant servers and that your child can keep with them. The cards can include information about how restaurants can avoid cross-contamination and list your child’s allergens.
Testing for food allergies and intolerances
While food allergy testing is available, Shah notes it is most helpful when combined with a history that suggests a food allergy. Your child may have a history of food allergies if they have developed symptoms such as hives or an itchy throat within an hour of eating a certain food.
“A positive food allergy test — either through skin testing or laboratory evaluation — isn’t always diagnostic of a food allergy. Results from these tests aren’t always accurate.”
In fact, she says, 50 to 60% of results can be false positives.
“The most important test to help diagnose a food allergy is a patient’s history,” says Shah.
Food allergy reactions are usually easy to recognize and may include one or a combination of these symptoms shortly after eating a specific food, typically within an hour: hives, swelling of the lips or tongue, itching in the mouth or throat, tightness in the throat, coughing, difficulty breathing, vomiting, or low blood pressure. If your child experiences these symptoms after eating a particular food, it's likely they have a food allergy.
If your child has a history of such reactions, a food skin prick test or laboratory test can confirm if they have a food allergy. However, if your child hasn't had this type of reaction before, these tests for food allergy are usually not helpful.
“Additionally, there are no reliable tests for identifying food intolerances,” she says.
Can food allergies be prevented?
“There’s a growing body of evidence that shows the early introduction of common food allergens (such as milk, eggs and peanuts) into an infant’s diet can help prevent the development of food allergies,” says Shah. “This can be particularly helpful for children at high risk of developing food allergies, such as babies with moderate to severe atopic dermatitis, a type of skin rash.”
Talk to your pediatrician about when and how to introduce common allergens into your baby’s diet.
Can children outgrow food allergies?
It is possible for children to outgrow their food allergies. Seventy to 80% of children with milk, eggs, soy or wheat allergies will outgrow them. Twenty to 25% of children with peanut allergies will outgrow them. Ten to 15% of children with tree nut allergies will outgrow the allergy. Five to 10% of children with fish and shellfish allergies will outgrow their allergy.
Keeping Kids Safe in School and Beyond
Being aware of food allergies in settings like schools and birthday parties is essential for creating a safe environment for all children. Adhering to peanut-free policies in schools prevents potential allergic reactions and ensures all children can participate without fear.
When planning events like birthday parties, offering allergen-safe food options demonstrates consideration for guests with dietary restrictions, allowing everyone to join in the celebration comfortably and safely. By being cognizant of food allergies, we contribute to a community that values the well-being and inclusion of every child.
When to seek medical care
“If you suspect your child has a food allergy or intolerance, schedule an appointment with their pediatrician,” says Shah. “Your pediatrician can evaluate your child for a possible food allergy and refer them to an allergist if needed.”
To learn more about how to keep your child safe from food allergies, schedule an appointment with an Atrium Health Levine Children’s pediatrician near you.
