It is natural to feel challenged or even overwhelmed when your child has been recently diagnosed with a food allergy. Managing food allergies requires changes in diet and lifestyle, and these changes will affect the entire family. Over time, as you establish helpful strategies to avoid the allergenic food you will have confidence that you can keep your child safe while living a normal family life. The information below and on this site will assist you in learning the facts about food allergies and how to manage them which will make you feel less overwhelmed and more in control.
Food Allergy Is...
the result of the immune system reacting to one or more proteins found in a food. This immune reaction leads the body to trigger an allergic reaction, which causes symptoms of food allergy.
Most Common Foods Responsible for Food Allergy
Eight foods are responsible for approximately 90% of reactions. These foods are: cow’s milk, egg, peanuts, tree nuts, soybean, wheat, fish, and shellfish.
Typical Symptoms of Food Allergy
- Skin symptoms: Hives, rash, and/or itchy skin; swelling of lips, tongue, or eyelids
- Abdominal symptoms: Vomiting, abdominal pain, and/or diarrhea
- Eye and nose symptoms: Itchy and/or runny eyes; stuffy, runny, itchy nose, and/or sneezing
- Airway symptoms: Hoarseness, throat tightness or a lump in the throat, chest tightness, wheezing, cough, and/or shortness of breath
Some children can have any combination of these symptoms while others may only have one symptom. Symptoms usually occur within minutes of eating the food, although symptoms may appear up to two to three hours later. For some people, exposure to even a small (and barely visible) amount of the allergy-causing food can lead to a reaction while others can eat larger quantities before symptoms develop. Food allergy reactions can be life threatening. This type of reaction is known as anaphylaxis.
Diagnosing Food Allergy
The diagnosis of food allergy should be made by a qualified allergist or nurse practitioner who specializes in allergic disorders. Accurate diagnosis of food allergy is extremely important since an apparent reaction to a food could be caused by other conditions, and not necessarily related to food allergy. Many questions about the reaction will be asked. A detailed description of the reaction should be given. If your health care provider determines that it is likely that a food reaction has occurred, testing will be ordered to better confirm the allergy. Testing can be done by skin test or blood work. A skin test is performed by using a tiny plastic device to place food extract on the surface of the skin on either the back or lower arm. Redness with swelling at the tested site is usually considered as a positive test. Results are ready in 15 minutes. Blood work (known as ImmunoCAP testing) measure levels of food-specific allergy antibodies. It can take several days to receive these results. These results can be helpful to determine if it is safe to undergo a food challenge (see below). Both types of testing usually help to make the diagnosis of food allergy in a child who has had a suspected reaction to a specific food. However, it is usually not recommended to perform these tests in a child who does not have history of reaction to a specific food (i.e., as a screen), as these tests are highly sensitive and often yield false positive results.
What Is a Food Challenge?
A food challenge may be done to confirm the diagnosis of food allergy or to determine if the food allergy has been “outgrown”. Food challenges are performed based upon the child’s history and testing results. During a food challenge the child eats the allergy-causing food. The food is provided in several doses, starting with a very small amount. If there are no reactions, the dose is increased to larger amounts over several hours. Food challenges should be done only under direct medical supervision by a team prepared to handle reactions, including anaphylaxis. A food challenge is the only way to determine if a child no longer has food allergy to a specific food.
Long Term Effects of the Food Allergy
Some children outgrow their food allergy, while others do not. Children are more likely to outgrow allergies to milk, egg, soy and wheat; unfortunately, allergies to peanut, tree nut, fish and shellfish are less likely to go away.
Management of Food Allergy
- Strict Avoidance: If your child is diagnosed with a food allergy, he/she will be told to strictly avoid that food. Some children with milk or egg allergy might be able to tolerate milk or egg in baked goods; you should discuss this option with your allergist.
- Careful Label Reading: To ensure that your child will not accidentally consume the allergenic food, it is very important to read every food label every time to be sure the ingredients have not changed. We say “read every line, every time and if you can’t read it, don’t eat it!” Click here to learn how to read a food label.
- Awareness of Potential Cross-Contact: Cross-contact occurs when a small amount of food allergen accidentally gets transferred onto an object or other food. This transfer could cause an allergic reaction. To avoid cross-contact, food allergic children should wash hands with soap and water before and after eating, or use hand wipes when soap and water are not available. Hand sanitizers are not effective for removing allergens. In addition, tables should be wiped down before eating, and only clean utensils, dishes, pots/pans should be used.
- Caution When Dining Out: Special precautions should be taken when eating in restaurants, call ahead of time and inform restaurant personnel of what your child is allergic to and if they can accommodate. Take similar precautions as well as when planning to eat foods prepared by family or friends. You should communicate your child’s food allergies, as well as state that your child’s food must be cooked in a clean and safe environment to avoid cross-contact.
- Epinephrine Always Available: The only treatment for a severe allergic reaction (called anaphylaxis) is an auto-injectable epinephrine device. should be available all times to treat a food reaction. 911 should immediately be called if epinephrine is needed. Oral antihistamines (such as Benadryl) should NEVER be used alone in severe reactions but can be used to control very mild symptoms. Click here to learn how to use an epinephrine auto-injector.
- Food Allergy and Anaphylaxis Emergency Care Plan: A Food Allergy and Anaphylaxis Emergency Care Plan is a written document that includes information regarding your child’s food allergies and symptoms of a reaction. The plan states recommended treatment, as well as emergency contact information, in case of an allergic reaction. The plan should be available at home, as well as daycare, school, camps, or any time the child is away from home or with another caregiver. An extra copy should be available to send with your child if he/she is to spend time at a friend or relative’s home. Click here to see sample plans.
There Is NO Cure for Food Allergies – Avoidance Is KEY!
Unfortunately, there is no treatment currently available that has been shown to be safe and effective in curing food allergy. Oral desensitization protocols (introduction of small but increasing doses of the allergenic food) have shown some benefits in research studies. However, these treatments should only be considered as a part of research (study) protocols, and are currently not ready as a routine treatment.