Kids’ Food Allergies: All You Need to Know

Food allergies are more common than many parents realize — about 1 in 13 children in the United States has one. If you’re just starting to introduce new foods, the uncertainty can be stressful. What if your child has a reaction? How do you recognize the signs? What’s the best way to keep them safe?

Not knowing the basics can make feeding your child feel like a guessing game, and in some cases, the stakes are high. A single bite of the wrong food can lead to a severe reaction.

That’s why this guide is here — to give you the knowledge and confidence to navigate food allergies. Because when it comes to food allergies, what you know can make all the difference.

What Is a Food Allergy?

A food allergy is an adverse food reaction that involves a person’s immune system. While the immune system protects the body from germs and other invaders, it can make mistakes.

When you ingest a food containing an allergen, its proteins bind with the body’s immunoglobulin E (IgE) antibody. The IgE antibody responds by fighting the allergen off, releasing histamine and other allergic substances in the process. This chain reaction results in the person experiencing respiratory, gastrointestinal (GI), or cardiovascular distress.

Although the food itself may not be harmful, the way the body reacts to it is. Some reactions are mild, while others can be serious or potentially life-threatening.

Food Allergies vs. Food Intolerances

Although their symptoms may be similar, food allergies differ from food intolerances.

The key feature of a true food allergy is that the body reacts each time it encounters a food allergy trigger. Reactions tend to be worse with each subsequent exposure. A food intolerance involves less serious symptoms, with people typically only experiencing GI distress. Additionally, food intolerances do not affect the immune system.

Other diseases, such as celiac disease or food protein-induced enterocolitis syndrome (FPIES), may be mediated by our immune system but are not considered allergies, as they are delayed and inconsistent.

Common Food Allergies in Kids

Kids can have an allergic reaction to more than 170 foods. That said, these are the most common allergens:

1. Milk
2. Eggs
3. Fish
4. Shellfish
5. Tree Nuts
6. Peanuts
7. Wheat
8. Soy
9. Sesame

The Food Allergy Safety, Treatment, Education, and Research (FASTER) Act of 2021 added sesame as a major food allergen.

It’s important to note that peanuts are legumes rather than tree nuts. Thus, when we discuss nut allergy, we’re referring to tree nut allergy, not peanuts. There are similar proteins found in tree nuts and peanuts. However, there is still an increased risk of cross-reactivity between peanut and tree nut proteins.

Shellfish and finned fish are considered separate allergens with different shared protein families. Shellfish include crustaceans, such as shrimp, lobster, and crab, and mollusks, such as clams, oysters, and scallops. Some children can tolerate shellfish or fish, but not both. If your child needs to avoid all seafood, it is important to discuss this with your allergist.

Soybeans, along with peanuts, lentils, and peas, belong to the legume family. There is less cross-reactivity within the legume family, so kids with soy allergies are often not allergic to other legumes. Due to its protein content, soy is common in vegetarian cuisine and can be found across Asian cuisines. Edamame, tofu, soy sauce, and tempeh are all examples of soy-based foods.

Due to different cultural diets, different food allergens are prevalent in other countries. For example, mustard is a common allergen in Canada.

Signs of Food Allergies in Children

The following food allergy symptoms in children may appear within seconds, minutes, or two hours after ingesting the food protein:

• Skin symptoms: Rash, hives, itching, or swelling.
• Oral symptoms: Itching, tingling, and swelling of lips, mouth, or tongue.
• Airway symptoms: Runny nose, sneezing, hoarse voice, throat swelling, or difficulty breathing.
• GI symptoms: Nausea, vomiting, abdominal cramps, bloating, diarrhea, or an urge to have a bowel movement.
• Cardiovascular symptoms: High pulse, irregular heartbeat, low blood pressure, circulation issues, or loss of consciousness.

The above are known as anaphylactic reactions, or anaphylaxis, which can vary from person to person with varying degrees of severity. It’s a strong, sudden, and potentially life-threatening reaction after exposure to a specific allergen.

Some symptoms that are common with food allergies can also be common characteristics of children simply eating. For example, children often have flushing while eating. And, as parents know all too well, spitting up and stomach aches are quite common in young children. Also, infants with eczema have symptoms throughout the day, so given the frequency of feedings, it can be difficult to decipher if eczema is flaring due to eating or other factors.

Symptoms that fade quickly without treatment are less likely to be allergic ones. Symptoms that happen with many different foods and inconsistently suggest nonallergic reactions as well.

Seeing a Pediatrician or Allergist vs. Going to the Emergency Room

If the reaction is more severe, go straight to the emergency room (ER). If you feel that the reaction is getting dangerous, call 911 for an ambulance so that care starts immediately and continues en route to the hospital.

All children with known food allergies should have an allergy action plan. In conjunction with your physician’s advice and the action plan, treatments like Benadryl and Epinephrine may be indicated. Once your child is treated and stable in the ER, you may be discharged after three or four hours, or the next morning. Follow up with your pediatrician, and we highly recommend seeing an allergist as well.

The folks in the ER have a tough job. They receive patients in acute distress and must diagnose and treat them in the moment. ER care providers must assume every reaction is potentially life-threatening and, therefore, need to prioritize managing the symptoms rather than assessing the triggers of the symptoms.

Additionally, if you do have to take your child to the ER, you may not receive a prescription for Epinephrine, commonly known as adrenaline. The concern is that families may not follow up with specialists to ensure the best course to navigate food allergies. Ideally, you should test for your kid’s allergies with an allergist before severe symptoms occur.

If your child isn’t currently having a reaction or seems to be having a mild one, you can consult your pediatrician or allergist.

Allergists will know how to identify food allergies. They’re able to help families avoid the wrong foods while keeping safe foods in the diet, which may help prevent the development of new allergies. Once children walk into an allergist’s door, they are in a much safer space.

Allergists have the luxury of stepping back and really questioning whether a severe reaction was truly triggered by foods. They can often deduce that there was no food reaction and safely reintroduce the foods back into your kid’s diet. This is essential, as some children may develop a food allergy precisely because the food was erroneously eliminated.

How Do Allergists Diagnose Allergies in Kids?

Allergists diagnose kids’ food allergies through different assessments and tests.

Reviewing Detailed Histories

A detailed history of reactions gives allergists clues as to which foods should be tested. If you think your child may be allergic to a specific food, keep a journal of what your child is eating, the time of day, and any reactions. Allergists try to avoid allergy panels, especially when history indicates a food is safe, since panels can lead to false positives.

Performing Skin Prick Tests

Testing can be done by a skin prick test with a safe dilute sample of the protein or by measuring allergy antibodies in the blood. A positive skin test elicits a small hive at the site of the scratch within minutes, which will fade soon after the visit. Allergists avoid testing too many foods, as the false positive rate for skin prick tests is between 50% and 60%.

Conducting Oral Food Challenges

The gold standard test for food allergy is the oral food challenge, which requires actually giving the food to a patient to eat and monitoring for a reaction. However, allergists may be hesitant to trigger symptoms just to diagnose an allergy — especially in children.

If your child tests positive for a food that had nothing to do with a reaction and has been able to tolerate the food in the past, your allergist may recommend that they keep eating the food. Especially in younger children, avoidance of safe food may trigger a true reaction.

What Is the Prognosis for Food Allergies?

Although many children are affected by food allergies, the majority will outgrow most allergies. For instance, the majority of kids will outgrow their milk and egg allergies during adolescence, but for a few, these allergies may persist until adulthood. However, allergies to peanuts, tree nuts, and seafood are not commonly outgrown.

With these allergens, strict avoidance gives the best chance to outgrow allergies. In the future, treatments that safely teach the body to tolerate these foods may be developed.

Managing Food Allergies

There are various ways of managing your kids’ food allergies, including:

• Working with your family’s allergist to develop an allergy action plan.
• Communicating with your kid, family, and their teachers and peers about their allergies.
• Knowing how to read food product labels for allergens.
• Avoiding food products with no labels.
• Being adamant about food preparation with restaurants when eating out.
• Using internet resources to find allergy-safe restaurants.

As with most aspects of your family’s physical health, prevention is preferred over treatment. Setting up an appointment with an allergist to safely conduct allergic reaction testing is an important step in preventing severe allergic reactions for your kids, and it will also allow you to ask in-depth questions about your kid’s sensitivity to foods, an ideal diet for living with food allergies, and your child’s chances of outgrowing a certain allergy.

Know What You Get With Nurture Life

Having a child with a food allergy doesn’t have to be challenging. If you’re a busy parent looking for allergy-friendly foods that are convenient and save you time, look no further. Nurture Life takes food allergies and nutrition very seriously.

You’ll know exactly what’s in your baby, toddler, and kid’s meals with our meal tags and ingredient lists — which clearly highlight allergy items. We are also certified by the Safe Quality Food (SQF) Program and have strict allergy-friendly practices in place. As such, our state-of-the-art food production facility is free from peanuts and tree nuts, excluding coconuts.

Whether you’re looking for gluten-free, milk-free, egg-free, or soy-free, we’ve got delicious and nutritious food options for your child.