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ACAAI > Patients & Public > Allergies > Children and Allergies

Food Allergies in Children

About 5% of children under five years of age and 4 percent of kids 5 to 17roughly one in 13 kids under age 18 have at least one food allergy. Almost 40 percent of these youngsters have had a severe allergic reaction after consuming a food.Children with food allergy also have higher rates of asthma as well as skin and respiratory allergies.

Two things must happen before a child has an allergic reaction to a food: She must have consumed the food at least once before or been exposed through breast milk, and her immune system must produce antibodies to proteins in that specific food. This immune response is what helps allergists differentiate a life-threatening food allergy from food intolerance.

According to a2010 studyin the Journal of the American Medical Association, the prevalence of food allergy may be overestimated. While allergistsin the United States would agree that food allergy issues seem to be increasing, most would also point out that much of what people consider "food allergy" may instead be a food intolerance or non-allergic issue. Yet, food allergy remains an important problem and can be life threatening. Methods of testing for food allergies have their limits. Allergists can help determine whether the problem is occurring on an allergic basis or not.

Common Food Allergies in Children

The most common food allergies in children are caused by only a few foods, with peanuts, and cows milk leading the list. Other culprits include eggs, tree nuts, soy, fish, shellfish and wheat. The most severe food reactions are caused by peanuts, tree nuts, fish, and shellfish, allergies that tend to last a lifetime. Kids often outgrow allergies to wheat, eggs, soy, and cows milk, however.

Signs and Symptoms of Food Allergy

An allergic reaction to a food usually occurs within minutes to an hour.These are the most common signs and symptoms of food allergy:

  • skin: hives, itching, rash, swelling of the lips, tongue, face
  • digestive tract: nausea, vomiting, diarrhea, abdominal pain
  • respiratory: wheezing, congestion, shortness of breath, difficulty breathing due to swelling of the throat
  • cardiovascular: drop in blood pressure, causing dizziness, lightheadedness

Anaphylaxis, the most severe allergic response, is a medical emergency. Swelling of the throat prevents breathing and swallowing, the heart rate rises and blood pressure drops suddenly. If your child has been prescribed an epinephrine (adrenalin) auto injector, it should be with them at all times and used immediately at the first sign of an anaphylactic reaction and call 911 instantaneously. A second dose of epinephrine should always be on hand in case it is needed.

Diagnosis and Treatment

If a food allergy is suspected, your allergist will collect a complete medical history and perform a physical exam of your child. Be prepared with a complete list of foods the child consumed before the reaction as well as the signs, symptoms, severity and length of the reaction. Again, this can help diagnose actual food allergy from food intolerance.

An allergy skin test can help determine which foods caused a reaction in your child. A small amount of food extract is applied to the skin on the arm or back. The appearance of a red, itchy bump (or wheal) within 15 minutes may suggest an allergy. Blood tests may also help indicate an allergy exists. Any positive food allergy test can be wrong as much as 90 percent of the time. The most important part of the evaluation is talking to your allergist, who is skilled in making a correct diagnosis, before testing is done. Allergy testing only confirms the history.

An oral food challenge is the gold standard and only definitive test to diagnose food allergy. It is typically done in the allergists office, and only if the risk of anaphylaxis is low.

There is no cure for food allergies. The only treatment is avoiding foods that cause reactions in your child. Your allergist will prescribe an epinephrine auto-injector to be used immediately if your child has a severe allergic reaction. Always carry the epinephrine auto-injector and use it at the first sign of severe allergic reaction. After epinephrine is injected, call 911.

Living with Food Allergy

Keeping a child with food allergies safe is challenging and stressful. Parents must search food labels for ingredients that can cause reactions in their child; notify family, friends, schools, and restaurants of their childs allergy; and always be prepared for an emergency. An allergist can provide you with tips and tools to help your child stay safe and healthy.

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