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How Do I Recognize Food Allergies in My Children?

Posted Date: 5/1/2015
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How Do I Recognize Food Allergies in My Children?

There has been an increase in the number of children who develop food allergies. A study released by the Centers for Disease Control and Prevention states that food allergies among children have increased approximately 50% between 1997 and 2011. It is important for parents to recognize potential food allergies in their children and to know the difference between food allergies and intolerance.

When a child has an allergic reaction to food, the body's immune system views the food as a foreign substance (allergen) and creates antibodies to protect the body. Once the food is reintroduced there is an antigen (allergen)-antibody reaction and the allergic reaction. The body releases a substance called histamine.  Histamine dilates blood vessels and makes the vessel walls abnormally permeable resulting in swelling and inflammation anywhere in the body including the respiratory system, gastrointestinal tract, skin, or cardiovascular system. These symptoms might include a runny nose; an itchy skin rash; tingling in the tongue, lips, or throat; swelling; abdominal pain, vomiting; or wheezing.

Antihistamines work by preventing the release of histamine from certain cells (mast cells) thereby blocking the allergic reaction.

Symptoms of a food allergy can range from mild to severe. Just because an initial reaction causes few problems doesn’t mean that all reactions will be similar; a food that triggered only mild symptoms on one occasion may cause more severe symptoms at another time.

 The most severe allergic reaction is anaphylaxis . This is a life-threatening whole-body allergic reaction that can impair your breathing, cause a dramatic drop in your blood pressure and affect your heart rate. Anaphylaxis can come on within minutes of exposure to the trigger food, even small amounts.  It can be fatal and must be treated promptly with an injection of epinephrine.

Food intolerance is not a true food allergy because there isn’t any immune mechanism involved. It often is delayed and can occur after eating a large amount of the offending agent. It is not life threatening. A common example of food intolerance is lactose intolerance. Lactose is the carbohydrate in milk. Lactose intolerance is an example of a food intolerance that is often confused with a food allergy. Lactose intolerance occurs when a child has trouble digesting the milk carbohydrate (lactose) because he/she doesn’t produce enough of the enzyme necessary to break it down. As a result your child can have loose stool, abdominal pain and bloating.

 Common Food Allergies: Your child may be allergic to any food, but these eight common allergens account for 90% of all reactions in children

  • Cow milk
  • Eggs
  • Peanuts
  • Soy
  • Wheat
  • Nuts from trees (such as walnuts, pistachios, pecans)
  • Fish (such as tuna, salmon, cod)
  • Shellfish (such as shrimp, lobster)

    Peanuts, nuts, and seafood are the most common causes of severe reactions. Allergies also occur to other foods such as meats, fruits, vegetables, grains, and seeds such as sesame.

    The good news is that children often outgrow food allergies during early childhood. It is estimated that by the age of five, 80% to 90% of egg, milk, wheat, and soy allergies resolve. Some allergies are more persistent. There is resolution of allergic symptoms in about 20% of people with allergies to peanuts and about 10% of those allergic to tree nuts.  Fish and shellfish allergies usually develop later in life and are persistent.

     Your pediatrician or allergist can perform tests to identify and track your child's food allergies.

    How do I know if my child has a food allergy?

    Symptoms of a food allergy

    When the body's immune system reacts to certain foods, the following symptoms may occur:

    • Skin problems
      • Hives (red spots that look like mosquito bites)
      • Itchy skin rashes (eczema, also called atopic dermatitis)
      • Swelling
    • Breathing problems
      • Sneezing
      • Wheezing
      • Throat tightness
    • Stomach symptoms
      • Nausea
      • Vomiting
      • Diarrhea
    • Circulation symptoms
      • Pale skin
      • Light-headedness
      • Loss of consciousness

        If several areas of the body are affected, the reaction may be severe or even life-threatening. This type of allergic reaction is called anaphylaxis and requires immediate medical attention.

        Diagnosing a Food Allergy
        If you suspect that your child might have a food allergy, contact your doctor. To diagnose an allergy, the doctor will likely inquire about:

    • your child's symptoms
    • how often the reaction occurs
    • the time it takes between eating a particular food and the start of the first symptoms
    • whether any family members have allergies or conditions like eczema and asthma


    Your pediatrician or allergist will look for any other conditions that could cause the symptoms. For example, if your child seems to have diarrhea after drinking milk, the doctor may check to see if lactose intolerance could be the cause rather than a food allergy. Celiac disease—a condition in which a person cannot tolerate gluten, a protein found in wheat and certain other grains—also can mimic the symptoms of food allergies.

    If your pediatrician suspects a food allergy, you will likely be referred to a specialist in Pediatric Allergy and Immunology.

    Dr. Teresa Lemma is a Board Certified Pediatrician who practices at Pediatric Health Care PC.  She is the Program Director for the Pediatric Residency Program at Richmond University Medical Center. For more information, visit