Food Allergy
Is this your child’s symptom?
- Allergic reactions to foods
- The most common symptom is hives
- Questions about food allergies
- Oral Allergy Syndrome is also covered. The main symptom is mouth itching and swelling. The main triggers are raw fruits and veggies.
Symptoms of Food Allergies
- Hives all over and swelling of the face are the most common symptoms. Hives are raised pink bumps with pale centers (welts). They look like bug bites.
- Mouth itching and swelling
- Runny nose and coughing
- Vomiting and diarrhea
- Life-threatening allergic reactions also must have trouble breathing and/or swallowing. The medical name for this is anaphylaxis. Most of these reactions have a sudden onset within 10 to 20 minutes. All occur within 2 hours of eating a certain food. People who have had this carry an emergency kit like an Epi-Pen.
Causes of Food Allergies
- 8 foods cause 90% of food allergies
- In the first year of life: cow’s milk, soy milk and egg
- Older children: peanuts, tree nuts, fish, shellfish and wheat
- Shellfish include shrimp, crab, lobster, clams, oysters and scallops
- Tree nuts include all the nuts (such as almonds and cashews) except peanuts.
- Of children with a proven food allergy, 40% have severe reactions. The other 60% have mild reactions.
- Peanuts and tree nuts are the most common triggers for severe reactions.
Cross Reactions with Other Foods
Children with allergies listed below can react to other foods:
- Cow’s milk allergy: 90% also react with goat’s milk and 40% with soy milk
- Egg: 5% react with chicken
- Peanut: 5% react with other legumes (like peas or beans). About 30% also react to tree nuts.
- Tree nut: 40% react with other tree nuts
- Fish: 50% react with other fish. Only 10% also react to shellfish.
- Shellfish: 70% react with other shellfish
- Melon: 90% react with banana and avocado
How Long do Food Allergies Last?
- Cow’s milk: 80% outgrown by age 16
- Soy milk: 80% by age 16
- Egg: 70% by age 16
- Peanut: 20% by age 16
- Tree nut: 10% by age 16
Allergic Disease – Can You Prevent with Diet?
- Most allergic diseases (food allergies, eczema and asthma) cannot be prevented.
- Helpful: Feeding only breastmilk for 6 months or longer
- Not helpful: Avoiding high-risk foods for pregnant or breastfeeding women
- Not helpful: Soy formulas instead of cow’s milk formula
- Not helpful: A delay in starting baby foods past 6 months
- Not helpful: A delay in starting high-risk foods like peanut butter or eggs
- Source: AAP
Oral Allergy Syndrome (OAS)
- A minor reaction to some raw fruits and veggies
- Causes itching and swelling only to the lips and tongue
- Also called Pollen-Food Syndrome
Symptoms of OAS
- Rapid onset of itching (or tingling) and swelling of the mouth.
- This can involve the lips, tongue, throat, and roof of the mouth.
- The uvula (tag of tissue hanging down in back) can become very swollen.
- These symptoms follow eating a high-risk raw fruit or veggie.
- OAS can start by age 5.
- Serious symptoms or very bad reactions rarely happen.
Causes of OAS
- A contact allergy. It only involves the parts of the mouth that touch the raw food.
- Trigger foods for OAS are always raw (not cooked.)
- Fresh Fruits. These include apple, apricot, banana, cherry, melons, orange, peach and pear.
- Raw Veggies. These include carrot, celery, parsley, potato and tomato. Carrots and celery have the highest risk for also causing serious symptoms.
- Certain Seeds. These include sunflower seeds and fennel seeds.
OAS and Nose Allergies Can Be Linked
- Over 50% of people who are allergic to pollen also have OAS. This means 10% of all people.
- Ragweed pollen allergy can cross-react with all melons. Also, sometimes with bananas and tomatoes.
- Birch pollen allergy can cross-react with raw potatoes, carrots, celery and apples.
- Grass pollen allergy can cross-react with tomato and kiwi.
When to Call Us for Food Allergy
Call 911 Now
- Life-threatening allergic reaction to similar food in the past. Food eaten less than 2 hours ago.
- Trouble breathing or wheezing
- Hoarse voice or cough start all of a sudden
- Trouble swallowing, drooling or slurred speech start all of a sudden
- You think your child has a life-threatening emergency
Call Doctor or Seek Care Now
- Hives all over start 2 to 4 hours after eating high-risk food. High-risk foods include nuts, fish, shellfish, or eggs.
- Major face swelling (not just lips) starts 2 to 4 hours after eating high-risk food
- Vomiting or stomach cramps starts 2 to 4 hours after eating high-risk food
- Your child looks or acts very sick
- You think your child needs to be seen, and the problem is urgent
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Contact Doctor Within 24 Hours
- Other symptoms that might be from a food allergy and present now
- You think your child needs to be seen, but the problem is not urgent
Contact Doctor During Office Hours
- Recurrent symptoms that might be from a food allergy but not present now
- Oral Allergy Syndrome suspected but never confirmed by a doctor
- Food allergy diagnosed and you want to restart that food
- You have other questions or concerns
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Self Care at Home
- Food allergy: mild reaction
- Oral allergy syndrome
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Care Advice
Treatment of a Food Allergy
- What You Should Know About Food Allergies:
- About 5% of children have food allergies.
- Most children with a new food reaction need to be seen.
- If your child is stable, hives often can be treated at home.
- Hives as the only symptom can have many causes.
- Your child can be seen later to decide future risks and best treatment.
- Here is some care advice that should help.
- Allergy Medicine for Hives:
- Give Benadryl 4 times per day for hives all over. Age limit: 1 and older.
- Use the allergy medicine until the hives are gone for 12 hours.
- If the hives last more than a few days, switch to a long-acting antihistamine, such as Zyrtec. No prescription is needed. Age limit: 2 and older.
- Caution: if your child is less than 1 year, call your doctor for advice.
- Cool Bath for Itching:
- To help with any itching, can also give a cool bath. Do this for 10 minutes.
- Caution: Do not cause a chill.
- How to Prevent Future Reactions:
- Help your child avoid the food that caused the symptoms.
- Read labels on all food products fully.
- Tell other people who care for your child of your child’s food allergy. Also, inform the staff at your child’s school.
- Learn more at Food Allergy Research and Education.
- What to Expect:
- Hives from foods often last just a short time.
- They often are gone in less than 6 hours.
- Return to School:
- Hives cannot be spread to others.
- Your child can go back to school once feeling better. The hives shouldn’t keep him from doing normal things.
- Call Your Doctor If:
- Trouble breathing occurs
- Trouble swallowing or drooling occurs
- Severe hives not better after 2 doses of Benadryl
- Hives last over 24 hours
- You think your child needs to be seen
- Your child becomes worse
Treatment of Oral Allergy Syndrome Symptoms
- What You Should Know:
- Oral Allergy Syndrome (OAS) is very common. It happens in 10% of people. Most of them also have pollen allergies.
- The symptoms are not harmful and can be treated at home.
- Needed for OAS: Your child has never had any serious symptoms with this food.
- OAS symptoms don’t last very long.
- Here is some care advice that should help.
- Rinse the Mouth:
- Rinse the lips and mouth with warm water. Do this a few times.
- Reason: To remove any traces of the food.
- Cold Pack:
- Use ice or a cold pack to the swollen lips or tongue for 10 minutes.
- Reason: To lessen the swelling and the itch.
- Allergy Medicine:
- One dose of Benadryl may help the symptoms go away faster.
- No prescription is needed. Age limit: 1 or older.
- How to Prevent Future OAS:
- Keep a list of the foods that cause your child’s symptoms.
- Avoid these foods if they are raw (fresh).
- The cooked version of these foods usually won’t cause any symptoms.
- What to Expect:
- With or without treatment, the itching will go away in 1 to 2 hours.
- The mouth swelling will also go away quickly.
- Call Your Doctor If:
- Trouble swallowing or drooling occurs
- Trouble breathing occurs
- Swelling or rash occurs anywhere else
- You think your child needs to be seen
- Your child becomes worse
And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.