Food allergies in children: Pediatric guidelines, diagnosis and more

Food allergies are a common concern for parents when their children are young. But how common are food allergies? Can your child have food allergies instead of food allergies? Will they increase their food allergies? Lena Van der Leist and Dan Bloomberg, pediatricians at UC Davis Children’s Hospital, answer these questions and their podcasts on food allergies are considered in children.

How common are food allergies?

Real food allergies affect about 4-8% of children, and some develop more. As a result, food allergies affect approximately 2-5 adults. Food allergies have increased significantly in the last 10 years. There are a few theories of this increase, and it is likely a combination of theories that contribute to the increase in food allergies:

  • One is the hygiene hypothesis. This asserts that because the environment has become cleaner and we’re disinfecting things more regularly, kids’ immune systems aren’t as distracted by responding to frequent infections. Instead of responding to those infections, their bodies may respond by developing new allergies instead.
  • Another theory is that children are exposed to food proteins through the skin. Children can then become sensitized to that allergen, and it can cause a response later when they eat the food.
  • A third theory is attributed to pediatric guidelines from many years ago that advised children shouldn’t be introduced to historically allergenic foods at a young age. Not having these foods in kids’ diet early on may have contributed to the rise of allergies.

Food allergy vs. food intolerance

It is estimated that approximately 35% of patients and / or parents report a food reaction or intolerance that they believe is a real food allergy. The child may have nausea or diarrhea or any other reaction that looks like it may be an allergy, such as itching around the mouth. If your child has experienced any of these reactions with no other symptoms, it may not be a real food allergy. You should talk to your child’s pediatrician about this.

Real food allergies can recur when you eat a particular food. When a baby eats for the first time, he usually does not react. Peanuts are an exception because, presumably, the baby is already sensitive to their skin or in some other way.

What are the most common food allergies?

The most common foods that cause allergies are:

  • Milk
  • Egg
  • Peanuts
  • Tree nuts
  • Fish
  • Shellfish
  • Wheat
  • Soy

These 8 foods make up 90% of food allergies. But what about strawberries? Although this fruit is not listed as one of the food allergies, it seems that you or many people you know may be allergic to it. This “allergy” may be misunderstood or misdiagnosed because it looks like an allergy. As discussed above, it may appear as itching, but there are no other symptoms. Therefore, it can only be food intolerance.

How are food allergies diagnosed?

If you suspect that your child has a food allergy, list your child’s pediatrician for ingredients. You may also be asked about the process of preparing food (such as fried eggs in cakes versus baking eggs). Be prepared for details of how often your child has eaten. Time information is of the utmost importance – from the time your child eats the food to the reaction. Real allergic reactions usually occur within minutes and rarely appear more than two hours after exposure. Your child’s pediatrician will also want to know more about your child’s medical history and family history.

From there, tests can confirm that it is actually a food allergy. A blood test can look at the food of concern, and a skin tasting test can determine if the food in question causes an immediate reaction. Bloomberg and Van der Least do not recommend panel tests, which include 20 very common food allergies. They suggest that a test should look at specific doses of concern, as opposed to a panel test that may result in a false positive.

What are the guidelines on feeding children peanuts at an early age?

In 2015, a study called LEAP (or Peanut Allergy About Learning Early) considered giving peanut products to children at an early age. Research has shown that feeding peanut products to children aged 4 to 11 months was beneficial. In patients who used peanut products three times a week, the number of peanut allergies dropped from 14% to 2% by the age of five.

For parents of a child who has severe eczema or first egg allergy, consult your child’s pediatrician and possibly get an allergy test before introducing peanuts.

Can people outgrow food allergies?

About 80% of people will develop allergies to milk, eggs, wheat, or soy. These are very common in childhood. About 20% of people will develop allergies to peanuts, tree nuts, fish or shellfish. However, this is not something you want to experiment with. Talk to your allergist and they can track your allergies over time.


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