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  • Select from over 100 symptoms to read more about managing your child's illness.

    Is Your Child Sick? TM


    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 4 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 for Food Allergy

    When to Call 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

    Call 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

    Call 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

    Self Care at Home

    • Food allergy: mild reaction
    • Oral allergy syndrome

    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

    Call 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

    Call 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

    Self Care at Home

    • Food allergy: mild reaction
    • Oral allergy syndrome

    Care Advice

    Treatment of a Food Allergy

    1. 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.
    2. Benadryl:
      • Give Benadryl 4 times per day for hives all over. No prescription is needed.
      • If you only have another allergy med at home (but not Benadryl), use that. Follow the package directions.
      • Use the Benadryl 4 times per day until the hives are gone for 12 hours.
      • Caution: Do not use if age is under 1 year. Reason: Benadryl makes most children sleepy. Give your doctor a call for advice.
    3. 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.
    4. 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.
      • Join the Food Allergy Network (www.foodallergy.org).
    5. What to Expect:
      • Hives from foods often last just a short time.
      • They often are gone in less than 6 hours.
    6. 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.
    7. 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

    1. 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.
    2. Rinse the Mouth:
      • Rinse the lips and mouth with warm water. Do this a few times.
      • Reason: To remove any traces of the food.
    3. 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.
    4. Benadryl:
      • One dose of Benadryl may help the symptoms go away faster.
      • No prescription is needed.
      • If you only have another allergy med at home (but not Benadryl), use that. Follow the package directions.
    5. 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.
    6. 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.
    7. 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 2000-2018. Schmitt Pediatric Guidelines LLC.