Diagnosing Food Allergies in Children

Food allergies are some of the scariest things for a parent or caregiver to discover in a child.  One in every 13 children in the United States has a food allergy, according to the Food Allergy Research & Education Organization.  Allergies may develop at any time, and strangely they may also lessen or disappear over time. 

Some symptoms parents may observe in their child indicate a serious and potentially life threatening reaction if left untreated.  Most food allergies produce milder symptoms and require some patient observation by parents, food avoidance and talks with the child’s regular health care provider.  A child’s’ medical history and family histories of allergies may affect how parents and caregivers chose to introduce foods to younger children and infants. 

Besides food allergies, there are several medical conditions which can mimic allergic reactions, which is why suspicious parents should always start a food diary as soon as they have a suspicion of an allergic reaction. 

Life-threatening allergic reactions

If a child exhibits these symptoms, especially immediately after eating peanuts, tree nuts, fish or shellfish get prompt medical attention.  If children’s benadryl is easily available, giving them a proper dosage may be done on the way to an urgent care facility. Please note that children’s benadryl will not be sufficient to treat the allergy.  It will only delay it and buy medical professionals more time to treat the child. 

Swelling of hands, lips or face
Skin symptoms such as a Hives rash as well as one of the other symptoms
Wheezing or difficulty breathing
Reduced blood pressure as well as one of the other symptoms unless the child faints or is too weak to move.
Vomiting, diarrhea, cramping as well as one of the other symptoms.

Once a child is diagnosed with a severe allergic reaction, they will typically visit a pediatric allergist and be prescribed an auto-injecting epinephrine pen or “epi-pen”.  That epi-pen should travel with the child in case of accidental exposure to the allergen, and care givers should know how and when to use it. 

Milder symptoms that may indicate a food allergy

If a parent suspects a milder allergic reaction, there are probably symptoms they have noticed after observing their child eat specific foods.  These may be lesser versions of skin rash, typically hives that are not accompanied by any other symptom, a complaint by the child that a food feels spicy in their mouth when it does not actually have spice in it, or vomiting, diarrhea or cramping and intestinal discomfort that is not accompanied by any other symptoms.  There is any easy four step approach to narrowing down a possible food allergy;  observe, avoid, test and consult. 

Start by notifying the child’s pediatrician of the suspected allergy and reaction. Then get a notebook or electronic file.  Record what the child eats and any reaction they may or may not have after each meal.  Do not avoid the suspected food allergy yet, though do not offer it exclusively.  This is a food diary, and many food allergies and gastrointestinal diseases are discovered through this method.  

After the first two weeks flip back through the food diary and see if a co-relation exists between the suspected food and some forms of reaction.  If the suspicion is confirmed and the reaction is moderate, such as hives, and causes great discomfort, the child should avoid the food and an appointment should be made with the pediatrician, or through the pediatrician with a pediatric allergist for allergy testing.  If the suspicion is confirmed but the reaction is milder, a parent may chose to avoid the food and home test their suspicions. 

Home testing is a method of offering the suspected allergen by itself to the child, and observing whether there is a relationship between that food and the reaction.  For instance, if a mild allergic reaction to eggs is suspected, parents should begin by avoiding all foods that contain eggs of any type, including mayonnaise, breads, crackers and cookies. 

The major eight allergens in the united states are labeled on the back of prepared foods under the nutritional labels.  Reading all packaging is essential.  After a period of one to two weeks where the child does not consume the allergen, and a food diary is still kept, the child should be fed one egg, in a controlled setting as the first and only food they consume at this time.  Parents should have benadryl on hand with the proper dose to give the child following the test. 

Consultation is the essential final step in diagnosing a food allergy.  The food diary, and the parents observations should be brought to an appointment with the pediatrician or pediatric allergist, and a plan should be established to deal with the allergy.  In most cases this plan is three fold; avoiding the allergen, having medication on hand if the allergen is accidentally consumed, and scheduled allergy testing to confirm the visual observations.  After medical allergy testing is done, a better and more thorough understanding of the child’s food allergies will help guide the cuisine offered. 

Medical history, family history and similar illnesses

Allergies tend to run in families, or affect some children more than others.  While any child can develop food allergies, parents who themselves have food allergies are more likely to find that their offspring share this particular problem with them.  It would be best for a child whose biological parents have food allergies to avoid being introduced to that particular allergen until they are much older.  For example, parents who suffered from a pediatric allergy to milk protein or eggs should consult with their child’s pediatrician and opt for milk alternatives or come up with a plan to avoid introduction of those foods, or to introduce those foods to their child in a very control situation.  Similarly, children with some medical conditions, like pre-mature birth or asthma tend to have more allergies. 

One of the reasons that keeping a food diary is so important for parents who suspect a food allergy is that some illnesses, and common child hood conditions may mimic a food allergy.  Topical allergies to laundry detergents can cause hives when a child gets damp at a messy meal.  Diarrhea may be caused by excessive fruit in a diet, and can be common in toddlers.  There are other more serious illnesses which may also be exposed, such as juvenile diabetes or celiac disease. 

Regardless of what is causing a child’s symptoms, parents or caregivers who suspect a food allergy can easily cope with the discovery.  If the signs are of a severe reaction they should seek medical help for the child promptly.  If not, they should Observe, Avoid, Test and Consult with their medical professionals.  Most parents who have a history of food allergies themselves, should keep benadryl in the house and know the correct dose for their child.  Caregivers should learn to read food labels for the major eight allergens, so they can successfully record what their child is eating and how they reacted in a food diary.