Baby Food Allergies

Food allergy is caused by an allergic response to a particular food. This response can manifest itself in a wide range of symptoms ranging from the mild to spectacular.

Symptoms may be mild, moderate or severe. They are often experienced immediately after eating the food or delayed for several hours. An allergic reaction to a food might cause immediate symptoms to appear in the areas of the body that made physical contact with the food. For example: swelling of the lips, mouth and throat. However, some food allergies create a delayed response, and in these cases digestion and skin can often be affected.

The following are all possible symptoms of food allergy. It is important that if you are at all concerned about your child and their symptoms, that you contact further medical advice as allergic reactions can vary in speed of development and level of severity.

  • Facial swelling and itching including the mouth, tongue and lips, palate (may be called angiodema).
  • Skin symptoms such as itchy rash surrounded by wheals over the trunk of the body and limbs (may be called urticaria or hives).
  • Breathing difficulties (shortness of breath or wheezy symptoms which may develop into asthma).
  • Runny nose; swollen watery eyes.
  • Laryngeal swelling (Swelling of the voice box).
  • Abdominal pain and discomfort which may progress to nausea and vomiting, diarrhoea may be present. (sometimes rectal bleeding , poor growth, diarrhoea and reflux as in delayed milk allergies).
  • In severe cases anaphylaxis may develop. This will involve several areas of the body and can include the symptoms above plus: difficulty in speaking or swallowing; generalised flushing of the skin; heart rate alterations; severe asthma symptoms; sudden feeling of weakness, a feeling of impending doom (or in younger children, becoming quiet and clingy); collapse and unconsciousness.

Information from hospitals and GPs suggests that food allergy in children is increasing, with the rate of peanut and nut allergy in children doubling in the last decade. One in 70 children in the UK has been diagnosed with a peanut allergy.

There are about eight common foods UK children tend to be allergic to, these include: peanuts, other nuts (such as hazelnuts, almonds, cashews and all other nuts), eggs, milk, shellfish (e.g. prawns, crabs, lobsters); fish; sesame seeds; cereals containing the protein gluten (e.g. wheat, rye, barley and oats); soya; These and some other allergens common in other countries must be mentioned on food labels if they are included in food products that are pre-packaged in the UK and Europe. Two additional foods (molluscs and lupin), have been added to this list of those that must be mentioned on food labels, as they are now also considered to be common allergens.

Although not all food allergies are life threatening they may affect an individual's quality of life, and whether it is thinking about special dietary needs, shopping for specific items, or making sure everyone is informed, all of these areas can have a huge impact on a child's daily life, and the lives of those supporting them.

For more information on each type of allergy please see our guides using the menu to the left.

Food Allergies in children

Food allergy or food intolerance?

In families with a history of asthma, hayfever or eczema, there is an increased possibility of food allergies or intolerant children. In food allergy there is a specific antibody (called IgE) present to the food 'allergen'. These antibodies are measurable in blood tests, and food allergy can also be diagnosed by skin prick tests in most cases. Generally, food allergy reactions occur quite rapidly, often immediately or within minutes but generally within a maximum of 2 hours.

Food intolerance is a reaction which is not antibody dependent; many of the reactions which come under the heading of intolerance are delayed by hours or even days. Food intolerance is not fully understood and blood or skin tests are not always helpful in identifying them. By carrying out special food studies on the child (usually in hospital) it is possible to prove that the intolerance exists. Food challenges are ideal for the diagnosis of food intolerance and a positive test result confirms the need for avoidance of the relevant food. Food challenges are unsuitable in children who have had severe allergic reactions, as even minute quantities of the food will provoke the same response.

Diagnosis of a food allergy or intolerance is difficult and it is best to be referred to an allergy specialist for assistance with determining the cause. If a case of food allergy or intolerance is proved, it may be difficult to find alternatives which are acceptable to the child. Dieticians work in conjunction with allergists and they are skilled in finding suitable alternatives to the offending food and ensuring a nutritional diet is maintained.

When possible, your GP should refer your child to a specialist in allergy or immunology for diagnosis. Often the history of your child's reactions will provide enough evidence for diagnosis but confirmation is helpful. It is also possible that there may be more than one cause of the allergic reactions. In many cases children are allergic, not just to foods, but also other allergens including pollens, pets and the house dust mite. Your specialist will be able to assist in diagnosing other allergies and suggest treatments to prevent symptoms or at least reduce them. Children with asthma or suspected to be suffering with asthma will benefit greatly from such consultations and their whole quality of life can improve as a result of such specialist help.

With serious food allergy, confirmation by skin prick tests or blood tests will reassure the child and parents that avoidance is necessary and compensate somewhat for the difficulties in excluding a food from the diet. However there are limitations to how much the allergy tests can show. Unfortunately, there is no direct correlation between the size of the response in the skin prick test or the result of the blood tests to show how severe an allergic response will be. There is also no way to determine how severe the next response will be to the food which caused the last reaction. There is a tendency that if it was a severe reaction then the next reaction will be at least equally severe and probably worse.

Once a diagnosis has been made, the difficult part starts. Currently the best treatment is to avoid the offending food. Anti-allergic treatments, including vaccines, are being developed but it will be some years before these become available due to rigorous safety testing of new drugs. Certain drugs (such as antihistamines) can be used to try and reduce the allergy symptoms.

Despite careful avoidance of the trigger foods, allergic reactions do sometimes still occur. Severe reactions usually occur due to a combination of circumstances including misunderstanding with caterers as to what a dish contains or to the re-use of oil in which something to which one is allergic to has already been cooked, leaving traces of the allergen to contaminate the dish. With certain foods contamination may occur due to the same production line being for different products. Nuts are often the culprits in these instances. However, if one is properly equipped to deal with an allergic reaction, any accidental consumption of a trigger food may be frightening, but the child will be safer. "Properly equipped" in this instance is Epinephrine (adrenaline) in an automatic injector (Epipen or Anapen). With epinephrine there is enough time to avert the attack and reach a hospital emergency department, where further medication can be administered as required.

Most of the deaths of food-allergic people occur outside the home and mostly due to the late or non-administration of adrenaline. Adrenaline is quickly used up, so any effects will be short lived and a second injection may be required. Two autoinjectors are recommended for this reason. With severely allergic children (and adults) symptoms usually manifest themselves so quickly and clearly that the chance of wrong administration of adrenaline is very small. It may not seem very consoling to have to inject a child if a reaction occurs, but it is life saving. It is also recommended that one goes into hospital following the injection of epinephrine as a late phase allergic reaction may occur. People who are allergic to food and suffer from asthma are at greater risk of anaphylaxis and should therefore be especially carefully monitored and should be given their "reliever" inhaler in addition to adrenaline.

Alcohol potentiates the allergic reaction and may increase the severity and speed of the reaction. Fortunately most children do not drink alcohol, but it is something to consider as they grow-up

What can you as a parent do?

If you as parents have a history of allergy or you have another child with allergy then strict breastfeeding is best if possible. You may wish to avoid nuts, including peanuts, whilst pregnant and during breast-feeding and ensure that your baby is not fed with any bottles other than special formulas for allergic babies while you are in hospital. It is not advisable for the mother to avoid milk without medical and dietetic advice as this could result in serious nutritional deficiency for mother and baby. If you must stop breast-feeding or are unable to do so then a special non-milk formula may be recommended. If you decide to introduce solid foods before 4 months of age, then you should avoid giving your baby foods that are more likely to trigger allergy (peanuts, egg, cow's milk, nuts, seeds, wheat, fish or shellfish) until after 6 months. When you do introduce these foods, give them one at a time and look for any signs of an allergic reaction.

Even with all these possible precautions there is no guarantee that your child will not be food allergic. Research has shown that the later the introduction of potentially allergenic foods the less severe the reaction is likely to be. There is also no age limit to becoming allergic, it can occur even in old-age. But by making a good effort to reduce allergen exposure reduces the chance of an allergy developing and helps reduce the severity of the allergy.

More information about childhood food allergy is available from the 'Blossom' campaign (via the Allergy UK helpline or on the blossom website).

Website links for further information

Allergy UK - UK website for all types of allergies.