Browse over 100 articles to help you manage your child's symptoms.
Browse our library of information about various medical conditions.

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

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 Now or Go to ER

  • 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 Now or Go to ER

  • 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 information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Copyright 1994-2017 Schmitt Pediatric Guidelines LLC. All rights reserved.