Food Allergies

Food allergies are a growing concern for families across the United States. According to Food Allergy Research & Education (FARE), approximately 15 million Americans suffer from food allergies, including 5.9 million children under the age of 18. That’s nearly one in every 13 children — or about two in every U.S. classroom. However, recent insights suggest that the prevalence of true food allergies may be lower than previously thought, as some reported reactions are now being linked to other underlying conditions rather than genuine allergies.

In this article, we’ll explore everything you need to know about food allergies, from symptoms and common triggers to diagnosis, treatment strategies, and the evolving recommendations for children.

What Are Food Allergies?

A food allergy is an immune system reaction that occurs shortly after eating a specific food. Even a tiny amount of the allergen can trigger symptoms ranging from mild irritation to severe or life-threatening reactions, such as anaphylaxis. The body mistakenly identifies certain proteins in food as harmful and launches an immune response.

It’s essential to differentiate food allergies from food intolerances, such as lactose intolerance, which involve the digestive system and are not life-threatening.

Why Food Allergy Cases May Be Declining

Dr. Julia M. Pillsbury, a respected pediatrician, notes a shift in diagnosis trends: “We’re beginning to see fewer cases of confirmed food allergies. In many instances, what appeared to be a food allergy was actually caused by another health issue.”

Improved testing and deeper understanding of symptoms are helping healthcare providers distinguish between true food allergies, intolerances, and other underlying causes such as gastrointestinal disorders, eczema, or autoimmune responses.

Common Food Allergens in Children and Adults

Though nearly any food can cause an allergic reaction, there are a few culprits that are especially common:

Most Frequent Food Allergens:

• Peanuts and tree nuts

• Eggs

• Milk (distinct from lactose intolerance)

• Wheat

• Corn

• Tomatoes

• Soy

• Shellfish (like shrimp, crab, and lobster)

• Fish

In children, milk, eggs, peanuts, and wheat are the most frequent allergens. Adults often develop allergies to shellfish, nuts, and certain fruits.

Symptoms of Food Allergies

Symptoms of food allergies can range from mild to severe and typically appear within minutes to a few hours after consuming the allergen.

Mild to Moderate Symptoms:

• Hives or itchy skin

• Stomach cramps

• Diarrhea

• Abdominal pain

• Eczema flare-ups

• Sneezing or nasal congestion

Severe Symptoms (May Indicate Anaphylaxis):

• Swelling of the lips, face, or throat

• Difficulty breathing or wheezing

• Rapid pulse

• Dizziness or fainting

• Severe drop in blood pressure

If breathing problems occur, seek emergency medical attention immediately. Anaphylaxis can be life-threatening and requires an epinephrine injection (EpiPen) followed by hospital care.

Diagnosing Food Allergies in Children

Diagnosing food allergies involves a combination of parental observation, elimination diets, and medical testing. Dr. Pillsbury emphasizes a step-by-step approach, especially for infants and toddlers.

Steps to Identify Food Allergies in Babies:

1. Introduce one food at a time.

2. Wait 4–5 days before introducing another.

3. Monitor for any signs of rashes, stomach upset, or changes in behavior.

4. If symptoms appear, eliminate the food and retest after one month.

For older children, blood tests and skin prick tests are often used to identify specific allergens. These can usually be conducted starting at age three or older.

Introducing Potential Allergens to Infants

There has been a shift in recommendations regarding when to introduce allergenic foods, particularly peanuts. Previously, it was advised to delay peanut exposure until after age two. However, recent studies support early introduction, which may help reduce the risk of peanut allergies.

Dr. Pillsbury recommends:

• Start with cereals, followed by yellow vegetables, then green vegetables, and finally fruits.

• Introduce peanut butter in small amounts before age two (under medical guidance if there is a family history of allergies).

• Watch for any signs of reaction and consult a pediatrician before reintroducing any foods that cause symptoms.

Treatment and Long-Term Outlook

 Managing Food Allergies:

• Avoid known allergens completely

• Read food labels carefully

• Carry an EpiPen if prescribed

• Wear a medical alert bracelet for severe allergies

• Educate teachers and caregivers about potential allergens

In many cases, children outgrow their food allergies, especially those related to milk, eggs, wheat, and soy. However, allergies to nuts and shellfish tend to persist into adulthood.

Frequently Asked Questions:

Q1. How can I tell if my child has a food allergy?

Look for signs like hives, vomiting, stomach pain, or eczema after eating a new food. Keep a food diary and consult a pediatrician.

Q2. Are food allergies permanent?

Not always. Many children outgrow allergies to milk, eggs, and wheat by school age. Allergies to nuts or shellfish are usually lifelong.

Q3. What’s the difference between a food allergy and a food intolerance?

A food allergy triggers an immune response, while a food intolerance affects digestion and is not life-threatening.

Q4. Can babies be tested for food allergies?

Yes. While allergy testing is more accurate after age three, pediatricians may use elimination diets and careful observation in younger children.

Q5. What should I do if my child has a severe allergic reaction?

Administer an EpiPen immediately if prescribed and call 911. Do not wait, as reactions can escalate rapidly.