Food Allergy Pediatric Care Plan

By David Shafran, MD
Medically reviewed
December 30, 2020

What are food allergies?

Food allergies occur when your child’s body has an abnormal immune response to a specific food or food additive. Most commonly, they present before a child is 6 years old.

The most common food allergies are to 

  • Milk
  • Eggs 
  • Nuts 
  • Fish/Shellfish 
  • Soy
  • Wheat 

Symptoms of food allergy affect one or all of the following systems

  • Respiratory- cough, wheezing or throat tightness
  • Circulation- lightheadedness or dizziness
  • Skin- hives, eczema, or skin swelling
  • Stomach- diarrhea, stomach ache, nausea, vomiting

How are food allergies diagnosed?

  • First, you have to suspect that your child has an allergy to a specific food. Your child should only be tested if you’ve identified a food that you think is a problem. Children should not be tested at random for allergies.
  • Once you’ve identified a problematic food, a pediatric allergist can test for an allergy in one of two ways:
    • Blood test- a small amount of blood is taken to see if your child has made antibodies against a suspected food
    • Skin test- a small prick or scratch is made in your child’s skin and the food in question is placed over the scratch to see if your child develops hives or not. If a small hive appears, it means your child is probably allergic to that food.

Food allergies can be evaluated and managed as follows…

While there are new treatments on the horizon that target making children less sensitive to foods to which they are allergic, they are still experimental and not used regularly. 

The staple of food allergy management is avoidance. 

  • Read labels for allergic ingredients
  • Be careful not to mix foods at home- everyone in the family might not have the allergy but everyone needs to be careful not to mix their ‘unsafe’ food with the food a child who has an allergy
  • In restaurant, be sure to ask how foods are prepared and give clear instructions to your server

In the case of a severe allergic reaction (anaphylaxis), this is a medical emergency:

  • You must have an EpiPen on hand for immediate use. Epipens contain the medicine epinephrine which can quickly reverse severe allergic symptoms. Make sure there’s one everywhere your child goes including school and make sure to renew it every year.
  • Proceed immediately to the emergency room

What about school?

  • Make sure that teachers and faculty who oversee your child are aware of the allergy
  • Keep an EpiPen at school and make sure the appropriate people are trained to use it

Will my child outgrow their allergies?

  • Most children outgrow allergies to milk, wheat, and eggs by the time they’re 5 or 6 years old
  • Only about 20% of children outgrow an allergy to peanuts, treanuts, or seafood

Check in with K if…

  • You have general questions about your child’s condition
  • You want general followup for your child
  • You have questions about supportive care
  • Your child’s symptoms don’t go away after treatment but are not alarming

See a doctor in person if…

  • All children suspected to have a food allergy should be evaluated by a pediatric allergist to identify and confirm the specific food or food additive to which your child is allergic. 
  • A severe allergic reaction called anaphylaxis can be life threatening and requires immediate care in an emergency room. In addition to hives, symptoms can include difficulty breathing, throat tightness, vomiting, and loss of consciousness
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

David Shafran, MD

Dr. Shafran is a board-certified pediatrics physician. He joins K Health from the Cleveland Clinic, where he led a pediatrics practice and completed a fellowship in transplant ethics. He has completed multiple fellowships, including one in pediatric nephrology at Rainbow, Babies & Children's University Hospitals. He received his medical degree from the Sackler School of Medicine in Tel Aviv and completed his medical residency at the Jacobi Medical Center.