
Food Allergy
Is this your child's symptom?
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Allergic reactions to foods. The most common symptom is hives.
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Questions about food allergies
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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
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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.
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Mouth itching and swelling
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Runny nose and coughing
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Vomiting and diarrhea
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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
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8 foods cause 90% of food allergies
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In the first year of life: cow's milk, soy milk and egg
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Older children: peanuts, tree nuts, fish, shellfish and wheat
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Shellfish include shrimp, crab, lobster, clams, oysters and scallops
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Tree nuts include all the nuts (such as almonds and cashews) except peanuts.
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Of children with a proven food allergy, 40% have severe reactions. The other 60% have mild reactions.
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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:
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Cow's milk allergy: 90% also react with goat's milk and 40% with soy milk
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Egg: 5% react with chicken
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Peanut: 5% react with other legumes (like peas or beans). About 30% also react to tree nuts.
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Tree nut : 40% react with other tree nuts
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Fish: 50% react with other fish. Only 10% also react to shellfish.
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Shellfish: 70% react with other shellfish
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Melon: 90% react with banana and avocado
How Long do Food Allergies Last?
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Cow's milk: 80% outgrown by age 16
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Soy milk: 80% by age 16
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Egg: 70% by age 16
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Peanut: 20% by age 16
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Tree nut: 10% by age 16
Allergic Disease - Can You Prevent with Diet?
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Most allergic diseases (food allergies, eczema and asthma) cannot be prevented.
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Helpful: Feeding only breastmilk for 4 months or longer
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Not helpful: Avoiding high-risk foods for pregnant or breastfeeding women
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Not helpful: Soy formulas instead of cow's milk formula
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Not helpful: A delay in starting baby foods past 6 months
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Not helpful: A delay in starting high-risk foods like peanut butter or eggs
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Source: AAP
Oral Allergy Syndrome (OAS)
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A minor reaction to some raw fruits and veggies
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Causes itching and swelling only to the lips and tongue
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Also called Pollen-Food Syndrome
Symptoms of OAS
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Rapid onset of itching (or tingling) and swelling of the mouth.
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This can involve the lips, tongue, throat, and roof of the mouth.
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The uvula (tag of tissue hanging down in back) can become very swollen.
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These symptoms follow eating a high risk raw fruit or veggie.
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OAS can start by age 5.
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Serious symptoms or very bad reactions rarely happen.
Causes of OAS
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A contact allergy. It only involves the parts of the mouth that touch the raw food.
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Trigger foods for OAS are always raw (not cooked.)
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Fresh Fruits. These include apple, apricot, banana, cherry, melons, orange, peach and pear.
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Raw Veggies. These include carrot, celery, parsley, potato and tomato. Carrots and celery have the highest risk for also causing serious symptoms.
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Certain Seeds. These include sunflower seeds and fennel seeds.
OAS and Nose Allergies Can Be Linked
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Over 50% of people who are allergic to pollen also have OAS. This means 10% of all people.
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Ragweed pollen allergy can cross-react with all melons. Also, sometimes with bananas and tomatoes.
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Birch pollen allergy can cross-react with raw potatoes, carrots, celery and apples.
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Grass pollen allergy can cross-react with tomato and kiwi.
WHEN TO CALL FOR FOOD ALLERGY
Call 911 Now
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Life-threatening allergic reaction to similar food in the past. Food eaten less than 2 hours ago.
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Trouble breathing or wheezing
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Hoarse voice or cough start all of a sudden
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Trouble swallowing, drooling or slurred speech start all of a sudden
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You think your child has a life-threatening emergency
Call Doctor Now or Go to ER
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Hives all over start 2 to 4 hours after eating high-risk food. High-risk foods include nuts, fish, shellfish, or eggs.
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Major face swelling (not just lips) starts 2 to 4 hours after eating high-risk food
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Vomiting or stomach cramps starts 2 to 4 hours after eating high-risk food
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Your child looks or acts very sick
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You think your child needs to be seen, and the problem is urgent
Call Doctor Within 24 Hours
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Other symptoms that might be from a food allergy and present now
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You think your child needs to be seen, but the problem is not urgent
Call Doctor During Office Hours
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Recurrent symptoms that might be from a food allergy but not present now
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Oral Allergy Syndrome suspected but never confirmed by a doctor
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Food allergy diagnosed and you want to restart that food
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You have other questions or concerns
Self Care at Home
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Food allergy: mild reaction
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Oral allergy syndrome
Care Advice
Treatment of a Food Allergy
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What You Should Know About Food Allergies:
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About 5% of children have food allergies.
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Most children with a new food reaction need to be seen.
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If your child is stable, hives often can be treated at home.
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Hives as the only symptom can have many causes.
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Your child can be seen later to decide future risks and best treatment.
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Here is some care advice that should help.
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Benadryl:
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Give Benadryl 4 times per day for hives all over. No prescription is needed.
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If you only have another allergy med at home (but not Benadryl), use that. Follow the package directions.
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Use the Benadryl 4 times per day until the hives are gone for 12 hours.
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Caution: Do not use if age is under 1 year. Reason: Benadryl makes most children sleepy. Give your doctor a call for advice.
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Cool Bath for Itching:
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To help with any itching, can also give a cool bath. Do this for 10 minutes.
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Caution: Do not cause a chill.
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How to Prevent Future Reactions:
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Help your child avoid the food that caused the symptoms.
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Read labels on all food products fully.
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Tell other people who care for your child of your child's food allergy. Also, inform the staff at your child's school.
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Join the Food Allergy Network (www.foodallergy.org).
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What to Expect:
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Hives from foods often last just a short time.
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They often are gone in less than 6 hours.
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Return to School:
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Hives cannot be spread to others.
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Your child can go back to school once feeling better. The hives shouldn't keep him from doing normal things.
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Call Your Doctor If:
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Trouble breathing occurs
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Trouble swallowing or drooling occurs
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Severe hives not better after 2 doses of Benadryl
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Hives last over 24 hours
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You think your child needs to be seen
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Your child becomes worse
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Treatment of Oral Allergy Syndrome Symptoms
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What You Should Know:
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Oral Allergy Syndrome (OAS) is very common. It happens in 10% of people. Most of them also have pollen allergies.
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The symptoms are not harmful and can be treated at home.
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Needed for OAS: Your child has never had any serious symptoms with this food.
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OAS symptoms don't last very long.
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Here is some care advice that should help.
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Rinse the Mouth:
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Rinse the lips and mouth with warm water. Do this a few times.
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Reason: To remove any traces of the food.
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Cold Pack:
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Use ice or a cold pack to the swollen lips or tongue for 10 minutes.
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Reason: To lessen the swelling and the itch.
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Benadryl:
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One dose of Benadryl may help the symptoms go away faster.
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No prescription is needed.
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If you only have another allergy med at home (but not Benadryl), use that. Follow the package directions.
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How to Prevent Future OAS:
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Keep a list of the foods that cause your child's symptoms.
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Avoid these foods if they are raw (fresh).
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The cooked version of these foods usually won't cause any symptoms.
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What to Expect:
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With or without treatment, the itching will go away in 1 to 2 hours.
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The mouth swelling will also go away quickly.
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Call Your Doctor If:
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Trouble swallowing or drooling occurs
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Trouble breathing occurs
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Swelling or rash occurs anywhere else
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You think your child needs to be seen
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Your child becomes worse
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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.