What are food allergies?

A food allergy is when your body's immune system reacts to a food that is normally harmless (known as an allergen). When this happens, your immune system responds to this food as if it were dangerous. The result is known as an allergic reaction.

Food allergies affect around 1 in 10 one-year-old children in Australia. Some allergic reactions are mild, but some can be severe and even life-threatening. If the reaction affects your breathing or your heart, this is called anaphylaxis.

The most common food allergies in children are to:

• tree nuts
• peanuts
• dairy
• wheat
• soy
• egg
• seafood
• sesame

Remember that anything that you eat might trigger a food allergy. This includes things that you don't normally think of as food, such as herbal medicines or spices.

What are the differences between a food allergy and a food intolerance?

A food intolerance is different from a food allergy, as it does not involve the body's immune system.

Food allergies always involve a reaction of the immune system. In contrast, food intolerances can have several causes, including:

• problems digesting or absorbing a particular type of food
• sensitivity to an ingredient
• toxic reactions such as food poisoning

Symptoms of food intolerances and food allergies can be similar, but food intolerances only rarely cause life-threatening symptoms.

A food intolerance will not show a positive result with an allergy test. Your doctor or dietitian can diagnose food intolerances with a temporary elimination diet — only do this under their supervision.

What are the symptoms of food allergy in children?

If your child has symptoms of food allergy, ask their doctor if a food allergy or intolerance may be the cause.

Symptoms of mild to moderate food allergies in children include:

• swelling of their face, lips or eyes
• hives (a bumpy red rash) on their skin
• stomach pain
• vomiting

Signs of a severe food allergy (anaphylaxis) include:

• difficulty breathing or noisy breathing
• swollen tongue
• swelling or tightness in the throat
• difficulty talking or a hoarse voice
• wheezing or coughing
• dizziness
• collapsing

Young children may also become pale and floppy.

Symptoms of cow's milk allergy in infants

Some babies with a cow's milk allergy experience anaphylaxis, but many have milder symptoms such as:

• eczema
• diarrhoea that lasts more than a few days (chronic diarrhoea)
• reflux
• slow weight gain (failure to thrive)

This can make it difficult to know if your baby has a food allergy. If you suspect your baby has a food allergy, speak to their doctor.

Learn more about cow's milk allergy in infants.

What causes food allergies?

Food allergies do not have a clear cause, but some factors may increase the risk of your child developing a food allergy, including:

• a family history of food allergy
• severe eczema
• the age your child is first exposed to common food allergens
• exposure to infections in early life

Research into the factors affecting food allergy risk is ongoing.

When should my child see a doctor about food allergies?

If you are concerned that your child may be experiencing food allergies or if they are showing a food allergy symptom, see their doctor.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

How are food allergies diagnosed?

If you think your child may have a food allergy, see your doctor for a proper investigation and diagnosis. Do not remove foods from your child's diet without medical advice, as avoiding foods unnecessarily can harm their health and wellbeing.

Your doctor will ask questions about your child's symptoms and when they occur. If your doctor suspects a food allergy, they may refer you to an allergy specialist for a skin-prick test or blood test.

These tests can help your doctor diagnose a food allergy, but a positive result does not always mean your child has an allergy. Ask your doctor what your results mean for your child.

Learn more about allergy testing.

How are food allergies in children managed?

There is currently no cure for food allergies. The best way to manage them is to:

• identify the foods your child is allergic to and take care to avoid them
• know what to do if an allergic reaction occurs

Avoiding foods that trigger an allergic reaction

Once you know what foods your child is allergic to, they must avoid eating them. All carers (including school and day care staff and family members) should read and understand the allergy information on food labels.

What is an ASCIA action plan?

An ASCIA action plan gives clear steps on what to do if your child has an allergic reaction.

Even if you are very careful, there is always a risk that your child could accidentally eat a food they are allergic to, so it's important to be prepared.

If your child has a confirmed food allergy, your doctor will prepare an allergy action plan that may include using an adrenaline autoinjector. The action plan will be:

• red if you need an adrenaline autoinjector (brand names EpiPen or Anapen)
• green if you don't need an adrenaline autoinjector

If your child is prescribed an adrenaline autoinjector, they should always carry it — at day care, school and whenever in the care of others.

Adrenaline autoinjectors

Adrenaline autoinjectors are used to treat a severe allergic reaction (anaphylaxis). The medicine in an autoinjector is called adrenaline. Adrenaline works very quickly to relieve the symptoms of an allergic reaction, such as throat swelling and difficulty breathing.

Learn more about how to use an adrenaline autoinjector.

Treating related conditions

Food allergies can be related to other conditions such as eczema and asthma.

Keeping these related health conditions under control can lower the chance of your child developing allergies or experiencing a severe allergic reaction if they already have an allergy.

Oral immunotherapy

Immunotherapy works by gradually introducing the body to very small amounts of the allergen under strict medical supervision. This can help the body build tolerance to the allergen and lower the risk of an allergic reaction.

Immunotherapy can be useful and effective for some types of allergies, but it isn't yet routinely used to treat food allergies in Australia. Ask your child's doctor if immunotherapy could be an option for managing their allergies.

Living with food allergies

Having a child with a food allergy can be challenging, but being prepared can help:

• Always carry your child's adrenaline autoinjector (EpiPen or Anapen) with you — even if you don't expect that your child will be eating.
• Always carry safe food with you when travelling with your child.
• At home, always read food labels— allergens can be hidden. In Australia, common allergens must be listed on the food label.
• Take extra care when eating out. Don't rely on menu descriptions. Tell the wait staff about your child's allergy and ask about ingredients, preparation and cross-contamination risks.
• Give your child their own food for school and parties. Teach them not to share or swap food with other children.

What are the complications of food allergies?

If your child is exposed to a food they are allergic to, they may have a serious allergic reaction (anaphylaxis), which may be life-threatening.

Avoiding allergens is the safest way to prevent complications.

Can food allergies in children be prevented?

Children who have known allergies

The best way to prevent your child with food allergies from having an allergic reaction is to help them avoid the foods that they are allergic to. If someone else cares for your child, make sure they know about your child's food allergy and what to do if an allergic reaction happens.

Your child should have an ASCIA action plan.

You should also discuss with their day care centre or school ways to prevent accidental exposure to allergens. Staff should be trained to recognise and respond to an allergic reaction, including knowing where your child's adrenaline autoinjectors are kept and how to use them.

Baby weaning and allergy prevention

Avoiding or delaying the introduction of common allergy foods has not been shown to reduce the chance of your child developing a food allergy.

In fact, giving babies common allergy foods early (before their first birthday) can reduce their risk of developing food allergies. This is also true for children at higher risk of developing food allergy, such as those with asthma, eczema or a family history of food allergies.

Learn about introducing allergy foods to your baby.

Can my child outgrow food allergies?

Many children outgrow food allergies over time. This means that as your child grows up, they may stop being allergic to a particular food.

Your child is more likely to outgrow some allergies than others. For example, allergies to cow's milk, soy, wheat and egg are commonly outgrown by 5 years of age.

Allergies to peanuts, tree nuts, sesame seeds or seafood usually persist into adulthood, although around 1 in 4 children may outgrow them.

Resources and support

• The Royal Australian College of General Practitioners (RACGP) has a fact sheet on food allergies in babies.
• Allergy & Anaphylaxis Australia has a free book series to help children manage daily life with food allergies.
• Manage your child's food allergies and share their ASCIA action plan on the Allergy Pal app.
• Learn more about the science of allergies in this short video produced by Allergy & Anaphylaxis Australia.
• Allergy & Anaphylaxis Australia has tips for managing any anxiety you may feel due to your child's food allergy.
• Take part in an online training session on anaphylaxis and how to help people experiencing a severe allergic reaction, or recommend a training session to your child's school or day care centre.
• Help your teenager connect with other young people with food allergies via the Allergy 250K network.
• Watch a series of videos provided by the National Allergy Council to learn how to read food labels, handle and store food to reduce your child's allergy risk.
• Nip Allergies in the Bub has resources about introducing common allergy foods to babies in a variety of community languages.