Food allergies in children

Immediate (IgE) allergy

Symptoms usually begin within minutes to two hours of eating: hives, swelling of the lips, face or eyes, vomiting, sudden abdominal pain, or a runny nose and sneezing. The commonest triggers in UK children are milk, egg, peanut, tree nuts, soya, wheat, fish and sesame.

Anaphylaxis - call 999

• Difficulty breathing, wheeze, or noisy breathing.
• Swelling of the tongue or throat, or a hoarse voice.
• Persistent cough or difficulty swallowing.
• Pale, floppy, dizzy or collapsing.
• Use an adrenaline auto-injector immediately if prescribed, then call 999 and lie the child flat with legs raised.

Delayed reactions and intolerance

Delayed, non-IgE reactions cause reflux, loose stools, blood or mucus in the stool, poor weight gain and worsening eczema over hours to days. Lactose intolerance causes bloating, wind and diarrhoea without any immune involvement. Neither is diagnosed by high-street IgG testing, hair analysis or applied kinesiology - these are not valid tests.

Getting a diagnosis

Diagnosis relies on a careful history, supported where appropriate by skin prick or specific IgE blood testing, and sometimes a supervised food challenge. Never exclude a major food group long term without dietetic support - unnecessary exclusion damages growth and can make future reactions more likely.