Food allergy is a common problem, affecting up to 5% of children.  Many food allergic reactions in children are mild and many children outgrow their food allergies with time.  A small range of foods are responsible for most food allergic reactions some of which have a good chance of going away with time (e.g. milk, egg, wheat, soy) and some of which are more likely to persist into adulthood (e.g. peanut/nut and fish/shellfish).  

 Food allergic reactions can cause a variety of signs and symptoms, including:

• Skin – rash, itching, redness, swelling
• Gut – tummy pain, vomiting, diarrhoea
• Respiratory tract – runny nose, sneezing, shortness of breath, cough, wheeze
• Cardiovascular system – faintness, collapse.

A severe food allergic reaction or anaphylaxis will result in difficult/noisy breathing, swelling of tongue, swelling/tightness in throat, difficulty talking/hoarse voice, wheeze or persistent cough, dizziness (loss of consciousness and/or collapse), and becoming pale and floppy in young children.  Anaphylaxis is a medical emergency – an anaphylaxis plan should be followed if there is one available and an ambulance called.  

Most often the cause of a food allergic reaction is apparent as there is prompt reaction after ingestion of a new food.  Allergy tests (skin tests or blood tests for specific IgE) will generally be done to confirm the cause of a food allergic reaction.  Ongoing management involves avoidance of the food in question, with follow up to determine whether an allergy has resolved.  All patients with food allergy should have a plan for management of any further reactions.  In the longer term food challenge may be needed to determine if a food allergy has resolved.