Food allergy signs and symptoms vary but may include wheezing, vomiting, and diarrhea. Reactions may be immediate or delayed, though immediate reactions are more common.

Every parent knows that kids can be picky eaters, especially when it comes to nutritious foods such as broccoli and spinach.

But pickiness has nothing to do with some kids’ refusal to eat certain dishes. According to the Centers for Disease Control and Prevention (CDC), about 1 of every 13 children has an allergy to at least one food.

A food allergy is serious and can be potentially life threatening. According to a 2018 study, 40% of children who have a food allergy have experienced severe reactions requiring treatment in the emergency department. Many foods can cause allergic reactions.

An allergic reaction may be mild, causing hives or minor abdominal pain. But it may sometimes lead to serious negative health effects, including anaphylaxis — a severe reaction in which your body goes into shock and loss of consciousness is possible.

A true food allergy can affect your child’s breathing, intestinal tract, heart, and skin. A child with a food allergy will develop one or more of the following symptoms within a few minutes to an hour after eating the food:

  • congestion or runny nose
  • cough
  • diarrhea
  • dizziness or lightheadedness
  • itching around their mouth or ears
  • nausea
  • red, itchy bumps on their skin (hives)
  • a red, itchy rash (eczema)
  • shortness of breath or trouble breathing
  • sneezing
  • stomach pain
  • a strange taste in their mouth
  • swelling of their lips, tongue, and/or face
  • vomiting
  • wheezing

Young children can’t always clearly explain their symptoms, so you may sometimes have to interpret what your child is feeling. Your child might be having an allergic reaction if they say something like:

  • “There’s something stuck in my throat.”
  • “My tongue is too big.”
  • “My mouth itches.”
  • “Everything is spinning.”

Most parents have no idea that their child has a food allergy until the child tries a food for the first time and has a reaction. That’s why it’s important for parents — as well as teachers, babysitters, and everyone else who spends time with the child — to be alert for symptoms of a food allergy.

A food allergy happens when your immune system has a specific response to a certain food or foods. Instead of protecting your body, as it typically would, your immune system reacts as though it’s in danger because of a harmless food protein or allergen.

It’s unclear what causes food allergy in kids, though family history may play a role.

There’s no cure for food allergies. Avoiding the food that causes the allergic reaction is the only way to prevent a reaction.

When a child has a food allergy, their immune system overreacts, producing antibodies to the food as if it were a virus or another dangerous foreign invader. This immune reaction produces allergy symptoms.

The most common food allergy triggers in kids are:

Some kids develop anaphylaxis in response to foods such as peanuts or shellfish. If your child has trouble breathing or swallowing after eating something, call 911 right away for emergency medical help.

Symptoms of anaphylaxis include:

  • chest pain
  • confusion
  • fainting or loss of consciousness
  • shortness of breath or wheezing
  • swelling of their lips, tongue, or throat
  • trouble swallowing
  • skin turning blue
  • a weak pulse

Caregivers of any child who has a known food allergy should ask the child’s allergist whether they should have an epinephrine auto-injector. If the allergy is serious enough to warrant the use of an auto-injector, both the child and their caregivers should learn how to use it.

Even if your child has a reaction to a particular food, it doesn’t necessarily mean they have a food allergy. Some kids have intolerances to certain foods. The difference is that a food allergy involves the immune system, while a food intolerance is usually based in the digestive system.

Food intolerance is more common than food allergy, occurring in roughly 20% of the population.

Food allergies, which can cause anaphylaxis, are far more dangerous than food intolerances. A child with a food allergy will usually need to avoid the offending food entirely. But in the case of a food intolerance, the child may be able to eat small amounts of the food without experiencing any symptoms.

Examples of food intolerance

The following sections describe some types of food intolerance.

Lactose intolerance

Lactose intolerance happens when your body lacks the enzyme needed to break down lactose, the sugar in milk. It can cause symptoms such as gas, bloating, and diarrhea.

Gluten sensitivity

Gluten sensitivity happens when your body reacts to a protein called gluten, which is found in some grains, including wheat. Symptoms include headache, upset stomach, and bloating.

Although celiac disease — the most severe form of gluten sensitivity — does involve your immune system, its symptoms are usually centered in your gut. Celiac disease can affect other systems of your body but doesn’t cause anaphylaxis.

Sensitivity to food additives

This happens when your body reacts to dyes, chemicals such as sulfites, or other additives in foods. Symptoms include rash, nausea, and diarrhea. Sulfites can sometimes trigger an asthma attack in someone who has asthma and is sensitive to them.

How to tell the difference

Because the symptoms of a food intolerance are sometimes similar to those of a food allergy, it can be hard for parents to tell them apart. Here’s a guide to distinguishing a food allergy from an intolerance:

SymptomFood intoleranceFood allergy
bloating or gasX
chest painX
itchy skinX
rash or hivesX
shortness of breathX
swelling of the lips, tongue, or airwaysX
stomach painXX

While there is currently no cure for food allergy, there are treatments that can reduce the risk of anaphylaxis when children consume small amounts of foods that cause allergic reactions.

In addition, there is some recent research to support giving allergenic foods to infants to try to decrease the incidence of food allergy. Researchers believe that if this approach became standardized, it could help reduce the overall prevalence of food allergy.

Talk with your child’s allergist to develop a plan for dining in restaurants and other places where you’re not preparing the food.

A food allergy does not mean you have to give up on enjoying restaurant meals. Waitstaff at many restaurants ask whether anyone at the table has any food allergies or dietary restrictions while taking the order. This is a good opportunity to explain your child’s food allergy.

Communication is important. You might want to call the restaurant in advance to ensure that they have menu items that are safe for your child to eat. It’s also a good idea to talk with a manager when you arrive, even if you’ve called in advance.

You can also explain that cross contamination must be avoided for your child’s safety. However, a restaurant may be unable (or unwilling) to guarantee this. In that situation, you may want to choose a restaurant that does not use the allergen at all.

Another possible strategy is to present an allergy card, often called a chef card, before or after you are seated. This card should clearly state the foods that should be avoided.

If you notice that your child gets hives after eating certain foods or regularly experiences itching after eating specific items, make an appointment with a healthcare professional. They may suggest an allergy medication and advise you to avoid the food.

If the symptoms persist or worsen and your child isn’t responding to the allergy medication, a healthcare professional may refer you to an allergist. In addition to taking your child’s history, the specialist may order skin-prick tests, patch tests, or blood tests to find out whether your child has an allergy.

They may also recommend trying an elimination diet to find the cause of the allergy.

If your child has a food allergy and carries an epinephrine auto-injector, use it immediately if they experience throat tightness or difficulty breathing. Hives with vomiting is another indication to use the epinephrine auto-injector or call 911.

If you suspect that your child has a food allergy, contact a pediatrician or an allergist. A healthcare professional can identify the food that is causing the problem and help you develop a treatment plan.

Your child may need medications such as antihistamines to treat the symptoms.