Know the signs

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

Yet pickiness has nothing to do with some kids’ refusal to eat certain dishes. According to Food Allergy Research and Education, about 1 out of every 13 children is allergic to at least one food. About 40 percent of those children have experienced severe, life-threatening reactions.

The big problem is that most parents have no idea if their children have food allergies until they try the food for the first time and have 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 signs of a food allergy.

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

The most common food allergy triggers in kids are:

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

Young children can’t always clearly explain their symptoms, so sometimes parents have to interpret what the 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.”

Some kids develop a severe allergic reaction, called anaphylaxis, in response to foods like peanuts or shellfish. If your child has trouble breathing or swallowing after eating something, call 911 right away for emergency medical help.

Signs of anaphylaxis include:

  • chest pain
  • confusion
  • fainting, unconsciousness
  • shortness of breath, wheezing
  • swelling of the lips, tongue, throat
  • trouble swallowing
  • turning blue
  • weak pulse

Kids with severe food allergies should have an epinephrine (adrenaline) auto-injector with them at all times in case they have a reaction. Both the child, and the people who care for them, should learn how to use the injector.

Reacting to a particular food doesn’t necessarily mean your child has a food allergy. Some kids are intolerant to certain foods. The difference is that a food allergy involves the child’s immune system, while food intolerance is usually based in the digestive system. Food intolerance is much more common than food allergy.

Food allergies tend to be more dangerous. The child will usually need to avoid the offending food entirely. Food intolerance often isn’t as serious. The child may be able to eat small amounts of the substance.

Examples of food intolerances include:

  • Lactose intolerance: This occurs when the child’s body lacks the enzyme needed to break down the sugar in milk. Lactose intolerance can cause symptoms like gas, bloating, and diarrhea.
  • Gluten sensitivity: This occurs when the child’s body reacts to a protein called gluten in grains like wheat. Symptoms include headache, upset stomach, and bloating. Although celiac disease — the most severe form of gluten sensitivity — does involve the immune system, its symptoms are usually centered in the gut. Celiac disease can affect other systems of the body but doesn’t cause anaphylaxis.
  • Sensitivity to food additives: This occurs when a child’s body reacts to dyes, chemicals like 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.

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

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

If you suspect your child has a food allergy, see your pediatrician or an allergist. The doctor can identify which food is causing the problem and help you develop a treatment plan. Your child may need medicines like antihistamines to treat the symptoms.