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Food allergy Q&As

Published by Bupa's health information team, September 2008.

Answers to questions about food allergy

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

How can I prevent my child from developing food allergies and will they grow out of them?

There are no proven ways to predict whether your child will have food allergies or to prevent your baby from developing them. However, a child born into a family with a history of allergies is more likely to develop food allergies than a child with no family history.

Explanation

Food allergies are more common in children than in adults. In most cases, a food allergy won't continue into adulthood but will disappear altogether or will be replaced by a different kind of allergy (such as an allergy to pollen, dust mites etc). The most common food allergies in children are to peanuts and tree nuts (such as Brazil nuts, hazelnuts and walnuts), cows' milk, hens' eggs, wheat, fish and soya.

Pregnancy and breastfeeding

If you're pregnant or breastfeeding and are on a restricted diet because of a severe food allergy, you should check with your dietitian that you're getting all of the nutrients you need to stay healthy while pregnant or breastfeeding.

Babies are, to a certain extent, exposed to the foods eaten by their mothers when in the womb and during breastfeeding. The British Nutrition Foundation recommends that women who are pregnant and breastfeeding shouldn't eat peanuts or peanut-containing foods if there is a close family history (mother, father or siblings) of allergies such as food allergy, asthma, eczema or hay fever. If there is no family history of allergy, there is no need to prevent exposure to peanuts in babies, in fact some researchers believe, preventing a child from eating peanuts may put him/her at greater risk of developing an allergy. This is because if babies are exposed to tiny quantities of peanut during pregnancy and breastfeeding, it may help them to tolerate peanuts in the future. Research into this area is ongoing.

It has been shown that breast-fed babies are less likely to develop allergies or eczema than bottle-fed babies. In the UK, it's recommended that babies are exclusively breastfed for the first six months of life. Breast-fed babies receive all the nutrients they need from their mother's milk, together with hormones and growth factors to help them develop, and antibodies which help protect them from infections.

Weaning

Talk to your health visitor about how and when to start introducing solid foods into your baby's diet (weaning). Usually, weaning isn't advised until a baby is six months old. When weaning your baby from breast or infant milk to solid foods, you should introduce new foods gradually. It's best to introduce foods one at a time and watch your baby's response carefully - keeping a food diary may help identify which foods are liked or disliked by your baby, and which foods cause any sort of reaction.

If you have a family history of allergy to a particular food, you should talk to your doctor or dietitian before introducing it to your baby. The Department of Health recommends that children with parents or siblings who have allergies shouldn't be given peanuts or foods containing peanuts until they are at least three years old. As with pregnancy and breastfeeding, if there is no family history of allergy, there is no need to stop young children eating peanuts, although you shouldn't let children under the age of five eat whole peanuts (or other types of nuts) in case they choke.

You shouldn't give wheat, rye or barley-based foods to babies younger than six months if there is someone in their family who can't eat foods containing gluten (ie they have coeliac disease).

Older children

Many children grow out of their food allergies by the time they are six or seven. However, some allergies (including fish and peanut allergies) are likely to continue into adulthood. If your child has been diagnosed with a food allergy at an early age and is under the care of an allergy specialist, it may be worth asking about having him/her re-tested in case his/her allergy has resolved.

Further information

Sources

  • Bischoff SC. Food allergies. Curr Gastroenterol Rep 2006; 8:374-382. www.current-reports.com
  • Adverse reactions to food and food ingredients. Committee on toxicity of chemical in food, consumer products and the environment, 2002, Section 2.27. www.food.gov.uk
  • Maternal and infant nutrition. British Nutrition Foundation. www.nutrition.org.uk, accessed 29 April 2008
  • Breastfeeding your baby. Food Standards Agency. www.eatwell.gov.uk, accessed 29 April 2008
  • Feeding your baby. DirectGov. www.direct.gov.uk, accessed 29 April 2008
  • Weaning your baby. Food Standards Agency. www.eatwell.gov.uk, accessed 29 April 2008
  • Key messages for midwives and health visitors. The Anaphylaxis Campaign. www.anaphylaxis.org.uk, accessed 29 April 2008
  • Peanut allergy. Committee on toxicity of chemicals in food, consumer products and the environment. Department of Health, 1998. www.dh.gov.uk, accessed 29 April 2008
  • Kovich H, Huntington J, Safranek S et al. Clinical inquiries. Does the age you introduce food to an infant affect allergies later? J Fam Pract 2007; 56:749-750. www.jfponline.com
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I have just been diagnosed with a peanut allergy - what precautions should I take with my meals?

After diagnosis of any food allergy, it's important to get as much information as possible about how you can identify the problem food and what you should do if you're accidentally exposed to it.

Explanation

Ask your GP or allergy specialist to refer you to a dietitian who will show you how to identify problem foods and how to ensure you have a healthy, well-balanced diet without them.

Since November 2005, it has been the law in the UK and European Union that every pre-packed food must be clearly labelled to show whether they contain certain foods (or if one of its ingredients is made from, or contains one of these foods). Peanuts and tree nuts (including macadamia and Brazil nuts, pecans, cashews, pistachios, almonds, hazelnuts and walnuts) are among the foods which must be clearly labelled in this way.

Whenever you buy a pre-packed food, always check the label first, even if you have bought the product before - the recipe or method of manufacture might have changed since you last bought it. If you buy your groceries online, detailed product information and ingredient lists may not be available on the website - always check the labels of the products you have bought when they are delivered.

It's much more difficult to make sure that foods which aren't pre-packed don't contain peanuts or other problem foods. Examples of these are the foods that you might buy from sandwich shops, deli counters, salad bars, butchers, bakers or anywhere that food is weighed and sold loose. These foods won't have detailed ingredient and allergy labelling, and are also at increased risk of cross-contamination from foods which do contain peanuts or other problem foods. It may be safer, particularly if you have a severe allergy, never to buy foods which aren't pre-packed.

Eating out

If you're invited for a meal prepared by friends or family, make sure they are aware of your food allergy and which foods you can't eat. Ask them to check the ingredients they use with you. If appropriate, take your own food with you.

Before booking a table at a restaurant, it's important to inform them of your allergy and make sure that they can provide you with a meal that won't give you problems. When you arrive at the restaurant, tell the waiter, waitress and chef about your allergy and make sure they appreciate how serious it is. Don't rely on the menu for accurate descriptions of the dishes - nuts may be present in the food but not as a main ingredient and therefore may not be mentioned on the menu. Before ordering any food, carefully check the ingredients with the waiter or waitress and ask them to double-check with the chef - preferably, you should speak to the chef yourself. If there is any doubt as to the suitability of a particular dish, don't order it.

Particular dishes to watch out for in restaurants are listed below.

  • Malaysian, Chinese and Indian dishes - these often contain nuts or are cooked using nut oils.
  • Salads - these can be garnished with nuts or dressed with nut oils.
  • Desserts - nuts are often used as garnishes or may be present in the form of ground almonds or in the dessert base where they aren't immediately obvious.
  • Food in self-service areas - these are at risk from cross-contamination (as in non pre-packed foods).

Before travelling and eating abroad, it's a good idea to learn how to tell people about your food allergy, learn the words to look out for on menus and become familiar with local dishes which contain nuts. You can get translation cards in many different languages which will help you.

Medicines

It's important to check the ingredient lists of any medicines you take, whether this is off-the-shelf or over the counter from a pharmacy, or if it's a prescribed medicine. Your pharmacist can contact the manufacturer of your medicine to check whether the medicine contains peanuts (often as peanut oil), or if they are used in the manufacturing process.

Emergency treatment

If you have a severe allergy, you will probably have been prescribed an adrenaline pen (EpiPen) to use in case of accidental exposure to your problem food. Always have two adrenaline pens with you and check them regularly to make sure they are within their expiry dates. It's very important that you're comfortable with using your adrenaline pen and are confident that you will be able to do so in an emergency. If you have any concerns about using your adrenaline pen, discuss them with your doctor and ask for more training on how to use it. If you ever have to use your adrenaline pen, it's vital that you seek medical attention immediately afterwards.

Make sure your friends, family and work colleagues are aware of your allergy and know what to do in an emergency.

If you need any further information about your food allergy, talk to your GP or allergy specialist.

Further information

Sources

  • Food allergy: how to avoid certain foods. Food Standards Agency. www.food.gov.uk
  • Common food allergens: peanut and tree nut allergy. The Anaphylaxis Campaign. www.anaphylaxis.org.uk, accessed 30 April 2008
  • Food allergy and food intolerance tips. Allergy UK. www.allergyuk.org, accessed 30 April 2008
  • Translation cards. Allergy UK. www.allergyuk.org, accessed 11 July 2008
  • Peanut oil: your questions answered. The Anaphylaxis Campaign. www.anaphylaxis.org.uk, accessed 30 April 2008
  • Eat well, be well - Allergic reactions to foods. Food Standards Agency. www.eatwell.gov.uk, accessed 30 April 2008
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I ate shellfish at a restaurant last night and have been sick and have a rash on my skin - is this a food allergy?

Food allergy and food poisoning can often result in very similar symptoms and it can be difficult to decide which of these conditions is causing the symptoms.

Explanation

Diarrhoea, feeling sick, vomiting and gastrointestinal discomfort can all be symptoms of both food allergy and food poisoning. However, there are some symptoms which you often get in food poisoning but not in food allergy and vice versa.

The common symptoms of food poisoning include diarrhoea, feeling sick, vomiting, abdominal cramping, pain, bloating and fever.

The common symptoms of food allergy are diarrhoea, feeling sick, vomiting and bloating, but you may also, or instead, have coughing and wheezing, runny nose, sore, red and itchy eyes, itching and/or swelling of your lips, mouth, tongue and throat, skin reactions (swelling, itching, rash, eczema), fainting and collapse.

These symptoms may also be caused by problems other than food allergy or food poisoning. Your GP is the best person to advise you as to whether you have a food allergy, food poisoning or another condition and what treatment you need.

In addition to thinking about the types of symptoms you're experiencing, consider the following points.

  • If you have had similar symptoms with this type of food before, it's possible that you may have a food allergy or an intolerance to this type of food.
  • If you have a history of allergic disease, or someone in your close family does, you're more likely to have allergies.
  • If other people eating the same food have had similar symptoms, this suggests that there was a problem with the food itself. Contact the restaurant and/or your local environmental health department (through your local council office) to find out if they have had any other similar reports.

Further information

Sources

  • Eat well, be well - Allergic reactions to food. Food Standards Agency. www.eatwell.gov.uk, accessed 22 April 2008
  • Food poisoning fact file. Foodlink. www.foodlink.org.uk, accessed 18 April 2008
  • Bischoff SC. Food allergies. Curr Gastroenterol Rep 2006; 8:374-382. www.current-reports.com
  • Eat well, be well - Food poisoning. Food Standards Agency. www.eatwell.gov.uk, accessed 30 April 2008
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Related topics

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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: September 2008

 

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