Managing a Severe Food Allergy

Medically Reviewed by Dan Brennan, MD on March 05, 2017
4 min read

Managing a child's food allergy sounds simple: Just avoid the trigger food. As any parent knows, that can be a challenge. Knowing how to prevent and handle a severe reaction can help you both feel more confident.

An allergic reaction happens when the body's immune system thinks something in a food (usually a protein) is harmful. Children are most likely to be allergic to peanuts and cow's milk. But they can also be allergic to:

  • Eggs
  • Fish
  • Shellfish
  • Tree Nuts
  • Wheat
  • Soy

Allergies to peanuts, tree nuts, fish, and shellfish are usually the most severe and last a lifetime. Your child may outgrow other food allergies.

Your child is likely to have a reaction within a few minutes to an hour after eating a problem food. Symptom of a mild allergy include:

Symptoms of a severe allergy can include those listed above, as well as:

  • Swelling of the lips, tongue, or throat
  • Trouble swallowing or breathing because of throat swelling
  • Shortness of breath or wheezing
  • Drop in blood pressure, causing dizziness and lightheadedness
  • Loss of consciousness
  • Chest pain

The most dangerous reaction, anaphylaxis, is a medical emergency. When it happens, the throat swells, preventing breathing or swallowing. The heart rate rises as blood pressure drops. If not treated, anaphylaxis can be fatal.

Your child's doctor can create a food allergy and anaphylaxis emergency care plan. This helps everyone in your child's life know how to spot a reaction and what to do.

The doctor will likely prescribe an epinephrine auto-injector. Learn how to use it, and keep two doses with your child at all times. Use the injector at the first sign of a reaction, even if the reaction may not appear allergy related. It cannot harm him and could save his life. If you suspect anaphylaxis, call 911.

Get your child a medical ID bracelet or necklace to wear.

The best way to prevent a reaction is to avoid problem foods. But allergy triggers can hide in packaged foods. To be safe:

Read the label. Even trace amounts can do harm. Reading food labels is one of the “most important thing you can do to keep your child safe," says Lynda Mitchell, vice president of the Asthma and Allergy Foundation of America and founder of its Kids With Food Allergies division.

By law, labels must plainly state if a product contains a common allergy trigger. Sometimes, the food is listed in parentheses after the ingredient -- for example, "whey (milk)." Other times, you can find it in a separate statement. For example: "Contains: wheat, milk, soy."

Avoid cross contact. Unsafe foods or food particles may touch a safe food in kitchens or processing plants. Dust from peanuts can drift onto candy bars without nuts if a candy maker isn’t careful. Food labels don't have to state if the item was processed near or with the same equipment as a common allergen.

"At home, the classic example of cross–contact is using the peanut butter knife in the jelly jar," Mitchell says. Countertops and hands also spread allergens. Keep the kitchen clean, and wash hands with soap and water -- not hand-sanitizer.

Cross-contact can happen at school, concession stands, summer camps, or in restaurants. It's especially common in restaurants that serve seafood or nuts, says Thomas Prescott Atkinson, MD, PhD. Most allergic reactions happen away from home.

Work with your child's school or summer camp to make sure he is not exposed to unsafe foods. When eating out, ask to talk to the restaurant manager about its cooking and cleaning methods. Work with your child's school or summer camp to keep him safe. When eating out, ask about the restaurant's cooking and cleaning methods. "Talk to the manager, not the waiter," Mitchell suggests.

Teach your child to ask questions, too. As he gets older, he can take charge of his own safety.

Cutting out problem foods can create other problems, like poor nutrition. Talk to your child's allergy doctor before taking healthy foods out of her diet. For example, milk, the most common childhood food allergen, helps your child grow. "An allergist can give you a list of alternative foods such as soy milk, orange juice with calcium, or vitamin D supplements," Atkinson says.

The doctor or a nutritionist can help you find the best ways to get her the nutrients she needs. Some kids may need special vitamins or supplements.

A severe food allergy affects the whole family. But it doesn't have to make anyone's life less full and active. "Your carefree, drive-through lifestyle will have to change," Mitchell says, "but once you learn to manage it, life starts to normalize again."