Abstract

True food allergies are much less prevalent than is generally believed. They are more common in infants and children under age three than in older children and adults. Infant colic generally is not caused by a food allergy. In infants, urticaria, eczema or gastrointestinal bleeding may be due to foods such as milk and eggs, but clinical tolerance usually develops within a few years. Peanuts, tree nuts, seafood and seeds, as well as milk and eggs, can cause anaphylaxis in highly allergic children, and reexposure to such foods presents the risk of life-threatening reactions. Immediate-reacting allergy skin tests and in vitro IgE antibody tests can be used to screen for food allergy. Only food challenge, however, can confirm a reaction to a particular food. Management of food allergy, once the initial symptoms are confirmed, consists of avoidance of specific foods, sometimes for a lifetime. All children at risk for food anaphylaxis should be identified, and their parents or caretakers should be prepared to administer epinephrine before taking the child to the emergency room.