Navigating Food Allergies and Intolerances in Children
Does your child have a food allergy or intolerance? You’re certainly not alone. In Australia, food allergies affect about 10% of infants and 4-8% of childrenⁱ. Food intolerances are even more common, with surveys suggesting they affect about 25% of all peopleⁱⁱ.
If your child has a disability or developmental delay, we know it can be challenging to manage issues around food and eating. Our dietetic experts explain more about food intolerances and food allergies, which are among the most common nutritional concerns in children. We’ll look at what food allergies and intolerances are, the signs and symptoms, and ways to help your child get the nutrition they need to thrive.
What’s the difference between a food allergy and a food intolerance?
The terms ‘food allergy’ and ‘food intolerance’ are often used together. However, they are not the same. Food allergies and food intolerances involve different processes in the body and have different implications for your child’s health.
About food allergies
A food allergy is an immune system reaction to a protein in food that is usually harmless. When your child eats a food they are allergic to, their immune system perceives it as a threat and reacts by releasing various chemicals. This immune response can cause a wide range of symptoms, ranging from mild to severe (more about food allergy symptoms below).
Common food allergies in children include:
- cow’s milk (although most children grow out of this allergy before they reach school age)
- peanuts and tree nuts
- fish and shellfish
Food allergies can be diagnosed by monitoring your child’s reactions to foods and using various tests. This must be done with guidance from a clinical immunology/allergy specialist. A dietitian is often also involved in the process.
About food intolerances
Food intolerance, on the other hand, does not involve the immune system. Food intolerance is a term used to describe a range of adverse reactions to eating certain foods. It occurs when the body has trouble processing or digesting a specific component of a food. Lactose intolerance, for example, is caused by difficulty breaking down lactose, a sugar found in milk. Other common substances found in food can trigger symptoms of intolerance in children. These include:
- salicylates – these natural, aspirin-like substances are found in some fruits, vegetables, herbs and spices.
- amines – which are found in a wide variety of foods, including chocolate, mature cheese and some fruits and vegetables.
- glutamates – such as monosodium glutamate (MSG) and natural glutamates found in some fruits and vegetables.
- some preservatives and artificial colours.
Unlike a food allergy, a food intolerance cannot cause a severe and potentially life-threatening allergic reaction (anaphylaxis). Your doctor or clinical dietitian can diagnose a food intolerance by assessing the relationship between diet and symptoms. It’s also important to rule out other potential causes of these symptoms.
Recognising signs of food allergies and intolerances in your child
Identifying the signs and symptoms of a food allergy or intolerance in your child is the first step towards managing their dietary needs effectively. These conditions can manifest in various ways, and not all children will exhibit the same symptoms. The severity of reactions can also vary from one child to another. It’s vital to see a qualified healthcare professional if you have any concerns about your child’s wellbeing. Here are some common signs of food allergy and intolerance to watch out for.
Food allergy symptoms
Food allergies typically cause rapid and more severe reactions, with symptoms appearing within minutes to a few hours after eating the allergenic food. Allergic reactions can affect various parts of the body. Symptoms of food allergy can include:
- skin reactions – such as hives (itchy, red welts on the skin) or eczema (a chronic, itchy rash).
- respiratory symptoms – such as runny nose, sneezing, coughing, or wheezing.
- gut issues – such as nausea, vomiting, diarrhoea, and abdominal pain.
- swelling – usually of the lips, tongue, or face. This is a concerning sign and should be treated as an emergency because it can lead to blockage of the main airway.
- anaphylaxis – in severe cases, food allergies can trigger a life-threatening allergic reaction known as anaphylaxis. Symptoms of anaphylaxis may include difficulty breathing, a drop in blood pressure, loss of consciousness, and a fast, weak pulse. Anaphylaxis is a medical emergency. The Australasian Society of Clinical Immunology and Allergy has a fact sheet about anaphylaxis and an action plan for dealing with it.
Food intolerance symptoms
Symptoms of food intolerances tend to be delayed and can appear several hours after eating the problematic food. The symptoms of food intolerance can affect various parts of the body and include:
Some children have an intolerance to substances commonly found in various foods.
- digestive discomfort – such as bloating, gas, abdominal pain, nausea, vomiting and diarrhoea.
- skin issues – some food intolerances can manifest as itching or a rash on the skin.
- headaches – food intolerances can trigger headaches or migraines.
- respiratory issues – such as sinus congestion or a runny nose.
- behaviour changes – children with certain intolerances may experience changes in behaviour such as hyperactivity, irritability or trouble concentrating.
- failure to thrive – if they are left unmanaged, severe food intolerances can lead to poor weight gain and growth in children. If you have any concerns about your child’s growth, see your healthcare professional for assessment and advice.
Managing food allergies and intolerances in children
Early intervention aims to give children the best possible start in life. In paediatric If you suspect your child may have a food allergy or intolerance, it’s essential to get guidance from a suitably qualified healthcare professional. Seeing your child’s doctor or paediatrician is a good place to start. Accurate diagnosis and management are vital to make sure your child gets all the nutrients they need for healthy growth and development.
Managing a food allergy or intolerance in a child usually involves the following strategies.
It’s possible to manage food allergies and intolerances while ensuring children get essential nutrients from their diet.
1. Identifying triggers
As yet, there are no reliable clinical tests for diagnosing food intolerance. If you suspect your child is intolerant of certain foods, it’s best to seek professional advice from an Accredited Practising Dietitian (APD) who works with children. They can place your child on a supervised elimination diet for a period of time. As different foods are gradually reintroduced, this can help to identify which foods are triggering symptoms and may need to be avoided.
2. Creating safe meal plans
Your paediatric dietitian can help you to:
- Understand food labels – under Australian law, if a packaged food contains substances that could trigger an allergic reaction, this must be clearly shown on the food label. Look for terms like ‘contains,’ ‘may contain,’ or ‘traces of’ to identify potential allergens in packaged foods.
- Cook safely at home – your APD can help you find healthy recipes that work for your whole family. They can also teach you how to prepare food in a way that minimises the risk of cross-contamination and accidental exposure to allergens.
- Find substitutes for different ingredients – as experts in food and nutrition, APDs have a wealth of knowledge about food. Whether your child has an allergy or intolerance to one food or several, they can help you find suitable alternatives.
- Plan safe school lunches and snacks – your APD can provide clear guidelines for safe snacks and lunches. They can also support you to inform your child’s caregivers or school about their dietary restrictions.
3. Follow up and support
For children with food allergies, it’s also important to have regular visits with their doctor and allergist or immunologist to ensure these are effectively managed.
Many people also find it helpful to join a support group, either in-person or online. Connecting with people who understand your situation can be incredibly helpful. Support groups, such as Allergy & Anaphylaxis Australia, offer valuable resources and support for families dealing with food allergies.
Expert support for children with a food allergy or intolerance
Children with disability, developmental delay or medical conditions often have unique dietary needs, including food allergies and intolerances.
At Active Ability, our experienced paediatric dietitians work specifically with children who have feeding or dietary issues related to autism, intellectual disability, neurological conditions and mental health issues.
Our caring paediatric dietitians work with young children and families through our early intervention services. We can provide tailored meal plans and personalised support to help ensure your child gets the nutrients they need without triggering allergy or intolerance symptoms.
We can also help you deal with any eating or mealtime behavioural issues.
[i] – https://www.allergy.org.au/patients/food-allergy/faqs. Available at https://www.allergy.org.au/patients/food-allergy/faqs. Accessed 1.11.2023.
[ii] – NSW Government Food Authority. Allergy and intolerance. No date. Available at https://www.foodauthority.nsw.gov.au/consumer/life-events-and-food/allergy-and-intolerance. Accessed 1.11.2023.
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