Food allergy and hypersensitivity in children
EBM Guidelines
Jul 8, 2021 • Latest change Feb 11, 2022
Table of contents
Extract
- Food hypersensitivity refers to both food allergy and food intolerance. See picture 1.
- Rapidly developing urticaria and angio-oedema are common symptoms of food allergy. It is typical that the symptoms recur or persist and that they are clearly associated with eating.
- Atopic eczema should be distinguished from food allergy. Mild eczema is rarely associated with food allergy, but in an infant with severe eczema foodstuffs may aggravate the eczema.
- Suspected food allergy is at least 6 times more common than food allergy confirmed by challenge testing.
- Reddening of the skin, baby reflux, loose stools or stools of different colours, excessive crying and restlessness often occur in infancy. These are common, benign and transient symptoms, and an underlying food allergy is often suspected as the cause.
- The assessment concerning nutritionally essential foods (milk, cereals) is performed by a specialist. Elimination trials with foods that only cause mild symptoms and that are easy to avoid (e.g. strawberry, tomato, citrus fruit) can be carried out at home under guidance from health care personnel. If the child has difficult cutaneous or gastrointestinal symptoms or if respiratory symptoms or anaphylaxis is suspected, he/she is referred to a specialist.
- An elimination diet started in infancy should either be timely stopped (at the age of 2 to 4 years in most cases) or proper grounds must be given for its continuation.
- Dietary requirements in children starting school are checked by the school nurse. A special diet is only indicated if there have been significant symptoms of food allergy in a fresh challenge test.
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Linked evidence summaries
- Maternal dietary antigen avoidance during pregnancy may not affect the incidence of atopic diseases in the infant during the first 18 months of life, and may have an adverse effect on maternal and foetal nutrition.C
- There is insufficient evidence from randomized trials on the preventive effect of maternal antigen avoidance diet during lactation in reducing the child apos;s risk of developing atopic eczema.D
Search terms
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