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FOOD ALLERGY TESTING

By: Debbie Taback   |   August 11, 2022

Roughly 32 million Americans have food allergies, 5.6 million of whom are children under age 18. That’s one in 13 children, or about two in every classroom. With such a high prevalence, many parents are understandably concerned about signs of food allergies yet confused about how to test for food allergies.

Debbie Chizever Taback, a co-founder at Latitude Food Allergy Care who has also managed her own family’s food allergies for more than 15 years, helps unravel common questions about food allergies.

 

What food allergies are the most concerning?

While over 170 foods have been reported to cause allergic reactions, in the U.S. nine allergens are responsible for most of the serious reactions. These include milk, egg, peanut, tree nuts, wheat, soy, fish, shellfish, and sesame.

While allergies to milk, egg, wheat, and soy are often outgrown during childhood, allergies to peanuts, tree nuts, fish, and shellfish are considered lifelong unless they are proactively treated.

What signs should parents look for?

Symptoms of an allergic reaction to food can range from mild (itchy mouth, a few hives) to severe and life-threatening (throat tightening, difficulty breathing and anaphylaxis). 

Children have their own way of expressing themselves, and that includes the physical signs of an allergic reaction. Learning how to recognize the signs of food allergy in children can help you react immediately during an allergic reaction, minimizing time to get emergency care. The food allergy advocacy non-profit FARE lists the most common physical signs of a food allergy reaction in children:

• Scratching or pulling at their tongues
•  Slurring their words
• Change in voice (e.g., they may sound squeaky or hoarse)

Just as their bodies have unique signs of an allergic reaction, children have equally unique ways of talking about it. The list below from FARE includes some phrases a child may use when experiencing an allergic reaction:

• “This food is too spicy.”
• “My tongue [or mouth] is hot [or burning, tingling, itching].”
• “It feels like something’s poking my tongue.”
• “My tongue feels full [or heavy, funny].”
• “There’s something stuck in my throat.”
• “My lips feel tight.”
• “It feels like there are bugs in there [itchy ears].”
• “My skin feels itchy.”
• “My chest is tight.”
• “My stomach hurts.”

If your child uses these types of phrases after eating, they may have a food allergy. In some cases, a child who is in the midst of an allergic reaction may only describe it as, “Something is wrong,” or “Something bad is happening.” If your child is exhibiting any severe symptoms (such as wheezing, dizziness, or severe swelling), seek help immediately, use epinephrine and call 911.

How do you test for food allergies?

If you suspect that your child has a food allergy, it's important to seek out an accurate diagnosis from a board certified allergist. The testing process can include blood testing, skin testing and oral food challenges, a highly monitored process of introducing the food in an allergist’s office.

While preventing anaphylaxis is obviously an important focus of food allergy testing, the process can also help you:

• Gain a deeper understanding of your child’s health and how to manage it
• Know what foods to avoid and what foods can be safely consumed
• Increase overall quality of life by removing unnecessary dietary restrictions
• Decrease stress or anxiety over accidental exposure

My child has eczema. Is this a food allergy reaction? 

A very common question for parents is regarding the correlation of eczema and food allergies. While some eczema can be related to food, not all children with eczema have food allergy and not all children with food allergy have eczema. There is evidence that babies with eczema may develop food allergy because they're exposed to an allergenic food through a dysfunctional skin barrier, triggering a process that sensitizes the body to that food. For infants with moderate or severe eczema in particular, you can consider evaluation with an allergist before early introduction of potentially allergenic foods.

 

My child has been diagnosed with a food allergy, what are my next steps?

In addition to building a support network for your family, including a knowledgeable food allergy specialist, our team often recommends these steps:

• Do not unnecessarily avoid safe foods, work to incorporate all of the foods that an allergist has assured you are safe into your child’s diet. Diversity of diet at a young age is important.
• Always carry two auto-injectable epinephrine (EpiPen, AuviQ, etc) doses at all times. Ensure that all caregivers have access to epinephrine and that they understand your family’s emergency action plan.
• Consider desensitizing a child to their allergens with oral immunotherapy (OIT), potentially reducing the risk of reaction to accidental exposures.
• It’s important to recognize that managing a food allergy can be stressful not only for the person with the allergy, but also for the whole family. Taking proactive steps— including testing and treatment with OIT—can help a family take control of food allergies. 

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