Introduction

Allergic reactions to different fruits and vegetables can develop in children at any age. Some allergies can start during the teenage years after developing hay fever.

Certain fruit and vegetable families are more likely to cause allergic reactions. These can include:

Rosaceae

  • apples
  • pears
  • cherries
  • peaches
  • plums
  • strawberries.

Cucurbitaceae

  • cucumbers
  • melons - including watermelon and rockmelon or cantaloupe
  • zucchinis
  • pumpkins.

Kiwifruit, bananas, and plantains are also common allergens.

Like any other allergy, it is important to talk to your child’s doctor before reintroducing foods that have caused an allergic reaction.

 Signs and symptoms

Allergic reactions can be fast and happen within minutes of exposure to certain fruits or vegetables.

Reactions can include:

  • hives or welts on the skin
  • redness of the skin
  • vomiting and stomach ache
  • tingling and swelling of the mouth, lips, face, and eyes.

Some children can have a more severe allergic reaction called anaphylaxis.

Signs of anaphylaxis include: 

  • wheezing, difficult, or noisy breathing 
  • swelling of the tongue
  • swelling or tightness in the throat
  • a persistent cough
  • difficulty talking or a hoarse voice
  • dizziness
  • becoming pale and floppy in young children
  • collapsing.

If your child has signs of anaphylaxis, you should:

  • follow your child’s ASCIA action plan for anaphylaxis if you have one
  • use an EpiPen® or Anapen®, if there is one available
  • call Triple Zero (000) for an ambulance.

Symptoms of a delayed reaction can include:

See your local doctor as soon as possible if your child is showing signs of an allergic reaction for the first time. 

Symptoms of mild allergic reactions should fade over time. See your local doctor as soon as possible if symptoms do not get better or you are concerned.

Diagnosis

If you think your child has had an allergic reaction that is not anaphylaxis, write down the following and see your local doctor as soon as possible:

  • time the fruit or vegetable was eaten
  • the amount that was eaten
  • time of reaction
  • type of reaction.

A specialist doctor can diagnose a fruit or vegetable allergy based on your child’s:

Some children will grow out of their allergy. 

A food challenge can be done to figure out whether your child has grown out of their allergy and whether certain fruits and vegetables can be reintroduced to their diet safely. Food challenges are done under the supervision of a doctor in the hospital. 

Treatment

Your child's doctor will find the best possible treatment for their allergy based on their individual health needs. 

In most cases, your child must carefully avoid specific fruits and vegetables. Children at risk of anaphylaxis need: 

  • an ASCIA action plan 
  • an adrenaline injector, also known as an EpiPen® or Anapen®.

Your child will also need to learn how to identify foods that contain specific fruits and vegetables as they get older and become more independent with their diet.

 Management

Other reactions to fruit and vegetables

Perioral contact dermatitis

Some children can develop a rash around the mouth after eating acidic foods like:

  • oranges
  • tomatoes
  • strawberries.

This is a common reaction called perioral contact dermatitis. Perioral contact dermatitis does not mean you need to remove a particular food from your child's diet. 

Oral allergy syndrome (OAS) 

Some children may develop symptoms like swelling, tingling and redness around the mouth and tongue after eating certain raw fruits and vegetables. 

This is called oral allergy syndrome (OAS). It is common in children who have: 

  • asthma
  • hay fever
  • pollen allergies.

OAS is also known as Pollen Food Syndrome (PFS).  Symptoms of OAS or PFS can occur at any time of the year but can be worse in the months when more pollen is in the air. This is spring and summer in most states and territories.

OAS or PFS happens when the immune system confuses proteins in fruit, vegetables, or nuts for the proteins found in pollen.

Pollens found in foods that trigger OAS or PFS include:

  • birch pollen: apple, almond, carrot, celery, cherry, hazelnut, kiwifruit, peach, pear, plum
  • grass pollen: celery, melons, oranges, peaches, tomato, peanut
  • ragweed pollen: banana, cucumber, melons, sunflower seeds, zucchini

In some children, allergies to pollen, fruits and latex happen together.

Latex allergy

Children with latex allergies are more likely to have an allergy to fruits and plants, including:

  • banana
  • avocado
  • chestnut
  • papaya
  • passionfruit
  • fig
  • melon
  • kiwifruit
  • pineapple
  • peach
  • tomato.

These foods do not always need to be avoided if your child has a latex allergy unless they cause a severe reaction.

In some children, allergies to pollen, fruits and latex happen together.

Allergens, food labels and eating out

It is important to always check the package and ingredient list of all foods your child eats.

In Australia, allergens are shown in bold each time they appear in an ingredient list. This may not include the fruit or vegetable your child is allergic to, so you should check the ingredient list where possible.

Always tell the staff that your child has a specific fruit or vegetable allergy when eating out. This will help you find safe foods and avoid contamination. 

If you cannot confirm that food does not contain your child’s allergen, it is safest for your child to avoid it.

Talk to your child’s doctor about what types of foods that contain certain fruits and vegetables are safe if you are unsure.

Education

The most important thing you can do is support your child in avoiding their allergen. You can also educate your child, family, and friends about allergies, reactions, and what to do in an emergency.

Parents of younger children will need to read ingredient lists and learn to find the allergens in foods and drinks.

Older children can be supported to learn how to read ingredient lists and find their allergens in foods and drinks. 

This can help keep children safe and encourage them to be more independent and confident about their diet and health.

Resources and more information

Allergy & Anaphylaxis Australia - Your trusted charity for allergy support.

title
Allergy and Anaphylaxis Australia

Phone1300 728 000
Biography
Provides valuable updates and tips for dealing with food allergies.
Related Links
The Australian Society of Clinical Immunology and Allergy (ASCIA)

title
The Australian Society of Clinical Immunology and Allergy (ASCIA)

Biography
Provides resources including fact sheets, e-training and information on locating allergy specialists.
Related Links
Food Standards Australia and New Zealand

title
Food Standards Australia and New Zealand

Biography
An independent statutory agency, part of the Australian Government's Health portfolio that provides detailed information on food labelling.

Related Links

Disclaimer

This factsheet is provided for general information only. It does not constitute health advice and should not be used to diagnose or treat any health condition.

Please consult with your doctor or other health professional to make sure this information is right for you and/or your child.

The Sydney Children’s Hospitals Network does not accept responsibility for inaccuracies or omissions, the interpretation of the information, or for success or appropriateness of any treatment described in the factsheet.


© Sydney Children’s Hospitals Network 2024