Fruit and vegetable allergy factsheet

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.

Rosaceae family, including:

apples
pears
cherries
peaches
plums
strawberries.

Cucurbitaceae family, including:

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

Other common fruit and vegetable allergens include:

kiwifruit
bananas
plantains.

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.

Symptoms of a delayed reaction can include:

vomiting and nausea
abdominal pain or stomach ache
bloating
diarrhoea.

If your child is showing signs of an allergic reaction for the first time, see your local doctor as soon as possible.

Symptoms of mild allergic reactions should fade over time. If symptoms do not improve or you are concerned, see your local doctor as soon as possible.

Anaphylaxis

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 available
call Triple Zero (000) for an ambulance.

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:

medical history
signs and symptoms
results from allergy tests.

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

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 their allergen in their diet.

Your child’s doctor will develop an ASCIA Action plan to share with anyone who cares for your child, including parents, carers, childcare and schools.

ASCIA Action plans are used to manage allergies and allergic reactions safely.

Children at risk of anaphylaxis will also need an adrenaline autoinjector, also known as an EpiPen® or Anapen®.

Management

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 when eating out that your child has an allergy. 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.

Education

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

Parents of younger children must read ingredient lists and learn to find peanuts in foods and drinks.

Older children can be supported in learning to read ingredient lists and find peanuts in foods.

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