Managing food allergies
Understanding how to read a food label is important to reduce allergens in a child's diet and avoid the risk of an allergic reaction.
There is currently no cure for food allergies, but symptoms can be effectively managed once a diagnosis is confirmed.
A key step is learning to read food labels. Visit Understanding food labels to learn more.
Treatment Options
Allergen avoidance
The primary treatment for a food allergy is strict avoidance of the allergen. However, there are some exceptions:
- Children with milk or egg allergies may tolerate these foods in baked forms.
- An Oral Food Challenge (OFC) can help determine whether baked egg or milk needs to be removed from the diet.
This should always be guided by an allergy specialist.
Medications
To manage symptoms, doctors may recommend:
- Antihistamines
- Prostaglandin synthetase inhibitors
- Corticosteroids.
For severe reactions like anaphylaxis, adrenaline (epinephrine) is the only effective treatment, delivered using an auto-injector.
Approved auto-injectors in Australia include:
- EpiPen®
- Anapen®
These are used in emergencies to treat anaphylaxis.
Images sourced from the Australasian Society of Clinical Immunology and Allergy (ASCIA) 2024.
Oral Immunotherapy (OIT)
OIT involves increasing exposure to allergens under medical supervision. It is not routinely recommended by ASCIA in Australia.
OIT aims to achieve:
- desensitisation – increase the amount of allergen tolerated before symptoms appear
- sustained remission – no reaction even after stopping OIT and reintroducing the allergen.
Can children outgrow allergies?
Yes, some children do outgrow their allergies. The likelihood of outgrowing an allergy varies depending on the allergen and the severity of the reaction.
| Allergen | % Who Outgrow It | Age range |
|---|---|---|
| Egg | ~88% | Preschool to adolescence |
| Milk | ~79% | Preschool to adolescence |
| Soy | ~70% | By adolescence |
| Wheat | ~65% | By adolescence |
| Peanut | ~20% | By preschool |
| Tree nuts | ~10% | By preschool |
Other allergy patterns:
- sesame: often lifelong
- fish, crustacea, molluscs: usually lifelong, more common in adults
- lupin: rare in children, not routinely tested in Australia
Remember: Always consult an allergy specialist before reintroducing a food into your child's diet.
Supporting children with food allergies
Food allergies can impact your child’s quality of life, especially if they feel different from peers or siblings.
Managing food allergies means more than avoiding foods – it includes creating safe, supportive environments and considering emotional wellbeing.
Emotions
Avoiding allergen foods can impact how a child feels. They may experience:
- feeling different or left out during meals and celebrations
- anxiety or fear about past or future reactions
- confusion about why they can’t eat the same foods as others
- self-consciousness or frustration.
Try to balance safety with emotional security. A predictable, low-risk environment with easy access to emergency treatment can help your child feel confident and cared for.
Nutrition and growth
Food allergy diets can be restrictive and may affect your child’s nutrition, growth, and overall wellbeing, especially when avoiding common allergens like milk, eggs, soy, peanuts, or wheat. Cross-contamination during food processing can also make finding allergen-free options challenging.
To maintain essential nutrient intake, it is important to include safe alternatives from the same food group whenever possible.
Example: If a child can’t have cow’s milk, a fortified non-dairy alternative like soy milk may be recommended to ensure they get enough calcium for bone development.
| Allergen | Nutrients at risk | Food alternative |
|---|---|---|
| Cow’s milk | Protein, Fat Vitamins A, B2, B5, B12, D Phosphorous, Calcium | Fortified soy/rice/oat drinks, meat, poultry, legumes, nuts, whole grains
|
| Soy | Vitamins B1, B2, B6, B7, B12, Folate Iron, Calcium, Magnesium | Meat, legumes, whole grains |
| Egg | Protein, Fat Vitamins B2, B5, B7, B12, Folate Selenium | Meat, poultry, legumes, whole grains
|
| Wheat | Protein, Fat Vitamins B1, B2, B3, B7, Folate Selenium | Rice, oats, quinoa, corn, millet, buckwheat, amaranth, rye, barley, sorghum |
| Nuts | Vitamin B3, E Magnesium, Manganese, Chromium | Meat, legumes, whole grains, vegetable oils |
| Fish, crustacea, mollusc | Protein Vitamin B12 Iron, zinc | Meat, poultry, legumes, whole grains, vegetable oils |
Tip: If you're concerned about your child’s nutrition or growth, speak with your local doctor or paediatric dietitian.
If a child has a food allergy, a lot of time may be spent talking about food, food choices and what the child is eating. Creating normal and relaxed eating environments and habits, even if a child has a restricted diet, can create healthy relationships with food. If children fear mealtimes or are anxious about eating outside of the home, it may lead to negative relationships with food. This could result in:
- abnormal or disordered eating
- poor body image
- social withdrawal.
Recent research shows that children who must follow a strict food allergy diet have an increased risk of developing an eating disorder.
Healthy relationships with food
Food allergies often lead to discussions around food safety, restrictions, and planning. However, a constant focus on food can also impact your child’s mental health.
Even with restrictions, encouraging relaxed, inclusive mealtimes can help children develop healthy relationships with food.
If food and eating become sources of fear or anxiety, it may lead to:
- disordered eating habits
- poor body image
- avoidance of social situations.
Recent research shows that children on strict food allergy diets may be at increased risk of developing eating disorders.
Creating safe environments
Children spend time in different settings, like:
- home
- school
- daycare
- activities in the community.
Consistent safety routines across these environments is important for allergy management.
At home
You can reduce risk by:
- avoiding the presence of allergenic foods in the home where possible
- teaching siblings about allergy safety, including not sharing foods and how to use an adrenaline auto-injector pen (if appropriate)
- washing hands thoroughly before and after food preparation and mealtimes to minimise contact with allergens
- using separate kitchen utensils, such as chopping boards and knives, to prevent cross-contamination during cooking
- clearly labelling safe foods and foods containing allergens
- keeping meals within designated eating areas
- keeping your child’s ASCIA Action Plan close by.
Outside the home
Anyone who cares for or interacts with children outside of the home, including educators, friends, and family, should be provided with:
- clear, written instructions on how to reduce the risk of allergen exposure
- a copy of your child’s ASCIA Action Plan for Anaphylaxis
- factsheets on recognising signs of an allergic reaction
- instructions on using adrenaline auto-injectors (e.g. EpiPen or Anapen) if necessary.
On-the-go
Whether at restaurants, playdates or while travelling:
- always inform staff about your child’s allergy
- carefully read food labels
- bring safe snacks or meals
- carry an adrenaline auto-injector (and a backup, if possible).
Did you know?
Children and teenagers at risk of anaphylaxis are encouraged to wear medical alert bracelets, necklaces, or wristbands to help identify their allergies in an emergency.