food allergy in children
There has been a huge increase in the occurrence of food allergy in children in the UK over the last 20 years and about 1 in 20 children are now affected. The NHS has published new NICE guidelines on the diagnosis and assessment of food allergies in children. The evidence-based guidelines are concerned with children who present with severe or recurrent asthma, eczema, anaphylaxis, urticaria (hives), rhinitis, gastro-intestinal symptoms and oral allergy syndrome (tingling and swelling of the mouth and face after eating certain foods). Food allergy should be considered if a child has multiple symptoms affecting more than just the lungs or just the skin. The guidelines acknowledge that allergy services are few and far between, but recommend referral to a GP with special interest, or a specialist clinic for a full assessment and possible skin prick or blood tests. Some types of allergy do not have specific or reliable tests, and excluding certain foods may be needed – but this should not be considered unless on the advice of experienced doctors and usually specialist dietician advice is needed as well. There are a number of allergy “tests” which are not validated and have not been shown to be reliable but which are available from private practitioners. The results of the tests are often falsely positive and in some cases children are placed on very restrictive diets unnecessarily, leading to potential malnutrition and vitamin deficiencies.
Most food allergies are to natural foods rather than food additives. The commonest foods involved are cow’s milk, eggs, soya, wheat, shellfish and nuts.
- Guidance on Food Allergy in Children Lancet 2011 (Editorial)
- Food allergy in children and young people, NICE clinical guidance 116; 2011
Article written and supplied by Dr A W B Crockett FRCGP, Allergy Central
Last Reviewed: 1 April 2011
Next Review Date: 1 April 2013
