Types of food allergy
| Name of food | Features of allergy & risk of anaphylaxis | Do young children tend to grow out of this allergy? | How common is anaphylaxis to environmental contamination? |
|---|---|---|---|
| Peanuts | Likely to be a risk of anaphylaxis. Can be very severe particularly in older children who may react to minute traces of nuts from cross contamination of food during preparation. About 30% of peanut allergic children are also allergic to tree nuts | No – only up to 5% of children grow out of this allergy. Young children with mild allergy are most likely to resolve. | It is very rare for children to react to contact with peanuts (including airborne nut proteins). This should be confirmed in the medical evidence. |
| Tree nuts | Likely to be a risk of anaphylaxis in most cases. Tree nuts include Brazil, hazelnut, cashew, almond, walnut, pecan and macadamia. The symptoms are the same as for peanut allergy and there is a risk of anaphylaxis. Can be very severe particularly in older children who may react to minute traces of nuts from cross contamination of food during preparation. A person with tree nut or nut allergy may also be allergic to peanuts. | No – only those with the mildest allergies will grow out of it. | It is very rare for children to react to contact with tree nuts (including airborne nut proteins). This should be confirmed in the medical evidence. |
| Egg | Likely to be a risk of anaphylaxis in a minority of cases. Very common in young children – the majority have mild reactions with hives and facial swelling when lightly cooked egg is eaten. The majority grow out of this by age 5 years. As their allergy resolves, they can tolerate baked egg products first, followed by lightly cooked egg. A small number have persistent allergy to cooked egg as well as raw egg, Reacting to cooked egg severely limits their food options. Reactions in a small number may be severe involving collapse and difficulty breathing, some may be severely affected by small amounts of contamination in foods. | Yes, most cases will be mild and will have started to resolve by age 3 years. Children who react severely are less likely to grow out of it.
Children with persistent egg allergy tend to have more severe reactions on re-exposure. |
A small number of children will react to contact with eggs with anaphylaxis, this is also very rare. These children are unlikely to grow out of their egg allergy. This should be confirmed in the medical evidence. |
| Cow’s milk (Dairy) | Likely to be a risk of anaphylaxis in rare cases. Is very common in young children – commonly causes mild reactions involving hives and lip or facial swelling when milk or milk containing products are ingested. The majority will grow out of this by age 3. A small number have severe allergy and may be severely affected by tiny amounts in contaminated foods. | Yes, most cases will be mild and will have started to resolve by age 3 years. Children who react severely are less likely to grow out of it.
Children with persistent milk allergy tend to have more severe reactions on re-exposure. |
A small number of children will react to contact with milk proteins with anaphylaxis. Milk proteins are ubiquitous in environment where milk is regularly consumed – both inside and outside the home These children are unlikely to grow out of their allergy. This should be confirmed in the medical evidence. |
| Soy | Common in young children and may coexist with milk allergy in the same child. Usually causes food intolerance or mild allergic reactions when soy or soy containing products are ingested. The majority will grow out of this by age 3. Anaphylaxis caused by soy protein is extremely rare in the UK. | Yes, in most cases children will grow out of soy allergy. | No |
| Sesame | May cause anaphylaxis and be difficult to avoid | Rarely resolves. | Rare. |
| Wheat | Is uncommon in young children – it can cause swelling and hives, or more commonly intolerance type reactions. Anaphylaxis due to wheat is rare. | Yes. | No |
| Fish | Likely to be a risk of anaphylaxis in most cases. May cause severe reactions. Cross contamination of fish products is common so may be advised to avoid fish and shellfish even if not allergic to shellfish. May have severe reactions to traces of fish allergens for example eating food cooked in oil previously used to fry fish. | No. Rare in young children. Tends to develop in teenagers and young adults and it does not resolve. | Fish is relatively easy to avoid as its presence in food is usually obvious. |
| Shellfish | Likely to be a risk of anaphylaxis in most cases. May cause severe reactions. Cross contamination of fish products is common so may be advised to avoid fish and shellfish even if not allergic to fish. May have severe reactions to traces of fish allergens for example eating food cooked in oil previously used to fry shellfish. | No. Rare in young children. Tends to develop in teenagers and young adults and it does not resolve. | Shellfish is relatively easy to avoid, as its presence in food is usually obvious. |
| Fruit | Most often causes mild reactions with lip swelling or mouth itching as part of ‘oral allergy syndrome’ (OAS), OAS does not lead to anaphylaxis.
Emerging severe allergy to fruit, especially kiwi with anaphylaxis |
Usually long lived allergy, cooked fruit tolerated in OAS
Severe fruit allergy rarely resolves. |
No even in severe allergy. Reactions to environmental allergens are likely to be mild e.g. facial swelling or hives. |
| Pulses –peas, beans and lentils | Can cause spectrum of reactions from mild to anaphylaxis. Avoidance can compromise diet in vegetarians. | Rarely resolves. | No even in severe allergy, reactions to environmental allergens are likely to be mild e.g. facial swelling or hives. |
