“Every child with a food allergy should be diagnosed by a physician, have access to lifesaving medication such as an epinephrine autoinjector and receive confirmation of the disease through diagnostic testing,” said lead author Ruchi Gupta, M.D., an associate professor of pediatrics at Northwestern University Feinberg School of Medicine and a physician at the Ann & Robert H. Lurie Children’s Hospital of Chicago. “Not all children are receiving this kind of care.”

The study was published in the Journal of Allergy and Clinical Immunology (1) online.

The data from this study came from a randomized online survey of United States households with children, and where children had symptoms associated with mild to severe food allergies. This is the first time a paper has been published to offer insight on the protocol for typically diagnosing pediatric food allergies, and what changes can be made to streamline disease management and keep those children who are affected safe.

The study’s key findings are as follows:

  • 70 percent of parents report receiving a doctor’s diagnosis for their child’s food allergy.
  • The most popular diagnostic test was the skin test used 46 percent of the time, followed by a blood test used 39 percent.
  • Of the physician-diagnosed children, 32 percent of the children never received diagnostic testing — such as a skin, blood, or oral food challenge test.
  • Lower income and minority households were much more likely to have a child with a food allergy that was undiagnosed.
  • Only 1 in 5 parents reported that their child received an oral food challenge test, which is the ‘gold standard’ in the diagnosis of food allergies.

“An oral food challenge might be scary for parents because their child is being fed the allergenic food,” Gupta said. “Some physicians think the risks outweigh the benefits, but it is the best tool we have to diagnose a food allergy.”

The top nine food allergies are:

  • Egg
  • Finfish
  • Milk
  • Peanuts
  • Sesame
  • Shellfish
  • Soy
  • Tree nut
  • Wheat

The key findings for these top nine food allergies were:

  • Cutaneous symptoms, such as puffy eyes or lips, eczema, and hives occurred in 80 percent of food-induced anaphylactic reactions.
  • During severe, life-threatening reactions, hives only occurred in 40 percent of the cases and puffy eyes or lips in 34 percent of the cases.


“Not all food allergy reactions start with swelling or a rash,” Gupta said. “If you suspect your child has eaten something they are allergic to and you don’t see a visible sign of a reaction, you need to think about what might be going on internally.”

If you suspect a child has ingested a food he/she is allergic to, start by asking the child these questions:

  • Are you having trouble breathing?
  • Does your throat feel tight?
  • Is your stomach hurting?
  • Are you feeling faint or dizzy?

“This study shows why it’s vital that children receive an accurate diagnosis and that parents and other caregivers know the signs of a severe reaction and are equipped to respond immediately,” said Mary Jane Marchisotto, executive director of the Food Allergy Initiative (FAI) (2), which provided financial support for the study.

It’s obvious that parents are in need of more tools, to help them understand and deal with food allergies. One such organization is FAI, which is the world’s largest privately funded food allergy research center. No matter where you  live, we recommend you visit FAI at www.faiusa.org where you can find plenty of information and tools for dealing with children’s food allergies.

1) Journal of Allergy and Clinical Immunology
2) Food Allergy Initiative (FAI)