Food allergy symptoms: Mild vs. serious

Sasha was a fussy eater – often just turning her head away and rubbing at her lips. She also had frequent eczema spots on the inside of her elbows and on her cheeks. Little Will had a small rash around his mouth and a nagging cough.

Parents who tell me about these seemingly minor symptoms – which might even be considered "normal" – are often surprised when I tell them it could be food allergy.

A food allergy reaction isn't always sudden and dramatic, especially in young children, but most will appear within minutes or a couple hours after consuming the food.

Babies and young children may cry, look flushed and break out into hives. They may vomit or begin wheezing. It could happen the first time a child tries a new food or after they've safely eaten it a few times. Children might also experience ongoing symptoms that are hard to link to a specific food – eczema is the most common.

Related: Most common food allergies

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Most common food allergies to be aware of
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Most common food allergies to be aware of

Peanuts and peanut products

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Tree nuts

(Photo by Jeremy Woodhouse via Getty Images)

Cow's milk

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Eggs

(Photo by Andrew Unangst via Getty Images)

Wheat

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Soy

(Photo by Vlad Fishman via Getty Images)

Fish

(Photo by Lew Robertson via Getty Images)

Shellfish

(Photo by Alexandra Grablewski via Getty Images)

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Older children and adults may react more with flushing, hives and wheezing, or with stomach discomfort but not necessarily vomiting. If breathing is difficult or there's dizziness or confusion, it's likely anaphylaxis.

Mild allergy symptoms can erupt into serious events without warning. That's why it's important to talk with your child's pediatrician about any and all symptoms. Simple skin testing by a board-certified allergist will confirm or disprove a suspected food allergy, so a safe and nutritious diet can be developed and followed.

[See: 10 Concerns Parents Have About Their Kids' Health.]

Clearing Confusion

There's no such thing as a "mild food allergy." There are mild symptoms, for sure, but there's no way to predict the severity of a reaction from one day to the next – which is why allergists recommend staying away from any food that you're truly allergic to.

Ask a board-certified allergist for a written Allergy and Anaphylaxis Emergency Plan, with specific instructions about what to do if symptoms appear, plus what to do if you suspect you or your food-allergic child has been exposed to a food allergen. The American Academy of Pediatrics recently published a sample form at aap.org.

Always follow the instructions on your Allergy and Anaphylaxis Emergency Plan, if you have one. If not, for mild symptoms call your doctor; for serious symptoms, call 911 and use an epinephrine auto-injector as soon as possible. A general rule of thumb in an emergent situation is if skin symptoms are rapidly spreading or you have any other symptom with it – nausea, vomiting, cramps, dizziness, coughing or wheezing – it's serious.

Related: Lower risk of reactions when traveling

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Tips for Minimizing the Risk of Peanut Allergy Reactions When Traveling
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Tips for Minimizing the Risk of Peanut Allergy Reactions When Traveling

When traveling, the safest bet is to pack your own nut-free snacks. If you're planning to bring your own homemade treats, we've got some great recipe ideas for small bites that pack and travel well and taste great. Read on to discover recipes for delicious and travel-friendly nut-free snacks.

Image Credit: Flickr/Pat Guiney

Orange Spice Molasses Cookies

These nut-free cookies stay moist due to the applesauce and have tons of whole grains.

Get the recipe: Orange Spice Molasses Cookies

Cayenne Pretzels

Replace boring pretzels with this cayenne and ranch seasoned version.

Get the recipe: Cayenne Pretzels

DIY English Muffins

Slather on a bit of butter and honey on these homemade English muffins for a delicious treat.

Get the recipe: DIY English Muffins

Sweet & Spicy Jerky

This beef jerky takes inspiration from coffee and Asian flavors. Make it well ahead of time, and you’ll be rewarded with a mouth-watering in-flight eat.

Get the recipe: Sweet & Spicy Jerky

Pizza Roll-Up

This kid-friendly snack is easy to make and packs neat for travel.

Get the recipe: Pizza Roll-Up

Cherry Pie Bars

The classic cherry pie dessert gets reinvented in bar form for on-the-go snacking. This recipe is perfect for travelers with nut allergies.

Get the recipe: Cherry Pie Bars

Quick Applesauce

Whip up this quick recipe for applesauce (it uses the microwave and only takes 3 ingredients) and pack it to go.

Get the recipe: Quick Applesauce

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Food allergy symptoms can be broken down into types: skin, gastrointestinal, respiratory and cardiovascular.

1. Skin symptoms are the most common: a skin rash or hives; itchy mouth or lips; flushing of the face; swelling of the lips or tongue.

Mild:

  • A few hives around the face.
  • Flushing
  • Itchy mouth, tongue, lips or eyes; this is a form of hives, developing under the skin.
  • Mild swelling of lips.

Serious:

  • Hives that pop up and spread across different parts of the body; this indicates that the allergic reaction is spreading through the bloodstream.
  • Swelling of the mouth or tongue that interferes with breathing or swallowing.

Special cases:

  • Any amount of hives or swelling is considered serious in a person who has experienced a serious allergic reaction in the past.
  • When hives appear along with symptoms in another part of the body, like respiratory or gastrointestinal, this is considered serious.
  • Some people with hay fever will experience mild food allergy symptoms – an itchy mouth, for example – when eating certain fruits and vegetables that are related to the tree, grass or weed pollens they are allergic to. This is called OAS, or oral allergy syndrome. Call your physician if you notice these symptoms.
  • Others may experience sensitivities to food, such as lactose intolerance. These sensitivities make food difficult to eat, but they are not a true allergy. That's why it's important to see an allergist for testing.

[See: 8 Surprising Facts About Asthma and Seasonal Allergies.]

2. Gastrointestinal symptoms like vomiting are particularly common among infants and children.

Mild:

  • Stomach discomfort
  • Bloating

Serious:

  • Vomiting
  • Severe pain or cramping
  • Diarrhea

3. Respiratory sympotoms are also quite common and often serious – especially for people with both asthma and food allergies.

Mild:

  • Small cough
  • Hoarse voice

Severe:

  • Wheezing
  • Shortness of breath
  • Hoarse voice
  • Uncontrollable cough

Special cases:

  • Respiratory symptoms are always serious in people with asthma; if they arise in a person with food allergies soon after eating, they should be treated with epinephrine, not albuterol. Epinephrine will improve breathing whether the reaction is to a food allergen or asthma trigger. Fatal cases of anaphylaxis have been reported in people with both food allergy and asthma, so you should not hesitate to use your epinephrine.

4. Cardiovascular symptoms are always serious and require immediate treatment – use an epinephrine auto-injector or call 911.

[See: How to Survive Ragweed Allergy Season.]

Serious:

  • Dizziness, fainting or confusion; this indicates decreased blood flow to the brain.
  • Pale skin, blue-tinged lips or fingernails; this indicates restricted oxygen and blood flow throughout the body.

There is no substitute for the care of an allergist when food allergy is suspected. Be sure to have allergy testing under the guidance of a board-certified allergist if you think you or your child may have a food allergy. There are many tests that have not been validated for allergies, so you want to be sure you are undergoing accurate and reliable testing. Misinformation for food allergies can be dangerous.

MildSerious
• Few hives• Hives plus any other symptoms
• Eczema• Hives spreading across the body
• Mild swelling of the lips• Swelling that affects breathing
• Flushing• Vomiting or diarrhea
• Itchy nose, mouth, eyes• Shortness of breath, wheeze, cough
• Stomach discomfort• Pale skin; blue lips or fingernails
• Fainting or dizziness
• Feeling of doom, confusion, agitation

Copyright 2017 U.S. News & World Report

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