A food allergy is a response by a person’s immune system to a food or food component it perceives as a threat. After a susceptible person ingests a problem food, the immune system reacts with the release of histamines and other chemicals that trigger symptoms ranging from mild to severe

The only way to avoid a food-related allergic reaction is to strictly avoid the allergy-causing food. Food allergies can be fatal if dietary avoidance is not diligently practiced. Individuals with a food allergy will need to read ingredient labels on foods and avoid products with unknown or questionable ingredients. If a label contains any unfamiliar terms, people with food allergies should call the manufacturer for a definition or avoid the food.

Over 90 percent of food allergies are triggered by proteins in the following foods:

• Cow’s milk
• Eggs
• Peanuts
• Wheat
• Soybeans
• Fish
• Shellfish
• Tree nuts

Removing a food type and all of its related ingredients and foods from the diet can be a large undertaking. An individual should work closely with a physician to better understand their condition and how to best avoid problem foods. Individuals with food allergies need to be constantly vigilant to avoid accidental contact.

Some allergic reactions can be brought on by just a trace amount of a food. Inhaling the gases produced by some cooked foods (e.g., fish) can trigger an allergic reaction in some people. Other people can have a reaction from cross-contamination if a cooking utensil or surface touches both a problem food and a person’s own meal.

To better prevent an individual from ever developing a food allergy in the first place, some experts recommend that infants not be exposed to some types of food in the first years of life. Nursing mothers may be advised to remove any allergenic foods from their own diets to avoid passing on certain food proteins to their children.

Food allergies are a response by a person’s immune system to a food or food component it perceives as a threat. After a susceptible person ingests a problem food, the immune system reacts with the release of histamines and other chemicals that trigger symptoms ranging from mild to severe.

Individuals who have a food allergy should work closely with their physicians to better understand their condition and its causes. A food allergy can result in a fatal reaction if not treated properly. Once individual food allergens (any food component or additive that is mistakenly perceived as a threat, triggering an allergic reaction) have been identified, people must begin the difficult task of removing all forms of that food from their diet.

The most commonly allergenic foods, along with their more popular forms, include (Note: This is not a complete list):

• Milk. Includes cheese, butter, cream, casein (a milk protein) and whey.
  
  
• Wheat. Includes crackers, pastas, bread and malt.
  
  
• Soybeans. Includes lecithin (a food ingredient often made from soy), some types of baked foods, canned tuna, sauces and baby formulas.
  
  
• Peanuts. Includes peanut butter, "gourmet" peanut oil (includes cold-pressed, expelled or extruded), many types of ethnic foods (including Chinese, Indonesian, Thai, Vietnamese, and possibly Mexican) and some flavorings.
  
  
• Tree nuts. Includes hazel, cashew, almond, sesame seed and Brazil nuts.
  
  
• Shellfish. Includes crab, crayfish, shrimp and lobster.
  
  
• Fish. Includes yellowtail, salmon, mackerel, tuna and hake.
  
  
• Eggs. Includes commercially processed cooked pastas and some brands of egg substitutes.

After visiting a physician and identifying which foods are most likely causing the reaction, individuals need to work to remove those foods, products that contain those foods and all derivatives of those foods from their diets. Removing a problem food from the diet is a way to prevent the allergic chain of events – known as the allergic cascade – from ever occurring.

Many types of food allergies can be triggered by just a trace amount of the food. Reactions can occur when a person eats a food that was prepared on the same surface as a problem food, or when the gases or fumes produced by cooking a problem food are inhaled.

Removing a specific food from the diet is often very difficult. Besides avoiding the food itself, individuals need to avoid any foods derived from the problem food. This often requires the allergic individual to memorize (or carry with them) a long list of alternate food names. For example, albumin is a derivative of chicken eggs that contains egg proteins that can trigger an allergic reaction in individuals with egg allergies. 

It is very important for individuals with food allergies to learn the name of every dangerous food derivative. New legislation may make it easier for people to determine if a food item contains a potential allergen. As of January 2006, food manufacturers are required by the Food and Drug Administration (FDA) to clearly list food allergens on their product labels.

With young children, some physicians believe it may be possible to avoid sensitization to food allergens by waiting to introduce some food types. While a controversial theory, it is believed this may prevent the immune system from forming the IgE antibodies that will later recognize the food and cause allergic reactions. When the child’s immune system is stronger, it may be able to tolerate the foods without becoming sensitized to them. Some physicians believe this technique shows more promise for the prevention of allergies in infants with a family history of allergies.

Individuals should learn what steps to take if they do come into contact with an allergen. Physicians often recommend that the most sensitive individuals carry a shot of epinephrine (a synthetic form of adrenaline that, when injected, opens breathing tubes and restores normal respiration quickly) to counteract the affects of the potentially life-threatening allergic reaction known as anaphylactic shock. These individuals should know how to correctly self-administer their medication.

Individuals with strong reactions should also carry a medical alert bracelet or necklace to inform healthcare workers of their condition.

There are several steps people can take to reduce their chances of an accidental exposure to a food allergen (any food component or additive that is mistakenly perceived as a threat, triggering an allergic reaction) . These include:

• Checking food ingredient labels on the outside of packaged foods. The U.S. Food and Drug Administration (FDA) requires that food manufacturers list every type of food ingredient on food packaging. Checking these labels for problem foods is vitally important to anyone with a food allergy. Many times a food will contain a seemingly unrelated type of food as an ingredient. For example, some types of root beer contain eggs.
  
  
• Learning the names of dangerous ingredients. Many types of ingredients contain proteins from other foods – even if they are not listed. For example, albumin contains egg proteins. By checking food labels to make sure there are no alternate ingredients present, a person can greatly reduce the chance of accidentally encountering a food allergen.
  
  New legislation may make it easier for people to determine if a food item contains a potential allergen. As of January 2006, food manufacturers are required by the FDA to clearly list food allergens on their product labels.
  
  
• Checking to see if the ingredients have changed. Food manufacturers often change the ingredients of their foods. A person should never assume that a product is safe. If a label contains any unfamiliar terms, people should call the manufacturer for a definition, or avoid the food.
  
  
• Avoiding foods that do not have a label.
  
  
• Being careful about inhaling food gases and fumes. Some people with food allergies can have a reaction triggered from a trace amount of an allergen, including the tiny amounts of allergen that are released into the air when some foods are cooked (e.g., fish).

Tips to avoid accidental exposure while eating out include:

• Ask about ingredients in restaurants. Because restaurants rarely have labels listing the ingredients of their dishes, they can be dangerous places for a person with a food allergy. To be safe, a person should always ask questions about the ingredients in the food. Be sure the person asked is qualified to answer the question. Waiters are often not aware of every single ingredient found in a food dish. If in doubt, speak with the owner directly.
  
  
• Ask about kitchen procedures when at a restaurant. Always inquire about a kitchen's preparation techniques and whether there are any types of dangerous foods present. Some people can have an allergic reaction if a kitchen utensil or cooking surface shares contact with a problem food and their own meal. Passing along an allergen in this manner is called cross-contamination. Make sure to question someone familiar with the restaurant's kitchen procedures, such as the owner.
  
  
• Avoid buffets and bakeries. Foods in the buffet line and at bakeries are kept very close to each other. In addition, tongs and utensils are frequently reused.
  
  
• Order simple dishes when eating at a restaurant. Ordering a simple dish, such as a baked potato or steamed vegetables, is safer than ordering a dish with several ingredients.
  
  
• Avoid sauces and order plain dishes. Allergens are often found in condiments such as sauces and gravies.
  
  
• Avoid eating desserts when dining out. Caterers and restaurants often bring in desserts (e.g., cookies, cakes) from outside bakeries. As a result, the staff is often unaware of the ingredients in the items. Because desserts may have significant allergens in them, patients should avoid eating them when eating outside the home.
  
  
• Ask about ingredients and preparation techniques when eating at a friend's home. Do not assume that friends know what is safe to serve and what is not. Always ask to be sure.
  
  
• Bring food when eating somewhere unfamiliar. Sometimes it is almost impossible to tell what is in a food or how it was cooked. In these situations (e.g., group cookouts, pot-luck dinners) it is best for people with a food allergy to bring their own food.

Physicians agree that breastfeeding offers an infant many different advantages. There is less agreement on whether breastfeeding can prevent the development of food allergies. While a highly controversial issue, some physicians believe that exposing a child to potential food allergens at a young age may cause the child to develop food allergies they would otherwise not have developed. These physicians contend that this early sensitization is able to occur because a child’s immune system is still immature (particularly in the first few months of life). Many of the control mechanisms used to prevent a child’s sensitization to harmless antigens (substances the body perceives to be a threat) may not have fully developed yet. As a result, the child’s immune system forms antibodies (proteins that attach to foreign substances and help destroy them) that will later recognize the food and cause allergic reactions.

It is recommended by most physicians that nursing mothers breastfeed their child as long as possible. Many suggest continuing until the child reaches at least the age of 1. However, some clinical research has shown that a nursing mother who has a history of allergies in her family may be able to prevent or delay passing on a food allergy to her child by avoiding common trigger foods. Many types of food molecules pass into breast milk. By introducing certain foods to her own diet gradually, a nursing mother may keep her young child free of the proteins that can trigger a food allergy.

Physicians who believe in the value of limiting infant allergen exposure believe a child should be kept from immediately trying some food types, even after they have moved on to solid foods. They suggest that parents try to adhere to the following schedule when introducing foods to their child:

• Infants should not be exposed to any solid foods until they reach 6 months of age. Foods that are commonly associated with allergies should be introduced one at a time so that any reactions can be noted.
  
  
• Nursing mothers should refrain from eating any type of allergenic foods (e.g., peanuts, seafood). This reduces the likelihood of a child encountering a problem food at a very young age – when they may be most susceptible.
  
  
• Infants should not have any contact with cow’s milk until they turn 1. Nursing mothers should avoid cow’s milk for the first year to avoid passing milk proteins on to their children.
  
  
• Egg yolks should not be introduced until after the first year.
  
  
• Egg whites should be avoided until after the child turns 2.
  
  
• Children should not be introduced to peanuts, fish and shellfish until they are at least 3 years old.

Children will often outgrow food allergies after the first few years of life. However, food to which a child once had an allergic reaction should never be reintroduced to the child without the direction of a physician. Some food allergies may persist throughout adulthood (e.g., milk, eggs).

Like adults, the most effective form of treatment for children who develop a food allergy is avoidance. It is important that a food allergic child be educated on the selection of safe foods. Children should also be taught about the importance of remaining vigilant. Parents should educate both themselves and their children on the various names a problem food might have, and constantly check ingredient labels for its presence.

Parents need to work closely with their children’s school or daycare center (or anywhere food might be served) to make sure these facilities are able to handle special dietary needs. Many schools and child care facilities have procedures in place for kids with special diets. However, many others do not. Parents should always check to be sure.

Adequate cleaning methods should be used wherever a food allergic child is eating. Parents should always be sure of the following:

• Equipment or facilities are cleaned of lingering food residues with warm soapy water or some kind of wet cleaner
  
  
• The chlorine solutions used by a facility are adequate for cleaning
  
  
• Hard scrubbing is employed with any cleaning solution
  
  
• Kitchen staff wash their hands after handling food

Parents are responsible for notifying the school, daycare facility or parental supervision of the child’s condition. Parents should work closely with the school to determine a solution that best meets the child’s needs in both the cafeteria and in the classroom. Important contact information, medical documentation, written instruction and medication should be provided to the school as well.

Parents can also purchase a number of products, such as bibs, T-shirts and buttons, to alert people to their child's allergy. These products display a written message warning people of the allergy and asking them to refrain from giving the child anything to eat or drink. These products are ideal for young children who are going to be around a large number of people, such as at a birthday party.

It is important that a food-allergic child understand who they should alert in the case of an allergic reaction. Children tend to trust any adult present, which can lead to a serious medical situation since many adults are unaware of the serious nature of food allergies. A child should be taught who is trustworthy, as well as who cannot be trusted to understand the allergy problem.

Children who are very sensitive to food allergies may be susceptible to the potentially life-threatening allergic reaction known as anaphylactic shock. These individuals should carry an injection of epinephrine (a synthetic form of adrenaline that, when injected, opens breathing tubes and restores normal respiration quickly) with them at all times, and be instructed on how to properly administer the drug. Sensitive younger children should always have supervision capable of administering an injection of this type.

Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctors the following questions about food allergy prevention:

1. Is it safe for me to occasionally eat a small portion of the food I am allergic to?
   
   
2. Is it safe for me to prepare foods that I am allergic to for my family?
   
   
3. Can I still eat out at restaurants?
   
   
4. What terms should I look for when reading an ingredient label?
   
   
5. How will I know if I am having an allergic reaction to a food?
   
   
6. What should I do if I suspect that I have ingested a problem food?
   
   
7. How can I teach my child about food allergy prevention?
   
   
8. What steps can I take to ensure my child’s safety when eating at school?
   
   
9. Are there steps I can take to prevent my child from developing a food allergy?
   
   
10. Should I wear a medical alert bracelet? If so, where can I purchase one?