True food allergies are not as common as most people believe and only affect about 2% of children, although they are more common in younger children (affecting about 5-8% of younger children). And fortunately, most younger children will outgrow these food allergies by the time they are three years old.

Symptoms of a food allergy can include wheezing and difficulty breathing, itchy skin rashes, including hives, vomiting, diarrhea, nausea, abdominal pain and swelling around his mouth and in his throat. These symptoms usually develop fairly quickly after your child ingests the food he is allergic to, often within minutes to hours. Nasal symptoms by themselves, such as congestion or a runny nose, are usually not caused by food allergies.

Symptoms may be mild or very severe, depending on how much of the food your child ingested and how allergic he is to the food. A severe reaction can include anaphylaxis, with difficulty breathing, swelling in the mouth and throat, decreased blood pressure, shock and even death.

More common than food allergies are intolerances to certain foods, which can cause vomiting, diarrhea, spitting up, and skin rashes. An example of such a reaction occurs in children with lactose intolerance, which occurs because of a deficiency of the enzyme lactase, which normally breaks down the sugar lactose. Children without this enzyme or who have a decreased amount of the enzyme, develop symptoms after drinking lactose containing food products, such as cow's milk. However, because this reaction does not involve the immune system, it is not a real food allergy.

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If you notice that your child develops symptoms after being exposed to certain foods, then you should avoid those foods. The most common foods that can cause allergies include: peanuts, tree nuts (walnuts, pecans, etc.), fish, shellfish, eggs (especially egg whites), milk, soy, and wheat. Keeping a diary for a few weeks and recording what foods your child has been eating, especially new foods, and when he develops symptoms may help figure out what he is allergic to.

Once you determine what your child is allergic to, it is important to learn to read food labels because the food your child is allergic to may be an ingredient of many other foods. You should also avoid eating foods that may have been prepared using equipment that was also used to prepare the types of food that your child is allergic to.

When trying to determine what your child is allergic to, parents often incorrectly assume that if he has eaten a food before and not had problems, then he probably is not allergic to that food. They usually only suspect new foods as being able to cause a food allergy. However, it is important to keep in mind that it takes time for the immune system to build up a reaction against something that the body is allergic to. It may take days, weeks, months or even years to build up enough of a response to cause noticeable symptoms. So your child may be allergic to a food even if he has eaten it many times before without problems.

In addition to avoiding what you think your child may be allergic to, children with more severe reactions should be evaluated by their Pediatrician or an allergist. Testing may be done, either skin testing or RAST (radioallergosorbent test, a blood test to check for antibodies against certain things your child may be allergic to) to see if specific food allergies can be found. In addition, your child will be prescribed an epinephrine autoinjection device (such as the EpiPen or EpiPen JR) and should wear a medical alert bracelet to notify others of his allergy.

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Preventing food allergies
may be possible, especially if your child is at high risk of having a food allergy, including already having an allergy to food or formula, eczema, hayfever, or asthma, or having other family members with these conditions or a food allergy.

Most importantly, breastfeed and avoid supplementing with infant formula or offering solids for at least the first six months. If you are not breastfeeding or need to supplement, then consider using a hypoallergenic infant formula (soy formulas and goat's milk may not be good alternatives, because many infants that are allergic to cow's milk may also be allergic to soy). If you are breastfeeding, then you should avoid milk, eggs, fish, peanuts, and tree nuts in your own diet.

If your child is at high risk of having food allergies, you should delay offering solids until he is at least six months old (and continue breastfeeding), and begin with an iron fortified infant cereal. It is best to start with rice and oat cereals and introduce wheat cereals later. Next you can introduce vegetables, but avoid legumes (foods in the bean and pea family) at first, and then non-citrus fruits and fruit juices. Meat and protein foods can be added once your child is 8-9 months old.

Foods to avoid until your infant is at least a year old include cow's milk and other dairy products, citrus fruits and juices, and wheat. Also, avoid giving eggs until age two, and peanuts (as smooth peanut butter) and shellfish until your child is at least three years old. Whole peanuts and tree nuts should be avoided until your child is four because of the choke hazard.

When you do introduce new foods, do so slowly and only give one new food every four to five days. This way, if your child does have a reaction or allergy, then you will know which food caused it and you will be able to avoid giving it again.

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