Managing Food Allergies Now Less Confusing With New Guidelines

Just-released government recommendations should help parents, pediatricians.


Food allergies are common, affecting 5 percent of all children. But they're often hard for doctors to diagnose, and are even harder for families to manage. So the federal government has stepped up to help, releasing its first-ever comprehensive guidelines for food allergy diagnosis and management.

The new guidelines, released Monday by the National Institute of Allergy and Infectious Diseases, give doctors and nurses 43 recommendations. Key points include:

  • Recognizing the difference between food allergies and food intolerances. Food allergies spark an inappropriate response from the body's immune system, and are most common with eggs, milk, tree nuts, peanuts, soy, and wheat. Intolerances to lactose, gluten, MSG, and sulfites in wine and other foods may be uncomfortable, but they're not allergies. Avoidance helps with both, of course, but food allergies can be life-threatening.
  • Many allergy tests are used inappropriately; the new standards ask doctors to first get a history of the patient's symptoms, and then ask the patient to eliminate the suspect food from his diet. The next step, if it's still unclear what's going on, would be a skin prick test, in which tiny amounts of the suspect allergen are injected under the skin. If welts form, it's an allergy. A blood test, which looks for antibodies produced by the body in response to allergens, can be used instead. The last option is an oral food challenge, in which the child eats the suspect food while being watched by a health professional. Do not try this at home; a doctor or nurse needs to be on hand in case the food sparks a severe reaction.
  • The new standards lay out the options for avoiding food allergens, including reading labels, and washing hands and kitchen surfaces regularly. Avoiding food allergens can be tough, as any parent of a child with life-threatening nut allergies can tell you. The Food Allergy and Anaphylaxis Network has great parent-tested advice on living safely and happily with food allergies.

Food allergies may be on the rise, particularly peanut allergies, which can be deadly and last a lifetime. On the plus side, many children outgrow allergies to common foods like egg, wheat, and milk. As with any potentially chronic health problem, smart management is the key.