According to the Centers for Disease Control and Prevention, 4 out of every 100 children under the age of 18 has a food allergy and unfortunately the prevalence is rising.

Experiencing anaphylaxis—a severe reaction that can cause breathing and blood-circulation difficulties, such as loss of consciousness—can be extremely scary. While the milder symptoms of a food allergy reaction, such as rashes or diarrhea, certainly are unpleasant, anaphylaxis can actually be fatal. That's why it's vital to have a plan in place to protect your child from potentially life-threatening reactions to food. Here are three steps to take once you've received an official diagnosis from an allergist:

1. Carry epinephrine. Epinephrine, usually dispensed in an auto-injector known commonly as an EpiPen®, is the first line of defense against anaphylaxis. Children should carry two injectors on them at all times and, if they're old enough (see, What's Old Enough, below) should know how to give themselves an injection. Make sure your child's school has epinephrine on hand; many school districts are now being required to have it available. If yours doesn't, ask for it to be kept for your child and ensure the staff knows how to use it.

2. Have a plan. The last thing you want is for caregivers to be caught unaware when your child is struggling to breathe or stay conscious. "Anyone tasked with caring for a child with a food allergy must understand that food allergies are potentially life threatening," says John L. Lehr, CEO of Food Allergy Research & Education (FARE), a national organization dedicated to food allergy research, education, advocacy, and awareness. "In school, children with food allergies should have a written food-allergy management plan that outlines how the school will address the individual needs of the child, allowing him or her to participate safely and equally at school, as well as instructions for treatment in case of allergic reactions."

If you hire babysitters, make sure you review food protocols with them and insure that they know how to use an epinephrine auto-injector in case of a reaction. Keep a written plan handy in several spots, such as the kitchen and the car.

3. Practice avoidance. There is no cure for food allergies so the only sure way to prevent anaphylaxis is to avoid the offending food entirely. If your child is old enough, make sure she or he knows exactly what is safe for her to eat and what isn't. Caregivers should be on top of this as well. Instruct everyone to read labels every time a food is offered and to ask questions if there's any concern. Siblings and friends should be asked to wash their hands after eating to minimize the chances of contact with a problem food.

What Is Old Enough?

Pediatrician Jennifer Kim, MD, FAAP, discussed food allergy management on Radio MD's, Healthy Children Show. Kim is an assistant professor of pediatrics in the division of pediatric allergy & immunology at the Mount Sinai School of Medicine and Jafee Food Allergy Institute. She says age matters. "Three, four and five-year-old children don't have well-developed impulse control, aren't necessarily cognizant about hand washing and in this age group food sharing is common," says the expert admitting that these factors can be a recipe for disaster. If your preschool-aged child has a food allergy, she's obviously not old enough to be responsible for her condition, but Kim suggests teaching your child to always ask questions about food safety before taking a bite.

Grade schoolers can be taught how to use the EpiPen® but in most cases this age group isn't mature enough to take on full responsibility for their problem either. "The transfer of responsibility is a years long process," says Kim.

Older children may be more independent but not less immune to food allergy dangers. Middle school age and teenagers in high school are actually more vulnerable to problematic reactions, according to experts at FARE in the video, "Managing Food Allergies in the School Setting" which is available on the organization's website. One of the downsides of the teenage years is an increase in risk-taking behavior. Teenagers are more able to care for themselves but less likely to treat the symptoms often because of social pressures. They may be hesitant about calling what they perceive to be negative attention to themselves. They don't want to interrupt activity or bother friends with their problem.

Other dangers inherent to this age group include sensitivity to a food allergen used in a science lab experiment and participation in after school activities when the school nurse may not be available. Experts recommend making your older children aware of these scenarios and discussing ways to feel comfortable asking for help should the need arise.

Barbara Rosenstein, FARE spokesperson, reviewed this article.


John L Lehr, CEO, Food Allergy Research & Education (FARE)email interview, 17 December 2013.

"Managing Food Allergies in the School Setting," Web. Video. Accessed 10 January 2014. Food Allergy Research & Education (FARE).

American Academy of Pediatrics. Radio MD, Healthy Children Show with Melanie Cole. Radio interview with Jennifer Kim, MD, FAAP, assistant professor of pediatrics in the division of pediatric allergy & immunology at the Mount Sinai School of Medicine and Jaffe Food Allergy Institute. Interview 4 September 2013. Accessed 10 January 2014.