From Daniel More, MD,
Your Guide to Allergies.
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A. It depends. Food allergies in children aren’t always a life-sentence for avoiding certain foods. Many children outgrow their food allergies, depending on the type of food they are allergic to. Most children outgrow allergies to milk, egg, soy and wheat, typically by 5 years of age. However, only a small proportion of children outgrow allergies to peanuts, tree nuts, fish and shellfish.

The severity of reaction is also a factor in whether a child will outgrow a food allergy. If the child’s reaction to eating the food was hives or eczema, the food allergy is much more likely to be outgrown compared to if they experienced anaphylaxis from eating the food. Some children have allergy symptoms from just touching or smelling the food; these kids are probably very sensitive, and much less likely to outgrow the food allergy.

Here is my approach to determining whether a child has outgrown a food allergy: First, I take into account how severe the reaction to the food was. I also want to ensure that there has been a significant amount of time, at least one year, since the last reaction, so that there has been some time to allow for outgrowth of the food allergy. Next, I will repeat allergy testing. The skin test may still remain positive even if the child can eat the food without symptoms. The size of the skin test reaction may be helpful in predicting whether the child has outgrown a food allergy, as is the level of a RAST to the food in question.

If the skin test and/or RAST level to the food is favorable, I then will perform an oral food challenge in my office. This procedure, which occurs under close medical supervision given the potential for a severe allergic reaction, takes about 3 to 4 hours to complete. The child is given small amounts of the food to eat, with increasingly larger amounts every 20 minutes or so, closely monitoring them for any signs of a reaction. Once an entire serving of the food is eaten, the child is monitored for an additional 1 to 2 hours.

It is only after passing an oral food challenge that you can truly consider that a child has outgrown a food allergy, and is no longer allergic to the food.

Want to find out more? Learn all about the basics of food allergies.

_Source:

The American Academy of Allergy, Asthma and Immunology, and Food Allergy Practice Parameters. Ann Allergy Asthma Immunol. 2006; 96:S1-68.

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