What you need to know about food allergy in children
TL;DR
The EU regulates 14 major allergens that must be declared on all food. The 9 most common in children are milk, eggs, peanuts, tree nuts, wheat, soy, fish, shellfish, and sesame. Allergy and intolerance are not the same. Early introduction of allergens prevents — it does not cause — allergy.
Food allergy in children is an area full of many myths and unnecessary anxiety — but also real risks that require clear knowledge. What is the difference between allergy and intolerance? When is a reaction serious? And what is the latest research really saying about early introduction of allergens? These questions are important to answer correctly because misinformation can lead to unnecessary dietary restrictions that harm children’s nutrition — or to serious symptoms being overlooked. This guide gives you the facts.
What is the difference between food allergy and food intolerances?
Food allergy is an immune reaction to a specific protein (allergen). Food intolerances — like lactose intolerance — are metabolic reactions without immune system involvement. The difference is very important for treatment.
The two conditions are often confused but are fundamentally different:
- Food allergy — the immune system mistakenly identifies a food protein as a threat and produces IgE antibodies. The reaction can occur seconds to minutes after ingestion. Can be life-threatening (anaphylaxis).
- Food intolerances — for example: lactose intolerance is caused by a lack of the enzyme lactase that breaks down milk sugar. Reactions (bloating, diarrhea) typically occur 30 minutes to 2 hours after. Not life-threatening.
- Celiac disease — an autoimmune disease against gluten. Neither allergy nor intolerance — a third category.
Important: many parents believe their child has a food allergy based on symptoms that are actually intolerance. A correct diagnosis — from a doctor with an IgE test — is crucial for proper treatment.
The 14 EU-regulated allergens
EU food regulation requires all 14 major allergens to be highlighted on ingredient lists in bold, italics, or underlined. Learn them by heart — it can save lives.
According to EU Food Regulation 1169/2011, these 14 allergens must always be declared:
- Gluten (wheat, rye, barley, oats)
- Crustaceans and shellfish (shrimp, lobster, crab)
- Eggs
- Fish
- Peanuts
- Soy
- Milk (including lactose)
- Tree nuts (almonds, hazelnuts, walnuts, cashews, pecans, Brazil nuts, pistachios, macadamia nuts)
- Celery
- Mustard
- Sesame
- Sulfur dioxide and sulfites
- Lupin
- Mollusks (mussels, squid)
Signs of allergic reaction in children
Allergic reactions range from mild itching (oral allergy syndrome) to anaphylaxis requiring emergency medical care. Know the difference — it is critical.
Symptoms by severity:
- Mild reaction: Itching in the mouth, redness, hives, runny nose, watery eyes
- Moderate reaction: Stomach cramps, vomiting, diarrhea, widespread hives
- Severe reaction (anaphylaxis): Swollen throat, shortness of breath, wheezing, sudden drop in blood pressure, fainting
Call 112 at signs of anaphylaxis. The Danish Health Authority has a guide for managing allergic reactions in children. If the child has been prescribed an adrenaline pen (EpiPen), ensure caregivers and teachers know how to use it.
Early introduction prevents allergy — new research
Rethink the classic advice to avoid allergens. Research now clearly shows: early introduction of peanuts and eggs in babies REDUCES the risk of allergy — it does not increase it.
The major paradigm shift in allergy research came with the LEAP study (Learning Early About Peanut) from 2015. The study published in the New England Journal of Medicine showed that babies at high allergy risk who were given peanuts from 4-11 months had an 86% lower risk of peanut allergy at age 5 compared to those who avoided peanuts.
Modern consensus:
- Do not avoid allergens in healthy babies — introduce them gradually from 4-6 months
- Existing eczema in babies is a risk signal — talk to a doctor about timing
- Introduce one new allergen at a time with 3-5 day intervals
Evaluation and diagnosis — IgE test and trial period
A correct food allergy diagnosis requires specialist evaluation. Skin prick tests and IgE blood tests can identify if the child is sensitized — but proof of a true allergy requires a controlled exposure test.
The diagnostic process:
- Step 1: Parents describe the reaction precisely (time, symptoms, food eaten)
- Step 2: General practitioner assesses and can order an IgE blood test
- Step 3: With a positive IgE test: referral to a pediatric allergist for full evaluation
- Step 4: Oral food challenge (OFC) — controlled exposure under medical supervision
Avoid removing foods from the child's diet based on symptoms alone — this can lead to unnecessary nutritional deficiencies and make the child more sensitive.
Living with food allergies in everyday life
Inform the institution and school in writing about the child's allergy and emergency medication. Review lunch menus, share recipes, and teach staff to recognize an allergic reaction.
Practical advice for everyday life with food allergies:
- Daycare and school: Send written information to management, have an action plan, and provide an adrenaline pen to staff in case of severe allergy
- Birthdays and parties: Prepare the child’s own alternative — let the child carry their safe candy/cake themselves
- Cooking at home: Separate cutting boards and utensils reduce cross-contamination
- Restaurant: Inform the waiter in writing — allergy communication should not fail due to language barriers
Children with food allergies can absolutely have a normal, rich social life — it just requires an informed network. See our inspiration blog for allergy-friendly recipes and family ideas. Our kitchen sets for children help involve allergic children in cooking.
Food allergies in children are real but require correct diagnosis rather than assumption. Allergy and intolerance are not the same. Early introduction of allergens prevents — it does not stop allergy. And the 14 EU allergens are your guide as a parent.
If you are concerned about your child’s reactions to food, contact your general practitioner. Proper evaluation provides clarity that makes everyday life easier — for the whole family.
Frequently Asked Questions
When do food allergies typically develop in children?
Most food allergies appear before the child’s 2nd birthday, after the introduction of solid foods. Milk and egg allergies are common in infants and most outgrow them. Peanut, nut, and fish allergies are more persistent and typically last a lifetime.
Can children outgrow food allergies?
Yes — milk and egg allergies disappear in up to 80% of children before school age. Peanut allergy disappears in about 20%. Fish and shellfish allergies are rarely outgrown. Regular follow-up with an allergy specialist can determine if the child is ready to cautiously try the allergen again.
What is oral allergy syndrome?
Oral allergy syndrome (pollen-food allergy) causes itching and mild swelling in the mouth and throat after eating raw fruits or vegetables. It is due to cross-sensitization with pollens (birch pollen and apples, for example). The reaction typically disappears when cooked and is rarely dangerous.
Is gluten intolerance the same as celiac disease?
No — celiac disease is an autoimmune disorder diagnosed with blood tests and intestinal biopsies. Non-celiac gluten sensitivity is a separate condition without an autoimmune reaction. Both require a gluten-free diet, but celiac disease is more serious and requires lifelong strict adherence. Suspect celiac disease? Eat gluten before the blood test — this is important for an accurate diagnosis.
When should I call 112 if I suspect an allergic reaction?
Call 112 immediately if: swollen tongue or throat, difficulty breathing, wheezing, low blood pressure, or fainting. Administer the adrenaline pen injection in the thigh (if prescribed) and have the child lie flat. These symptoms indicate anaphylaxis and require emergency medical help.