The Rise of Childhood Allergies
Childhood allergies have increased significantly over the past three decades. Today, approximately one in five children in the United States has at least one allergic condition, including food allergies, environmental allergies, eczema, or asthma. While researchers continue to investigate the reasons behind this rise, including factors like reduced early microbial exposure, dietary changes, and environmental pollutants, parents need practical guidance on managing allergies right now.
Whether your child has just been diagnosed or you have been managing allergies for years, this guide covers essential information to help you keep your child safe and comfortable.
Types of Childhood Allergies
Food Allergies
Food allergies affect approximately 8 percent of children and can cause reactions ranging from mild hives to life-threatening anaphylaxis. The most common food allergens in children are:
- Peanuts and tree nuts
- Milk
- Eggs
- Wheat
- Soy
- Fish and shellfish
- Sesame (recently added to the major allergen list)
Many children outgrow milk, egg, soy, and wheat allergies by school age, but peanut, tree nut, fish, and shellfish allergies tend to persist into adulthood.
Environmental Allergies
Also called allergic rhinitis or hay fever, environmental allergies are triggered by substances like pollen, dust mites, mold, and animal dander. Symptoms include sneezing, runny or stuffy nose, itchy and watery eyes, and throat irritation. These allergies typically develop after age 2 and are often seasonal but can be year-round depending on the trigger.
Eczema and Skin Allergies
Eczema (atopic dermatitis) affects up to 15 percent of children and is often the first sign of an allergic tendency. It typically appears as dry, itchy, red patches on the skin and is strongly associated with developing food allergies, environmental allergies, and asthma later in childhood, a progression known as the atopic march.
Getting a Proper Diagnosis
If you suspect your child has allergies, start with your pediatrician, who may refer you to a pediatric allergist. Diagnosis typically involves:
- Detailed medical history: Including symptom patterns, timing, and family allergy history
- Skin prick testing: Small amounts of suspected allergens are applied to the skin to check for reactions
- Blood tests: Measuring specific IgE antibodies to potential allergens
- Oral food challenge: The gold standard for food allergy diagnosis, conducted under medical supervision
Avoid self-diagnosing or eliminating foods from your child's diet without medical guidance, as unnecessary dietary restrictions can lead to nutritional deficiencies.
Daily Management Strategies
For Food Allergies
- Read every food label every time, as ingredients can change without notice
- Teach your child about their allergies in age-appropriate terms
- Always carry two epinephrine auto-injectors and know how to use them
- Develop an allergy action plan with your allergist and share it with schools, caregivers, and family members
- Inform restaurants about your child's allergies and ask about ingredients and preparation methods
For Environmental Allergies
- Use dust mite covers on pillows and mattresses
- Wash bedding weekly in hot water
- Keep windows closed during high pollen seasons and use air conditioning with HEPA filters
- Shower and change clothes after outdoor play during allergy season
- Consider allergen immunotherapy (allergy shots or sublingual tablets) for long-term management
When to Use an EpiPen
Anaphylaxis is a severe, potentially life-threatening allergic reaction that requires immediate treatment with epinephrine. Signs include difficulty breathing, throat tightness, swelling of the face or tongue, widespread hives, vomiting, dizziness, or loss of consciousness. If your child shows any of these symptoms after exposure to a known or suspected allergen, administer epinephrine immediately and call 911. It is always safer to use epinephrine and not need it than to wait and risk a delayed response.
Emerging Treatments
Oral immunotherapy (OIT) for food allergies has shown promise in building tolerance to allergens under close medical supervision. While not a cure, OIT can raise the threshold for allergic reactions, providing a safety net against accidental exposures. Discuss with your allergist whether your child might be a candidate for this or other emerging treatments.
Supporting Your Child Emotionally
Living with allergies can be socially and emotionally challenging for children. They may feel different from peers, anxious about accidental exposure, or frustrated by dietary restrictions. Validate their feelings, help them develop confidence in managing their allergies, and connect them with other children who share similar experiences through support groups or allergy organizations.