Do you suspect that your child has a food allergy or intolerance?

Food allergy is common in Australia and New Zealand. According to the Australasian Society of Clinical Immunology and Allergy (ASCIA), food allergy affects around 5–10% of children and 2–4% of adults. Severe allergy is also significant, with approximately 1 in 10 infants, 1 in 20 children and 1 in 50 adults living with severe allergic disease, including anaphylaxis risk.

Read more via ASCIA’s Food Allergy Fast Facts:

https://www.allergy.org.au/patients/fast-facts/food-allergy

With numbers like these, even if your child doesn’t have a food allergy, you probably know someone who does.

Fact: Many Children Outgrow Certain Food Allergies

Many children outgrow allergies to cow’s milk, egg, soy and wheat, particularly in early childhood. In contrast, allergies to peanut, tree nuts, sesame and seafood are more likely to persist into adolescence and adulthood.

This pattern is consistently reported by ASCIA and Allergy & Anaphylaxis Australia.

More information is available here:

https://allergyfacts.org.au/__interest/food-allergy/

Food Allergy vs Food Intolerance: What’s the Difference?

Food intolerance is often confused with food allergy, but they are very different.

• Food allergy involves the immune system and can result in severe reactions, including anaphylaxis.
  
• Food intolerance does not involve the immune system, is not life-threatening, and does not show up on allergy testing.
  

Food intolerances are usually caused by components in foods, such as naturally occurring food chemicals or fermentable sugars, rather than the food itself.

Things You May Not Know

It can be tempting to remove foods as soon as you suspect a problem, but this isn’t always the best approach. Identifying whether a child has a food allergy or intolerance can be complex:

• The culprit food is not always the last food eaten
  
• Reactions may be caused by non-food triggers (such as environmental allergens or irritants)
  
• Symptoms vary widely and may include rashes, eczema, tummy pain, vomiting, bloating, diarrhoea, constipation, swelling or breathing difficulty
  
• Allergic reactions usually occur quickly (within minutes to a few hours)
  
• Intolerance symptoms can be delayed by 24–48 hours or more
  
• Some children react to one food; others to multiple triggers
  
• A positive skin prick test or blood test does not equal a diagnosis of food allergy — false positives are common
  
• Food intolerances cannot be diagnosed with a single test and usually require structured elimination and challenge
  
• There are many elimination diets, each with different purposes and rules
  

Because of this complexity, it’s important to seek help from a health professional experienced in food allergy and intolerance.

Food Allergy: Most Common Triggers

The following foods account for the majority of food allergic reactions in children:

• Egg
  
• Cow’s milk (dairy)
  
• Soy
  
• Wheat
  
• Peanuts
  
• Tree nuts
  
• Sesame
  
• Fish
  
• Shellfish
  

While almost any food can cause an allergic reaction, allergies outside this group are uncommon.

See ASCIA’s overview of Food Allergy here:

https://www.allergy.org.au/patients/food-allergy

Food Allergy: Symptoms

Mild to moderate symptoms may include:

• Swelling of the face, lips or eyes
  
• Hives or welts on the skin
  
• Abdominal pain or vomiting
  

Signs of a severe allergic reaction (anaphylaxis) include:

• Difficult or noisy breathing
  
• Swelling of the tongue
  
• Tightness or swelling in the throat
  
• Difficulty speaking or hoarse voice
  
• Wheezing or persistent cough
  
• Persistent dizziness or collapse
  
• Pale and floppy appearance in young children
  

Anaphylaxis is a medical emergency and requires immediate treatment.

Food Intolerance: Common Triggers

Food intolerances are typically caused by specific components in foods rather than the food itself. These include:

• Artificial food colours
  
• Preservatives
  
• Flavour enhancers
  
• Naturally occurring food chemicals such as salicylates, amines and glutamates
  

Because these chemicals appear across many unrelated foods, it is uncommon for someone to be intolerant to a single food alone (for example, only strawberries).

Assessment by an Accredited Practising Dietitian with experience in food intolerance is essential.

Food Intolerance: Symptoms

Food intolerance symptoms can overlap with allergy symptoms but are often broader and more variable. They may fluctuate over time and be dose-related.

Symptoms may include:

• Skin: rashes, swelling
  
• Airways: asthma, runny or blocked nose, frequent infections
  
• Gastrointestinal: bloating, diarrhoea, vomiting, reflux, constipation, colic, mouth ulcers, bedwetting
  
• Central nervous system: headaches, migraines, fatigue, irritability, anxiety, poor concentration, sleep disturbance
  

Symptoms may be delayed by up to 48 hours or longer, making identification difficult.

Other Reactions That Aren’t Allergy or Intolerance

Symptoms may also be caused by:

• Food poisoning
  
• Toxic reactions
  
• Enzyme deficiencies
  
• Food aversion
  
• Skin irritation from contact with certain foods
  

This further highlights the importance of professional assessment rather than self-diagnosis.

Why Cutting Out Foods Can Be Risky

Children should never follow a nutritionally restrictive diet without proper guidance.

Unnecessary food avoidance can lead to nutrient deficiencies. For example, inadequate calcium intake during childhood may affect bone development and increase fracture and osteoporosis risk later in life.

Professional guidance helps identify:

• Which foods need to be avoided
  
• Which foods are safe
  
• Whether supplementation is required
  

What to Do If You Suspect a Food Allergy or Intolerance

1. Book an appointment with a health professional

Your GP can help determine whether referral to an allergy specialist or paediatric dietitian is required. Some allergy clinics allow direct appointments without GP referral.

2. Record symptoms and history

Before your appointment, record as much detail as possible:

• Timing, frequency and location of symptoms
  
• Photos of visible symptoms (rashes, hives, eczema)
  
• Bowel habits and toileting patterns
  
• Foods and drinks consumed
  
• Environmental exposures (soaps, detergents, pets, pollens)
  
• Parental observations and instincts
  

Your specialist may ask you to complete a structured food and symptom diary.

3. Seek professional diagnosis

Even if a food seems to clearly cause symptoms, confirmation by a qualified professional is essential.

An allergy specialist or experienced dietitian can:

• Interpret test results accurately
  
• Recommend appropriate testing if required
  
• Guide elimination diets and food challenges
  
• Assess nutritional adequacy
  
• Identify what doesn’t need to be avoided
  

Allergy Testing: What You Need to Know

Skin prick tests and blood tests (allergen-specific IgE) show sensitisation, not necessarily true allergy. Some positive results are false positives.

Only a clinician can interpret results correctly and determine whether food challenges are needed.

ASCIA explains allergy testing clearly here:

https://www.allergy.org.au/patients/allergy-testing/allergy-testing

Elimination Diets: Use With Care

Elimination diets should only be used long enough to confirm or exclude a suspected trigger, usually weeks to months.

They should always be supervised by:

• An allergy specialist
  
• Specialist paediatrician
  
• Accredited Practising Dietitian with food allergy/intolerance experience
  

The goal is always the widest, safest diet possible.

“May Contain Traces Of…” – What It Means

Precautionary allergen statements such as “may contain traces of…” are voluntary and indicate possible cross-contamination risk.

Unlabelled food or food prepared outside the home often carries higher risk.

ASCIA provides guidance on food labelling and risk management here:

https://www.allergy.org.au/patients/food-allergy

If your child has a food allergy, discuss how to interpret these statements with your specialist. For food intolerance, these statements usually do not require avoidance.

Cow’s Milk Protein Allergy vs Lactose Intolerance

True lactose intolerance is rare in infants and young children.

When babies react to milk, the more common cause is Cow’s Milk Protein Allergy, which may cause vomiting, diarrhoea, or blood/mucus in stools.

Temporary lactose intolerance can occur after gastro illness. A GP or dietitian can help distinguish between these conditions.

Beware of Unproven Testing

Many alternative tests claim to diagnose food allergy or intolerance but lack scientific evidence and can be costly and misleading.

ASCIA outlines unorthodox tests to avoid here:

https://www.allergy.org.au/patients/allergy-testing/unorthodox-testing-and-treatment

Allergy and Intolerance Support in Brisbane

Families can seek help from experienced services including:

• Queensland Allergy Services – http://www.qldallergy.com/
  
• Compass Immunology Clinic – http://www.immclin.com/
  
• Allergy Medical Group – https://www.allergymedicalgroup.com.au/
  
• Allergy First – https://www.allergyfirst.com.au/
  

Accredited Practising Dietitians with paediatric allergy and intolerance experience can also provide valuable support.

Final word

If you’re worried about your child, trust your instincts — but don’t go it alone. The right professional support can provide clarity, reassurance, and a safe path forward without unnecessary restriction.