Food allergies affect 32 million people in the United States, including 13% of children. They occur when the body’s immune system perceives a threat from proteins in food and overreacts to neutralize it. If you have a family history of food allergies, asthma, eczema or pollen allergies, you may be at higher risk for developing food allergy. Food allergies should not be confused with intolerance to food; food allergies can be life-threatening. The most common food allergens are peanut, milk, egg, tree nuts, wheat, soy, sesame, fish and shellfish.

Food allergies require vigilance, especially for children. Small children need careful supervision as they are likely to put any food or object into their mouth; even food left out for a pet can have allergens like dairy, wheat, soy, peanuts, egg or shellfish. Children with severe allergies need to have an emergency plan in place for daycare, school and friends’ homes. Medication and permission forms to administer it, prescriptions, and meetings to discuss accommodations and care should be in place anywhere children are out of their parents’ care.

Up to 30% of eczema patients will develop reactions to certain foods, including gastrointestinal distress, respiratory symptoms like wheezing, difficulty breathing or anaphylaxis, or skin reactions like itching, swelling, and hives. Sometimes eliminating foods from a patient’s diet can improve eczema symptoms, so working with an allergist is key. Skin tests, blood tests and oral food challenges can help identify food allergens. Immunotherapy is emerging as a treatment option for certain food allergens.

People with food allergies need to use caution when dining out. Even getting coffee can pose a risk of cross-contamination with milk and its alternatives. Keeping your order as simple as possible and communicating about the risks you face are all key. Personal “chef cards” that list allergens and severity of reactions, and the need for vigilance in the kitchen to avoid cross-contamination, are recommended when dining out. Chef cards provide the staff with a visual cue to remember the information and avoid potentially fatal mistakes.