The two most important parts of managing food allergies confidently are prevention and being prepared for emergencies. Learn more from Michael Pistiner, MD, director of the Food Allergy Advocacy, Education and Prevention in the Food Allergy Center at Mass General for Children.

What is a food allergy?

A food allergy is a when your immune system (the system in your body that fights off germs and illnesses) mistakes a certain type of food as something dangerous. When this happens, your child might develop a number of symptoms, including a rash or hives, swelling of the lips, eyes or tongue, trouble breathing, dizziness or nausea. Symptoms can happen within minutes or hours of eating a certain food.

What are the most common food allergens?

A food allergen is a food that your child is allergic to. The eight most common food allergens include:

  • Egg
  • Milk
  • Peanut
  • Tree nuts
  • Shellfish
  • Fish
  • Soy
  • Wheat

How can I manage my child’s food allergy confidently?

The two most important parts of managing food allergies with confidence are prevention and being prepared for emergencies.


  • Avoid your child’s food allergen. You can do this by reading labels every time you buy food, even if you buy the same product again. Companies can change their ingredients, food preparation or cooking methods at any time without warning.
  • Teach your child age and developmentally appropriate ways to take part in managing their food allergy.
  • While encouraging and teaching your child to follow age-appropriate food allergy rules, continue to emphasize that they are healthy. Remind them they are not sick and that they do not have something wrong with them.
  • Learn how to read a label for your child’s food allergens and understand the labeling laws.
  • When preparing or cooking food, prepare your child’s meal first. This prevents your child’s food allergens from touching their food, utensils or other surfaces.
  • Use soap and water or handwipes to wash your hands and clean all cooking utensils, dishes, cups and silverware. Remember, hand sanitizer does not remove food allergens from your hands.
  • Teach others who serve and prepare food for your child about food allergies and safe ways to cook, prepare and clean.

Prepare for emergencies

  • Recognize signs of an allergic reaction.
  • Keep your child’s Emergency Care Plan and epinephrine auto-injectors on hand at all times.
  • Follow the plan if your child has an allergic reaction.
  • Remember, epinephrine is the treatment for a severe, life-threatening reaction. It works fast and is safe. Its effects can wear off quickly and sometimes a second dose is needed.
  • Always call 911 so additional treatment and care can be given quickly.

How does my child’s age and developmental stage affect how they manage food allergies?

Age and developmental stage play an important role in food allergy management:


  • Babies cannot communicate their needs. It is up to the family to read their baby’s cues and watch for signs of an allergic reaction.
  • Babies explore the world with their hands and mouths. Babies can put their hands in their mouths up to 80 times per hour. As a family, you should watch your baby around food and wash their hands if they come in contact with their allergen.


  • Children become aware of their health issues and develop skills as they grow up.
  • Children, especially very young children, are likely to put their hands in their mouths. As a family, you should watch your child around food and wash their hands before eating and after potential contact with their allergen.


  • Some teens can feel like their food allergies are a burden to others. They can also feel isolated or like they do not fit in with their peers because of their food allergies.
  • It can help when others are educated about food allergies without your teen feeling like they are the center of attention.
  • Have an open line of communication with your teen. Help them problem solve and encourage them to share their feelings and mistakes.

What is cross-contact?

Cross-contact is when a food allergen touches another surface or food that is typically safe for your child. Common sources of cross-contact include:

  • Cooking and serving tools, such as pots and pans, silverware or serving utensils
  • Dishes and cups
  • Sponges and other cleaning tools
  • Surfaces used to prepare, serve and cook food (including hot surfaces, such as stovetop or grill)
  • Saliva, including pet and human saliva
  • Unwashed hands

What is anaphylaxis?

Anaphylaxis is a severe allergic reaction that can happen within minutes of coming into contact with an allergen. If not treated right away, anaphylaxis can be life-threatening. If your child develops anaphylaxis after eating a food allergen, give epinephrine with an auto-injector and call 911. Follow your anaphylaxis emergency care plan!

Symptoms of anaphylaxis can be different in every person. Sometimes, symptoms of anaphylaxis can be different every time a person has a reaction. Symptoms may include:

  • Itchy rash (like hives)
  • Swelling of the tongue, throat or face
  • Shortness of breath, coughing or wheezing (whistling sound when breathing in)
  • Vomiting, diarrhea, stomachache or stomach cramping
  • Dizziness or low blood pressure

Rev. 6/2018. The information on this webpage is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.