The Real Deal on Food Allergies

November 12, 2012 |  by  |  guest author, Medical Wrinkles
worried about food allergies
We’re heading into the holidays AKA “that time of year where strangers will hand your children cookies and treats.” Why? Because seeing their little faces light up as they bite into a chocolate nut brownie is the absolute BEST. Or course you won’t be enjoying it because you’ll too busy exploding into a full-blown “OMG MY BABY JUST ATE THEIR FIRST PEANUT AND IS PROBABLY GOING TO DIE!” panic attack. Well luckily Dr. Benaroch is here to help sort the truth from the panic-inducing myths about food allergies. He’s an ACTUAL doctor (not just somebody who reads a lot and writes like she is…ahem) who blogs about why you need to get your kid vaccinated, sleep, and lots of other cool doctor-type stuff. Welcome Dr. Benaroch!

Food allergies are real, and can make your child very sick. The idea that food can be dangerous is scary, especially when children start to go to school or share meals away from home. But sometimes concerns about food allergies go overboard.

But the truth is, food allergies are common, and becoming far more common. So it’s important to know what’s real about food allergies, and what is a persistent myth.

True allergies to food affect about 1 in 25 preschoolers. This has increased somewhat, probably by about 20%, over the last 10 years. However there are many children (and adults) who think they’re allergic, but really aren’t. And among people who do have allergy, the vast majority of reactions are mild.

If you have a reaction to a food, that means there is an allergy. “Allergy” refers to a specific kind of immune-mediated reaction. Symptoms of true allergy occur very soon after ingestion, and are consistent including: hives, difficulty breathing, vomiting, or diarrhea.

There are many other kinds of “adverse reactions” to foods that are not allergies. These include lactose intolerance, Celiac disease, heartburn, eczema, and many non-specific perceived changes in behavior. It’s important to make the distinction between a true allergy and other kinds of reactions because only true allergies have the possibility of leading to life-threatening reactions.

6 Common Food Allergy Myths


True allergies can be diagnosed by blood tests or skin tests.

This is untrue. True allergy is a clinical diagnosis—you have to document the actual allergic reaction that occurs. Testing can sometimes be useful to confirm the diagnosis, but it doesn’t make the diagnosis. Even the best, state-of-the-art testing done by allergists can have false positive and false negative results. And the internet is rife with sites promoting quacky, weird tests that are even less accurate. Many people think they have allergies because of bad testing that has been misinterpreted. If your child can eat a food and doesn’t have an allergic reaction, he is not allergic—no matter what any “testing” shows.


Any food can cause allergy.

That’s theoretically true, but the vast majority of food allergies are triggered by one of “the big eight”: milk, egg, soy, peanut, tree nut, fish, shellfish, and wheat. Extensive testing beyond these foods, without a history of a suggestive reaction to a specific food, is much more likely to falsely label an allergy than to uncover a true problem.


Any child with allergy can have a life-threatening reaction.

Most people with allergy have the same reaction with every ingestion—if they had hives last time, they’ll probably get hives again. However, it is possible for even mild reactions to be followed by more-serious ones, so parents and school do have to be alert.

A history of asthma or recurrent wheezing is an important risk factor for life-threatening food reactions among allergic individuals—even if wheezing or asthma hasn’t been triggered by foods in the past, anyone who has both a true food allergy and a history of asthma is at higher risk of a very serious reaction. Additional risk factors include a history of a prior life-threatening reaction to anything, or an allergy to peanut, tree nut, egg, fish, or shellfish.


Life-threatening reactions can occur through air or skin contact.

Peanut allergy alone accounts for about 80% of the deaths from food allergy in the United States, causing about 160 fatalities a year. For comparison, lighting strikes each year kill about 50-100 people.

Although it’s theoretically possible, all documented serious reactions have occurred from eating the food. “Peanut dust” in the air or touching peanut-contaminated surfaces has caused skin and eye and nose symptoms only. The best way to protect allergic kids is to prevent ingestion. Don’t allow sharing of foods, utensils, drinks, or cups, and wipe down eating surfaces to prevent cross contamination. Foods in the environment don’t cause serious reactions unless they contaminate other foods and get eaten.


Food allergies are permanent.

Most kids with egg, milk, and many other allergies will usually outgrow them. However, allergies to peanut, treenut, fish, and shellfish may have only about a 20% chance of resolving. Recent research into egg allergy specifically has shown that small, limited exposures to egg (typically, baked into food) can make it more likely that a child with true egg allergy will outgrow it.


Avoiding foods early in life helps prevent allergy.

This is a persistent, lasting myth that is completely untrue. In fact, delayed introduction of foods increases the risk of allergy. Pregnant and nursing moms should not avoid any foods, unless they themselves are allergic.

What if My Child Actually Has a Food Allergy?

Food allergies can lead to severe or life-threatening problems, though these kinds of reactions are rare. If you suspect your child has a food allergy, work with your pediatrician or a board-certified allergist to clarify what’s going on, and develop a plan. You’ll need instructions on how to avoid the trigger(s), and an action plan for what to do if an ingestion occurs. Make sure to share these instructions with the school and all caregivers, and make sure there is always access to the emergency medications that have been prescribed. With knowledge and reasonable precautions, food allergies can be managed, and parents do not need to live in fear.

Food allergies: Myths and facts
© 2012 Roy Benaroch, MD

PS. Because it was JUST on SNL this weekend I thought I would also include this funny digital short about faking allergies to get out of stuff you don’t like. Cheers!-Alexis


  1. THANK YOU Dr. Benaroch for laying down the science. I’ve heard countless people, even very well-informed ones, propagate myth #6 in particular. And I didn’t even know about #4. (I don’t have an allergic child, and since I haven’t walked a mile in those shoes I do NOT dismiss the concerns of parents with truly allergic children, but I also think that we are having an unmerited nationwide freakout about allergies right now.) I have a great pediatrician who is very forthright in busting these myths, but I have even heard about doctors who propagate #6.

    • Check the link Dr. Benaroch posted below for more deets on #6. I’m with you about the freakout. Glad you also have a good mythbusting pediatrician there 🙂

  2. Thanks for a great post! Even Baby Center propagates #6! I feel lucky to have an informed pediatrician who has taken the fear out of introducing foods. Instead we are having a great time watching our daughter begin to explore the world of food!

    • Feeding babies solids is the BEST. (If you can’t tell I’m having a little case of baby fever.) The first few months are rough but when they’re older and all cute, chubby, happy, and shoveling chocolate cookies into their beaming mouth? FABULOUS!

  3. Thanks for a very informative article!

    As a mom of an allergic (anaphylactic egg and gastrointestinal (projectile vomiting) dairy/milk – although she’s never actually had any dairy directly yet) 9-month old, I think the deal with #6 is not that delaying allergens will prevent allergies, but simply that dealing with a reaction is easier when your child is slightly older – especially with a severe reaction. That’s how I’ve understood the recommendations.

    • As I understand it, for a number of years it was believed that delaying exposure to certain foods would in fact reduce the risk of allergy. More recently studies suggest the opposite: delaying exposure might actually INCREASE the risk. I know there was a study comparing peanut allergy in the UK where most kids had zero exposure in infancy to kids in Israel, where peanut butter is often introduced in the 7-8 month range. The Israeli kids had a lot less peanut allergy.

      Hope your little one outgrows her allergies!

      • Yes, it Ws believed that it would decrease the risk. Or allergist had previously advised allergen avoidance in third trimester and while nursing, but no longer recommends that.

        Having said that, one of my children is allergic to peanuts, and had his first (horrible!) reaction to peanuts (in a popular snack called Bamba) in Israel.

        Also interesting, is that for some reason, many pediatricians try to deny your child’s food allergy. One of my children seemed to be having allergic reactions and the pediatrician just brushed it off as probably being an “insensitivity”.

        I finally listened to a friend with allergic children and went to an allergist. It turned out that my son was highly allergic to wheat and allergic to eggs. Over the years, we discovered allergies to yeast, spelt, and rye as well. (Our allergist was amazed by our finding the spelt and rye allergies, which are apparently very uncommon. I guess when you are looking for wheat alternatives, spelt and rye are obvious things to try!)

        We also have a child who is allergic just to eggs, and another who is allergic just to yeast. And some who have no allergies. Yay!

        One more point: as much as the airborne or by touch allergies are not usually fatal, they can still be uncomfortable for the child. When my son was in a camp where his bunk baked a lot, he would come home red and itchy until the camp finally stopped this activity. Even though he was not participating, flour was in the air and remained on the tables and he kept having reactions. Also, though he knows he is different and is really good about it, it is certainly not fun for him to constantly be excluded from projects and activities. We have had some teachers who were really sensitive about this, and their creativity and sensitivity have been much appreciated!

  4. Thanks for replies, and thanks to Alexis for the invitation to post here! You guys rock!

    RE: delayed introduction of solids, evidence that this didn’t prevent allergy began to accumulate about 10 years ago, and the American Academy of Pediatrics officially abandoned that strategy in a position paper published in 2008:

    The paper is long, but worth a read– you can jump to the 9 points in the summary at the end if you want the quick version. There is no reason to delay any solids beyond 4-6 mos of life (well, no reason regarding allergy. Obviously some foods should be delayed as choking hazards or other reasons. 6 mos old should not be gnawing on a hot dog.)

    Though that paper came out in 2008, there are still many people who cling to the older myths. I just googled “diet baby avoid allergy” and the volume of misinformation is staggering.

  5. Fantastic post! Again referring to #6 I am somewhat relieved as I have a very large, constantly hungry 4.5 month old who has been trying to steal my food for a while and I have delayed an early introduction of solids absolutely based on this myth. Our pediatrician even reminded me of it last week…. How hideously misinformed we are…..

  6. Yet more evidence, fresh off the presses:

    The more we look, the more evidence we get that earlier solids prevent allergic disease.

  7. So what do you do when your baby has a reaction such as bloody stools as an infant? My 4 month old had bloody stools so I went off of dairy completely (we’re talking absolutely NO dairy!). When would be a good age to see if he has outgrown the intolerance? And what food should I try first? Give him some yogurt or should I eat a piece of cheese and see how he reacts?? Thanks for the advice!!

  8. I’m still confused. This article answered nothing per the provocative title.

    When should I introduce peanut butter so my kid won’t develop an allergy? Why are there so many peanut allergies these days? When I was a kid everyone ate peanut butter and jelly.

    Since peanut butter allergies seem to be deadly do I need to stand next to him with an epi pen the first time he tries peanut butter?

    • That title was too provocative? Wow. I had considered going with something like:

      But OK.

      I believe the general answer to “why everybody has so many allergies” is largely considered to be due to the hygiene hypothesis. Basically that people used to live with dirt, animals, and all sorts of nasty creepy crawlies. Now we’re all clean and one of the unexpected outcomes is that our bodies have way more issues with food allergies, asthma, etc. Check this out:

      But the real answer is that nobody is quite sure yet.

      Do you have a history of food allergies with severe response? Is your pediatrician worried? If “no” then I’m not worried. But if you have an epi pen lying around and if makes you feel better, go ahead and hold it when you give your child a peanut butter cookie.

      Did you notice Dr. Benaroch’s stats on lightning strikes above? So you carry a portable lightning rod whenever you’re out in the rain? I guess my thought is, why do we spend so much energy worrying about what is, statistically, an enormously unlikely outcome?

      • I think autism rates follow a trend similar to the increase in allergies in developed countries and, apparently, there is a theory that now links that with the (inaccurately named) Hygiene Hypothesis. Something to do with the prevalence of histaminic reactions in the womb, which is related to how much bacteria is lying around.

        P.S. Instead of carrying a lightening rod when it storms, I just make sure not to be standing around in the middle of a large field or operating my ham radio. I suspect it’s the case that, while very few kids die from peanut allergies, enough suffer from them that it may be worth taking some easy precautions — it just happens that waiting until your kid is 3 before introducing peanuts is no longer one of them.

        P.P.S. So far my kid doesn’t seem to have any allergies but, just in case, I carry around an epi pin with an ACTUAL pen on the other end, so I can jam him with it and then immediately write a check for a co-payment or oil change or whatever 🙂

    • Debbie,

      “When should I introduce peanut butter so my kid won’t develop an allergy?”

      There is no such age. Earlier introduction seems to reduce allergy risk, but there is no age at which there is no allergy risk. We do not know the ideal time for the introduction of peanut (or any other food.)

      “Why are there so many peanut allergies these days?”

      As I said, the rate of peanut allergy has increased by about 20% over the last 10 years, which is a modest increase. It certainly isn’t shooting through the roof. The increased perception is in part because the media likes to inflate exciting stories, and because so many people are concerned about this, thinking about it and looking for it.

      The modest increase is perhaps related to the hygiene hypothesis (see Alexis’ answer) and the misguided trend towards later introduction of peanut and other solids.

  9. What about honey? Does that fall under the same category as peanut butter?

  10. The issue w/ honey isn’t allergies– it’s botulism, a very serious illness that can be transmitted by spores in natural honey. Babies less than 12 mos can catch botulism from honey, so it should never be given under that age.

  11. I was wondering if you have some references for the following statement that I could look through & take to my pediatrician’s office next week? “Recent research into egg allergy specifically has shown that small, limited exposures to egg (typically, baked into food) can make it more likely that a child with true egg allergy will outgrow it.”

    My 2 1/2 year old daughter has anaphylactic reactions to peanuts, and milder reactions (“asthma” flares – although she’s too young for the PFTs to diagnose asthma – and eczema). We had been told by the allergist a year and a half ago to completely avoid eggs as that was her best chance to outgrow this allergy. (He wants to see her again at 4 or 5 years old.) I recently discovered that daycare has been occasionally feeding her products baked with eggs, and as far as I can tell, these times coincided with increased cough and eczema. I had heard of sensitization studies, but not that I should be potentially feeding her eggs. I’d love more information about this. Thanks!

  12. Angela, if it seems like even small exposures are causing symptoms, you should make sure your child isn’t exposed to any egg. The studies and protocols I’ve seen are for children who can tolerate some egg without any reaction.

    Oral desensitization is being actively studied, but isn’t something I suggest anyone do on their own. If anyone would like to pursue this, they need direct evaluation and advice from someone qualified who can work with them.

    Oral immunotherapy shows promise to treat egg allergy:

    Baked egg in diet can help children outgrow allergy:

    Early introduction of egg may prevent allergy:

    Also: PFTs are useful and a good tool, but are not necessary– children can be diagnosed with asthma even when they’re too young to do PFTs.

    • Awesome resources on egg sensitivity – thanks so much for sharing this great research!

    • Thank you so much for this wonderful information! I think I’ll find out for sure today if she’s reacting to eggs still…. A sub at daycare gave her scrambled eggs for breakfast this morning! They think she only ate one spoonful before someone realised, but if she gets a rash and a cough it’ll be confirmed again. Sigh. If no sign of a reaction, though, I’ll think about asking the pediatrician about the desensitisation protocols. Thanks!

  13. Is it really necessary to only introduce one food at a time and then wait a few days to see if there is an allergy? For example, could I give her beef stew (beef, potato, carrot, onion,) before introducing each ingredient separately? Obviously, I would be very careful with shellfish and introduce that separately as her dad is allergic but for “normal” food is this necessary?

  14. Roxanne, introducing one food at a time is traditional, but that doesn’t mean it is necessary. As you suggest, it may make sense to consider whether a certain food is likely to be an allergen — almost all food allergies are to one of these: milk, egg, soy, peanut, tree nut, fish, shellfish, and wheat.

    Also, family history is important. If neither parent has a food allergy, the chance of food allergy in a child is quite small, probably less than 2%. If one parent has any food allergy, the chance increases to about 8%. If both parents have food allergies, the chance is quite high, probably 50%, that their child will have food allergies. Note that the specific food that triggers allergy doesn’t necessarily run in families, but the overall risk of any food allergies does.

  15. Ok, I’m intrigued from this last comment’s response, re: chance of food allergy increases if one parent has a food allergy but not necessarily for that same food. In my case….

    My husband has a shellfish allergy (at least, he’s allergic to iodine, which he found out the fun way when he was getting an MRI and had an iodine contrast injection, which caused his lungs to close up and his body to feel like it was on fire. He never had a prior reaction to shellfish, but avoids it now just in case). His mother has a moderate egg allergy (needs to be cooked completely dry) as well as an allergy to most fresh fruits (gets mouth tingles, eyes dilate for hours after, etc, when she consumes small quantities). His sister has the same egg problem as his mother and a shrimp allergy. However, there is no record of any food allergy on my family’s side. Can I still introduce things like peanuts, milk, and the like before the age of 1? My daughter is now 8.5 months old. I keep reading that milk can’t be given instead of formula until after the age of 1, but since I have a severely low milk supply (she actually lost weight between 4 and 6 months and wouldn’t put a lot on until we found a bottle she would take and got breastmilk from a friend), it would be a lot easier and cheaper to buy milk and give it to her instead of the formula.

  16. I am so happy to see this post. Do you have any information on dairy/soy allergies in breastfed babies? We are having a horrible time trying to identify all sources of soy (for example, toothpaste and baby wipes…) and would love any help that’s out there to make our 3 month old baby more comfortable and to stop the blood from appearing in his diaper.

  17. Dorothy, Iodine is a necessary and essential nutrient, and no one is allergic to it. It is a myth that radiocontrast reactions involve allergy to iodine, or that people who’ve had reactions to radiocontrast agents need to avoid shellfish or fish. There are lots of refs for this, here’s one:

    Mouth tingles to unpeeled fruit is usually called ‘oral allergy syndrome’, a cross reaction to pollens like ragweed. It can be unpleasant, but isn’t usually serious. More:

    Ordinary milk isn’t usually given to babies until 1 year of age because it is difficult to digest. Babies less than 1 can tolerate a little bit of it, but a big 8 oz bottle can be rough. This has nothing to do with allergy.

    There is no recommendation to delay the introduction of solids in babies with a family history of food allergy.

    Emily, I think, is referring to allergic proctitis, an issue unique to little babies. They develop bloody stools when drinking cow’s milk formula, or sometimes soy formula, or sometimes even from soy or cow’s milk in mom’s diet if she’s breastfeeding. If the baby is thriving and otherwise doing well, it is not necessary to be super-vigilant about keeping those foods out of mom’s mouth. Allergic proctitis is typically outgrown well before the toddler years.

    • So, why did he have such a horrible reaction to it? They actually went back and forth whether or not to give him antihistamines and asthma meds because they are apparently heart stimulants and he was getting an MRI because of a heart condition, but they ended up giving him both because a dead person doesn’t care too much how their heart is. 🙂

      He’d probably be happy to hear that he can actually eat shrimp, but he’s understandably skittish about it since the people at the hospital essentially told him not to.

      • Dorothy, he probably had a severe reaction because he’s allergic to the contrast dye. That’s still a serious allergy, and he needs to avoid that in the future (or use a different kind of dye.) But it is not actually an allergy to iodine.

        For the sake of not getting the admin in trouble: I suggest your husband speak with his doctor about this to get specific medical advice. I am speaking in general terms, and I am not your doctor, and I am not giving anyone specific medical advice.

  18. 5 & 6 are somehow usually combined into one messy and incorrect statement. What we have understood from working with the pediatric gastroenterologists at Cincinnati Children’s is that while delaying a food does NOT prevent an allergy, once an allergy is confirmed in a child (via clinical diagnosis), total avoidance in early childhood does increase the likelihood that the child will outgrow many of the food allergies that present.

  19. Actually, Stephanie, it’s questionable whether strict avoidance does increase the chance of outgrowing an allergy. For eggs, specifically, it’s been demonstrated that allowing a child to be exposed to eggs to the extent that is safe will increase the chance of outgrowing the allergy. This may be true of other allergens, like peanut, and is an active area of research.

    But let me make clear: if your child has a clinical reaction to an allergen, that allergen ought to be avoided. The studies that have looked at small exposures have only encouraged exposures to the extent that their is NO observable reaction. No one is suggesting that children be deliberately exposed if they have a reaction.

  20. Hot off the presses, the AAAAI (gotta love that name, the American Academy of Asthma Allergy and Immunology) weighs in with their recommendations:

    It’s long, but I’ll tell you what it says: introduce any solids, including egg, milk, peanut butter, everything, starting at 4-6 months. There is no reason to delay; and the available evidence suggests that earlier introduction, if anything, prevents food allergy.

    Note that this is a “permissive” recommendation– they say you CAN, not that you SHOULD. They do not feel that there is enough evidence, yet, to make this a SHOULD recommendation. But they do say there is no reason to wait any longer than 4-6 months of age.

  21. Thank you yet again Dr. Benaroch! I really admire the time you took to respond in detail to the many questions here.

    I liked your point above about family history. Our myth-busting pediatrician (see above) took our lack of family history issues into account when he told us to not worry about allergens. He might have been more cautious if things had been otherwise.

    And, I love this new news about early solids being OK, because that’s how my kids were, like it or not–and they didn’t want lame rice cereal or vegetable puree for more than a few weeks, they wanted the real deal. My (totally non-MD, layperson’s) guess is that evidence will show that it’s important to offer both solids and breastmilk (when able) for the first couple years. Just as with adults, there is probably no magic food, it’s probably all about offering a wide range of options. Which totally doesn’t lend itself to FEAR! or snappy headlines, so no one will want to hear it 🙂

  22. This article has made my week! I was told by my health visitor and the paediatric dietician that i had given my son eczema by allowing him to have solids at 5 months. They insisted that i should have introduced formula if he was hungry and interested in food, instead of continuing to breastfeed and starting him on pureed organic vegetables which i thought was a more sensible option. He is a strapping 8 year old now with no eczema for years. But it still smarts that the professionals told me off like that!

    Ps We are an English family living in London with a nine month old girl as well as sons of 8 and 6. Your advice has transformed her sleep. Thank you!

  23. I’m really thankful that I found this site. My one and a half baby has also allergy to eggs. Thanks to these article because I learned a lot from it. I’m thankful also to the link shared about egg sensitivity. It’s really a great help. Looking forward to read more of your works. 🙂

  24. Anyone here have any experience with dairy and soy allergies in your babies?

    • Yes and it’s REALLY common. Milk protein is #1 and about 10% of babies struggle with this (they outgrow it usually by 1 year). And it’s really hard to get milk protein out of your diet because it’s EVERYWHERE.

      • AGH I know…. I’ve been off dairy, sugar, MSG, ginger (as directed by a homeopathist) and now soy!! Any idea how long it takes for a rash to appear with a soy allergy? Does it take as long to leave the system as dairy?

  25. Hello. I gave my son egg a few weeks ago (around 7 months) and he went a little bit red around his mouth in patches. I held off for a while just in case and went back to egg again today. He had a tiny pea sized piece in his mouth bit spat it because he didn’t like it so I left it. After about five minutes he went red under his chin and broke out in swollen bumps. I took his bib off and noticed a bit of egg was trapped between his chin and the bib. The redness spread behind his ears and down his chest and he went red on his hand and arm where he’d touched the egg. He has been absolutely fine, no other reaction whatsoever. He has eczema and the doctor said he ‘may have’ childhood asthma but couldn’t confirm. Does this sound like an allergic reaction?

    He had French toast at 6 months without a visible reaction so I’m a bit confused.

    • Oh yeah, he also eats pasta and Yorkshire pudding without a reaction at all! The doctor has said it looks like a reaction but to try again in a few weeks and see what happens. And to have the emergency services number ready, great stuff thanks!

      Anyone got any ideas why he reacts so strangely?!

  26. Hi Dr,

    Thanks so much for this article – it’s been really helpful.

    I gave my 5.5 month old porridge that had milk powder inside it, and on tell occasions she came up with a moving rash on her face, beneath eyes and then to other parts of the face. I suspected it may be CMPA, so told the dr who took a blood test. The results came back at 1-2 positive on a 0-6 positive scale. The Dr said that suggests a possible intolerance. I’ve had conflicting advice since, saying that I shouldn’t stop having cows milk (I’m breastfeeding), and could try giving baby processed milk like cheese. What would your advice be? What should I try next if anything? I would love to give her custard as she isn’t really taking well to veggies (currently trying to wean her!)

    • Hey Sal,

      This post is sort of old-ish and thus Dr.Roy isn’t answering questions anymore but you should definitely check the resources in the MAMMOTH and RECENT post on food allergies linked below. I’m not a pediatrician and I know there is a TON of conflicting advice/research on the subject. But I think if your daughter is actively reacting to something (presumably cow milk protein) then cutting it out of your and her diet for now is likely the right path. Then you would theoretically re-challenge the food on occasion to see what is happening. Hope the post below helps!


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