Foods that children are likely to be allergic to

According to the unified consensus of the World Health Organization and the Chinese Pediatric Allergy Collaboration Group, there are currently nine categories of high-risk foods that are most likely to cause allergies in children, namely milk, eggs, peanuts, tree nuts (walnuts, cashews, almonds, etc.), wheat, soybeans, fish, crustacean shellfish (shrimp, crab, scallops, etc.), and sesame. More than 90% of children's food allergies are caused by these types of foods.

Among them, milk and eggs rank in the top two, and they are also the ones with the most allergy cases in outpatient clinics. I just received a 6-month-old baby last week. My mother was afraid that the breast milk would not be enough and she wanted to add some regular formula milk to make the transition. After just two sips, the area around her mouth turned red. She kept rubbing her eyes and nose. Within 10 minutes, a small wheal appeared on her face. This is typical of cow's milk protein allergy. There is also a point of debate among many parents: Can I switch to goat milk if I am allergic to cow's milk? One school of thought believes that the protein homology of cow and goat milk exceeds 80%, and the probability of cross-allergy is extremely high, so it is not recommended to directly replace it. ； There is also clinical data showing that about 15% of babies with mild to moderate cow's milk allergies do have better tolerance to goat's milk. Whether to switch to goat's milk cannot be generalized at all. Either do a precise component allergen test, or try a small amount under the supervision of a doctor. Don't try blindly at home and trigger severe allergies.

The next biggest allergen after milk is eggs. Many parents deliberately avoid egg whites and give only egg yolks when giving complementary foods. To be honest, I have seen many children who are allergic to only egg yolks. A while ago, a mother gave her baby a bite of a handmade egg roll brought by a relative. The baby vomited twice on the spot and broke out in rashes all over his body. He went to the emergency room overnight to get anti-allergy medicine. The timing of the introduction of eggs has also been a point of fierce debate in academic circles in recent years: old guidelines generally recommend not touching egg whites under 1 year old to reduce the risk of allergies. ； However, after 2022, the American Academy of Pediatrics and China's guidelines for adding complementary foods to infants and young children have updated their statements. They believe that when starting to introduce complementary foods at 4-6 months, egg ingredients can be gradually introduced in small amounts, which can actually reduce the probability of subsequent egg allergy. There is large sample data to support both sides. Parents do not need to worry. If no one in the family has a history of severe allergies, just add it normally. If the baby itself is allergic, observe it for two more days, stop for a while and try again if there is a reaction.

Allergies to peanuts and tree nuts are even more confusing. Many children are fine with eating anything at home. It is not uncommon for children to go to a child's birthday party and take a bite of a cookie with crushed peanuts, or stuff a cashew nut into their mouth, and they can't breathe on the spot. In severe cases, it can trigger anaphylactic shock. In the past, many parents were afraid of allergies and simply refused to let their children touch any nuts until they were three or four years old. Studies in the past two years have shown the opposite, saying that early introduction of small amounts can allow the immune system to "adapt" earlier and reduce the probability of allergies. Oh, by the way, if your parents or older siblings have a history of severe peanut nut allergies, it is better not to try blindly at home. It is safer to go to the hospital to see an allergist, and try eating them with first aid measures.

Of the remaining categories, the most overlooked are wheat and sesame allergies. I met a little boy before who was fine eating noodles and steamed buns. One time after eating steamed buns, he went to a football class. After running two laps, he suddenly had difficulty breathing and stomachache. After a long search, he was finally diagnosed with "wheat-dependent exercise-induced allergy." To put it bluntly, after eating wheat, nothing will happen as long as he does not exercise strenuously, but the allergy will be triggered when he exercises. This situation is particularly easy to miss, and many parents do not think that food is to blame. There is also sesame. The allergy rate has increased very rapidly in recent years. Sesame powder added to many complementary foods, sesame seeds in shredded seaweed, and even sesame seeds sprinkled on sesame seeds sold outside may cause rashes in children. Many parents have searched for allergens for a long time and cannot think of it as the problem.

Many parents ask me whether they should specially test their children for allergens and avoid all foods that they may be allergic to? There is no unified answer here: some doctors think it is completely unnecessary, because the false positive rate of allergen testing is extremely high. If a certain value is found to be high, it does not mean that the child will be allergic if he really eats it, but it will easily cause unnecessary anxiety to the parents. ； Some doctors also suggest that high-risk children with a family history of allergies should have their children checked in advance to have an idea of ​​what to eat to avoid triggering severe allergies by accidentally eating them. In my clinical practice, I generally advise parents not to deliberately avoid these highly allergenic foods when adding complementary foods. Add only one type at a time and observe for 3 days. If there are no reactions such as rash, vomiting, diarrhea, frequent coughing, or wheezing, you can eat normally. If there is a slight reaction, stop for 3 months and try again. There is no need to blackout all high-risk foods as soon as they are introduced, which may easily cause the baby to lack nutrients.

After all, every child has a unique immune system. Foods that other people’s children cannot touch may be delicious to your children, and vice versa. You don’t need to use other children’s lists to apply to your own children. Pay more attention in daily life. If your child suddenly becomes short of breath, has a swollen face, or becomes confused after eating, don’t hesitate to send him to the emergency room immediately. Remember the food your child is allergic to and tell the store in advance when you go out to eat. Basically, there will be no major problems.