Food Allergy in Childhood

There is a discrepancy between self-reported and pysician-diagnosed food hypersensitivity in children, and parents tend to selfinitiated dietary interventions. Evidence based guidelines for prevention of atopic diseases recommend breast feeding for at least four months. Conventional cow mild formula should be used if breast feeding is not possible. Only in high risk children, hypoallergenic formula are recommended. In children with atopic dermatitis, the possible influence of food allergies has to be investigated by history, skin and in vitro tests as well as by elimination and/or provocation diet. Children allergic to cow milk should be fed with extensively hydrolysed hypoallergenic formula. As most children lose their food allergy, the necessity of interventional diets has to be reevaluated every 12 - 24 month. Pollen-associated food allergies in children do not differ from those in adults and lead to oral allergy syndrome, especially in those with sensitizations to birch or mugwort. Pseudoallergens may trigger symptoms in children with chronic idiopathic urticaria, while in acute urticaria and in anaphylaxis, peanuts, tree nuts and cow milk are the main eliciting factors. Therapeutically, food avoidance is essential, which is facilitated by the duty of declaration regarding the 14 most frequent food allergens. In severe cases of food allergy, emergency kits have to be provided.