Health & Fitness

Food allergies sometimes fatal, but epinephrine can be a life saver

Gary Kleiner, M.D.
Gary Kleiner, M.D.

Over the past 10 years, research has provided compelling evidence of the increasing problems of food allergies and their damaging effects. Food allergies affect up to 15 million Americans, including 1 in 13 children. Nearly 40 percent of these children have already experienced a severe or life-threatening reaction.

A food allergy is when your body’s immune system reacts to a food protein because it has mistaken that food protein as a threat. With a food allergy, your immune system makes too much of an antibody that then fights the threatening food allergens by releasing histamines and other chemicals. The chemical release causes the symptoms of an allergic reaction.

People can be allergic to any food, but eight foods cause most food allergy reactions in the U.S.: milk, eggs, peanuts, tree nuts (such as walnuts and almonds), wheat, soy, fish and shellfish (such as lobster and shrimp). These and all food allergies can be managed with help from an allergist. Testing for food allergies can be done with a blood test or a skin-prick test.

Are Allergic Reactions Serious?

Yes. Allergic reactions can range from mild to very serious. The most dangerous reaction is anaphylaxis, which happens quickly and may cause death. Anaphylaxis can make it hard to breathe and difficult for your body to circulate blood. The first line of treatment for anaphylaxis is a medicine called epinephrine. Carefully avoiding problem foods is the only way to prevent allergic reactions.

How Do I Recognize a Reaction?

Work with your child’s allergist to know what to look for and how to respond. The first symptoms usually appear between a few minutes to two hours after exposure. Symptoms can be mild, like an itchy nose or a few hives, but they can also be severe, such as troubled breathing, repetitive vomiting, weak pulse, etc. Mild symptoms can quickly turn into a life-threatening reaction. Anyone having a reaction to a food allergen needs to be monitored closely.

How Do I Manage My Child’s Food Allergy?

Even a trace amount of a problem food can cause a serious reaction. Learn how to find your child’s problem food in both obvious and unexpected places. Read every label, every time. Ingredients in packaged food may change without warning, so check ingredient statements every time you shop. Federal law requires packaged food labels to list when one of the top eight food allergens is an intended ingredient.

Be mindful of cross contact, which happens when a food that is an allergen comes in contact with a safe food and their proteins mix. These amounts are so small that they usually can’t be seen. One example of cross contact is when the same utensil is used to serve a food that contains an allergen and a safe food.

How Do I Treat an Allergic Reaction?

No matter how hard you try to avoid food allergens, accidents will happen. A few steps go a long way in being prepared for an allergic reaction:

▪ Always carry your child’s epinephrine auto-injection. Epinephrine is the only medicine that can stop life-threatening reactions.

▪ Fill out a food allergy and anaphylaxis emergency care plan with your allergist. These plans tell you and those who care for your child how to recognize and respond to an allergic reaction.

▪ Know your emergency plan and share it with others.

▪ Have your child wear medical identification.

Antihistamines can be used to relieve mild allergy symptoms, but they cannot control anaphylaxis, which should always be treated with an injection of epinephrine. Give epinephrine for a serious reaction. It helps reverse the symptoms of a severe reaction and is considered a safe medication. Have your child’s pediatrician train you to use the device and practice with a trainer. Make sure caretakers and babysitters know how to use it in the event of an emergency. After using epinephrine, call 911 immediately. An ambulance can provide treatment on the way to the hospital.

Are There New Treatments?

Unfortunately, strict avoidance of the problem foods is still the only way to prevent a reaction. Clinical trials of promising new treatments are underway, including oral immunotherapy and skin patches. Early research has demonstrated that oral immunotherapy is effective in 70 percent to 80 percent of patients. However, researchers must still determine the most effective dosage and time frame for treatment.

Allergic reactions are unpredictable, from the severity of the reaction to the symptoms your child might experience. But having an understanding of what to expect and a plan to direct you in case of an emergency will help keep your child safe. For more information about food allergies, visit or schedule an appointment with a UHealth allergy specialist.

Gary Kleiner, M.D., Ph.D., is director of pediatric allergy and immunology at UHealth – the University of Miami Health System. For more information, visit