Outgrowing Food Allergies

When will my child outgrow his food allergy?

Mother and daughter having a meal
Most children will outgrow their food allergy by adolescence. BLOOM image/Getty Images

This is the burning question for many who deal with food allergies. Will my child outgrow her egg allergy? How long am I going to have this tree nut allergy? Fortunately, we have research to help guide us in this area. Having a food allergy isn’t necessarily your lot in life. Some food allergies can be outgrown over time, and other are less likely to see this fate. And, there are several areas of research, including oral immunotherapy, which may help in the future to offer options for treatment.

Children are more likely to be allergic to milk, soy, egg and wheat. As they get older, there is a chance they may outgrow their allergy to these foods. Hence, food allergies to milk, soy, egg and wheat is less common in adults.

Peanut allergy typically persists throughout life. Most of the deaths related to food allergy are associated with peanut ingestion and anaphylaxis. Peanuts are frequently found in our food supply, and sometimes hidden—in food and non-food items--making them a challenge to avoid.

Only five percent of those with a peanut allergy are allergic to legumes (beans). There’s a 20% risk of allergy to lupine (also known as lupin), a type of bean used in high protein, gluten-free and specialty food products. If you’re traveling to Europe or Australia, it’s worth knowing that lupine flour is mixed with wheat flour in bakery items. 

Allergy to tree nuts, fish and shellfish are also typically life-long.

It is difficult to predict whether a food allergy will be outgrown or not. A food-specific IgE level may indicate a greater likelihood of eventually outgrowing an allergy. For example, a person with a low cow’s milk IgE level is more likely to outgrow their milk allergy before a person with a high cow’s milk IgE level.

This is why it is important to see your board-certified allergist annually. Also, some children can tolerate small amounts of milk or egg when baked into a product, like muffins. These kids may have a greater chance of outgrowing their allergy over time, also. Always make sure to check with your doctor about this and never experiment on your own.

Let’s look at the specifics when it comes to food allergy resolution:

Peanuts: usually a life-long allergy. Studies show that about 20% of children under age two with peanut allergy will outgrow it by adolescence.

Tree nuts: also a long-term food allergy, but 5-10% of children diagnosed under age 2 will outgrow it by adolescence.

Milk: this allergy typically resolves in childhood. Odds are that 80% of children with milk allergy will see it resolve by age 5, although more recent studies indicate about half of children will still have a milk allergy at age 8. However, by the teen years, most kids with milk allergy will have outgrown it. Current research is underway to test milk oral immunotherapy as a way to develop tolerance to milk protein.

Egg: most children with egg allergy will see it disappear by age 5 (80%), but like milk allergy, the rate of outgrowing egg allergy has slowed, with about half of children still having an egg allergy at age 10. By adolescence, most will outgrow egg allergy. Egg oral immunotherapy is being researched to understand treatment modes for egg allergy.

Soy: eighty-five percent of children diagnosed with soy allergy will see it resolve before age 5, but again, half will still have a soy allergy at age 7. Most will outgrow soy allergy by the teen years.

Wheat: like milk and soy, most kids with a wheat allergy will outgrow it by age 5, but outgrowing this allergy has slowed just like milk and soy, with about half still allergic at age 6. By the time your child is a teenager, wheat allergy will likely be gone.

Fish and shellfish: these allergies tend to be life-long. The rate of outgrowing these allergies has not been well studied, but estimates are about 5-10% of fish and shellfish allergy will resolve in a lifetime.

How do you know when you or your child has outgrown a food allergy?

Your allergist will perfom skin and blood tests (to check IgE levels) to look for improvement in skin reactivity, or lowered IgE levels in blood. Decreasing test results are an indicator that the food allergy is resolving. For young children under the age of three, steady or no increase in blood IgE level is considered a positive sign.

Your allergist may want to do a medically supervised feeding challenge, where the food in question is eaten in a controlled environment, usually a doctor’s office. Your allergist may also want to do this if there was accidental ingestion without any reaction, or if your child hasn’t had a reaction for a long time.

Passing a medically supervised feeding test indicates a food allergy has been outgrown, or in the case of oral immunotherapy, sustained tolerance to the food allergen has occurred. However, studies have shown that if the food in question isn’t incorporated regularly into the diet, a reaction could happen later when the food is tried again—this has been shown in studies using peanuts and milk.

Visiting your board-certified food allergist on a regular basis is a good idea, especially if there is a milk, soy, egg or wheat allergy. Since there’s a good chance your child will outgrow these food allergens, you want to know when so his or her diet can be broadened. Children or adults with peanut, tree nut, fish or shellfish allergy may seek re-evaluation less frequently as these are less likely to be outgrown. 

Resources:

Sicherer SH. Food Allergies: A Complete Guide for Eating When Your Life Depends on It. 2013. The Johns Hopkins University Press. Baltimore, MD.

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