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Young boy with stomach pain holding a glass of milk.

Food Allergy or Intolerance: How to Tell the Difference

By Dr. Christopher Wrubel, Premier Pediatrics

A food allergy diagnosis can have a significant impact on both child and family. It requires vigilance during meal and snack time, and an emergency plan in case of a severe allergic reaction. To avoid a potentially dangerous allergic reaction, it is important to know the differences between a food allergy and a food intolerance.

A true food allergy can cause a serious or even life-threatening reaction by eating, touching, or inhaling just a small amount of a particular food, while a food intolerance may cause an upset stomach after eating a certain food.

A food intolerance response takes place in the digestive system, according to the American Academy of Allergy, Asthma, Immunology (AAAAI), and a food allergic reaction involves the immune system.

Food intolerance

If your child has had an upset stomach or diarrhea from a certain food, it’s likely a food intolerance. Common food intolerances include lactose (milk), wheat, gluten, fruits, and vegetables.

A food intolerance occurs when the body is unable to properly break down the food due to possible enzyme deficiency or a sensitivity to food additives or natural chemicals in foods. Most people can eat small amounts of the food without serious illness.

Food allergy

Food allergy symptoms are much more intense and can occur within 30 minutes or up to several hours later. Common food allergies include peanuts, tree nuts, eggs, milk, wheat, soy, fish, and shellfish.

An allergic response to a certain food can cause hives, itchiness, swelling of the skin, vomiting, and diarrhea.

Anaphylaxis is a very serious allergic response. Symptoms may include difficulty breathing or swallowing, dizziness, or loss of consciousness. Without immediate treatment, anaphylaxis can be fatal.

What to do if you suspect your child is having an allergic reaction

If you think your child is having an allergic reaction to a certain food, stop giving them that food and monitor your child for symptoms of a mild food allergic reaction. Symptoms include itchy nose, sneezing, itchy mouth, some hives, and mild nausea or stomach discomfort. If your child has any of these signs, call your pediatrician for advice. If your child has swelling of the mouth, lips, or tongue, or is experiencing difficulty breathing, call 911.

What to do if you know your child has a food allergy

If you know your child has a food allergy, make sure they always have an epinephrine auto injector with them and that they and others, including caregivers, know how to use it. Discuss your child’s food allergy with school administrators and have an anaphylaxis action plan in place.

Suspect a food allergy or intolerance? Call your pediatrician.

If you suspect your child has a food allergy or intolerance to a certain food, start keeping a food diary and list foods and beverages and their reactions. Share your concerns with your child’s pediatrician.



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About CHKD Medical Group

About CHKD Medical  Group Children’s Hospital of The King’s Daughters has been the region’s most trusted name in pediatric care for more than 50 years. As members of CHKD Health System, our pediatricians work closely with CHKD’s full range of pediatric specialists and surgeons. They also share a commitment to quality, excellence and child-centered care. With 18 practices in 29 locations throughout the region, a CHKD pediatrician is never far.