Food allergies in children: the most common allergies, signs and everyday life

The most common food allergies in small children are milk and egg, followed by peanuts, tree nuts, fish, wheat and soya. The signs are hives, swelling, vomiting or eczema that flares up shortly after eating. Swelling in the throat, wheezing or drowsiness is an emergency: call 112. If you suspect an allergy, your child should be assessed through BVC (the child health clinic every family in Sweden is enrolled in) or your vårdcentral (local health centre), not by cutting out foods yourselves, and most children grow out of milk and egg allergy before school age.

An eight-month-old who has just had her first spoonful of scrambled egg, and ten minutes later she is red around the mouth with small raised blotches on her cheeks. That is how many families discover a food allergy: in the middle of an ordinary lunch, with a certain amount of panic. Most reactions in small children are mild and pass, but there are signs that mean an emergency, and there is a route to answers that does not go through your own experiments. Here are both.

Common food allergies and how they usually go

Allergen	Most common in	Usually outgrown?
Milk protein	Babies and toddlers	Yes, usually before school age
Egg	Babies and toddlers	Yes, usually before school age
Peanuts	From the toddler years	Often stays
Tree nuts, such as hazelnut and cashew	From the toddler years	Often stays
Fish and shellfish	All ages	Often stays
Wheat and soya	Toddlers	Yes, often
Sesame	All ages	Varies

Signs of an allergic reaction

• Skin: hives, redness around the mouth, swollen lips or eyelids, eczema that flares up.
• Stomach: vomiting, loose stools, tummy ache, in babies sometimes mucus or blood in the stool with milk protein allergy.
• Mouth: itching, tingling, a swollen tongue.
• Airways: runny nose, coughing, wheezing, hoarseness.
• General: sudden tiredness, paleness, restlessness, in small children going floppy.

The reaction usually comes within minutes to a couple of hours. Skin and stomach are the common, mild reactions. Airways and general condition are the serious ones.

When it is an emergency

Call 112	Call 1177 (the national healthcare helpline) or contact BVC
Swelling of the mouth, tongue or throat, difficulty swallowing	Hives on the body with no effect on breathing
Wheezing, coughing or hoarseness that comes on suddenly	Redness and a few spots around the mouth
A drowsy, pale, floppy child, or a child who seems about to faint	Vomiting once after a new food, then bright again
A reaction from two organs at once, for example a rash and vomiting together with breathing difficulties	Eczema that has flared up after a particular food
The child has an adrenaline pen: use it and call 112	Suspected allergy with no reaction in progress

Assessment: how you get answers

1. Write down what your child ate, how much, how long it took and exactly what happened. Take a photo of the rash.
2. Contact BVC for small children, otherwise the vårdcentral. After a serious reaction there is an emergency assessment and then a referral.
3. A blood test or skin prick test shows whether there are antibodies. A positive test does not always mean allergy, which is why the doctor weighs the test against the history.
4. Elimination and reintroduction under medical supervision, sometimes as a food challenge in hospital where the child is given small amounts under observation.
5. A dietitian if your child has to avoid a staple such as milk, so they still get what they need. Formula for babies is prescribed by a doctor.

Cutting milk, gluten or egg out of a small child's diet on your own without a diagnosis is a bad idea. The child risks deficiencies, and if the allergy was not there, the exclusion itself can make the child sensitive. There is also a risk that you miss something else that caused the symptoms.

Everyday life: förskola, parties and the nanny

Förskola (municipal preschool, from age one) serves special diets on the basis of documentation, often a certificate from the vårdcentral, and the routines differ between municipalities. Raise it early, ideally during the settling-in period. Write a clear note for the staff: what your child cannot have, what a reaction usually looks like, what to do and where any medicine is kept. The same note goes to grandparents, to friends' parents before a party, and to the nanny. A child with an adrenaline pen should have it with them everywhere, and the adult looking after the child should have been shown how to use it. For parties: send along something of your own that resembles what the others are having, so your child is not sitting with a carrot while everyone else eats cake.

Early introduction reduces the risk

The advice from ten years ago, to hold off on peanuts and egg, is gone. Livsmedelsverket (the Swedish Food Agency) and BVC now recommend that ordinary food is introduced from the first tastes at four to six months, including egg and peanut in a form that cannot get stuck in the throat, such as peanut butter stirred into porridge. Studies show that early introduction reduces the risk of allergy. If your child has severe eczema or an allergy already diagnosed, talk to BVC about how to go about it, and you may need to introduce foods under medical supervision. We have a separate guide to Starting solids.

How we do it with our families

In one family with a four-year-old who is allergic to egg and hazelnut, there is a laminated note on the fridge: what he cannot have, what it looks like when he reacts, where the pen is kept and the parents' number. Doaa, who is with them every Wednesday, read the labels on every snack for the first few weeks until she knew them by heart. At the first meeting before we start, we always ask for exactly that note, and we never send a nanny who has not gone through it. The nanny does not bake anything new without asking either.

This text is general information and does not replace advice from BVC, your vårdcentral or 1177. If you are worried about your child, call 1177. In an emergency, call 112.

Read more: Starting solids · Eczema in children · Children's party food, fika and cake · Frequently asked questions

Frequently asked questions

Which food allergies are most common in children?

Milk and egg in the youngest, and then peanuts, tree nuts, fish, wheat and soya. Most children grow out of milk and egg allergy before school age, while allergy to peanuts and tree nuts more often stays. Every suspected allergy should be assessed through BVC or the vårdcentral, not by cutting out foods yourselves.

What does an allergic reaction look like?

Hives, swollen lips or eyes, vomiting, redness around the mouth or eczema that flares up within minutes to a couple of hours after eating. Swelling in the mouth and throat, wheezing, coughing, drowsiness or paleness means a serious reaction: call 112 straight away.

Should we hold off on peanuts and egg to be on the safe side?

No, quite the opposite. The advice from BVC and Livsmedelsverket is that ordinary food, including egg and peanuts in a form that poses no choking risk, can be introduced early, from the first tastes at four to six months. Waiting increases the risk of allergy. If your child has severe eczema or a known allergy, talk to BVC first.

Is lactose intolerance the same as milk allergy?

No. Lactose intolerance is difficulty breaking down milk sugar, causes stomach trouble and is unusual in small children. Milk protein allergy is a reaction from the immune system, can cause rashes, vomiting and breathing difficulties, and is what applies in babies. Lactose-free milk does not help with milk protein allergy.

How do special diets work at förskola?

Förskola serves a special diet when there is documentation, often a certificate from the vårdcentral or BVC. Municipalities and preschools have different forms and routines, so ask early. Describe clearly what your child reacts to and how, and how a reaction should be handled, and update it whenever something changes.