Has my child outgrown their food allergy?

Some children outgrow their food allergies, but researchers aren’t sure why. Here’s how to collaborate with your allergy specialist if you believe your child is no longer allergic.

Who is more likely to overcome their food allergy?

In South Africa, food allergy occurs in around 2.5% of one to three-year-olds. This figure is much higher in children with moderate to severe eczema, who have food allergies in about 30-40% of cases.

Egg, cow’s milk, and peanut allergies are common in young children. Adolescents are more likely to develop allergies to tree nuts, fish, and seafood.

Food allergies are becoming more common in children and adults worldwide. There has also been an increase in the number of children under the age of four who have been admitted to hospital with food anaphylaxis (a severe, life-threatening reaction).

However, according to research, almost all children (more than 80%) with an egg allergy outgrow their allergy by the age of four, as do about 20% of children with a peanut allergy.

On the other hand, food allergies are likely to persist in some people. This is more likely if they have eczema, hay fever, and asthma in addition to a tree nut allergy since childhood or a severe allergic reaction to a low dose of their specific food allergen.

Why do some children outgrow their food allergies?

Researchers are unsure why some children outgrow their food allergies. Their immune response to food allergens, however, appears to change.

For example, these children have lower levels of antibodies than would be expected as part of an allergic response (lower levels of allergen-specific IgE). They also have higher levels of other immune system components (allergen-specific IgG4, IL-10 and allergen-specific T cells).

Other studies have concentrated on a type of T cell known as a regulatory T cell, which controls how the adaptive immune system responds to antigens.

Children who are not allergic or who have naturally developed tolerance to these cells are more likely to have stable levels of these cells. Others, however, may be unable to regenerate these cells after being exposed to the food allergen, resulting in lower levels.

Children who outgrow their food allergies may also have a dampened inflammatory response in the innate immune system, which is a part of their immune system.

Finally, changes in the diversity of gut microbiota (microorganisms like bacteria that live in the gut) and the substances produced by these microbes may be involved.

However, more research is needed to confirm what is happening in both the immune system and the gut microbiome.

Always consult an allergist specialist before trying to establish if your child is still allergic

If you believe your child has outgrown their food allergy, it is critical that you do not test them on your child without first consulting with an expert. This is extremely dangerous, and they may experience an allergy specialist.

Depending on the allergen, the allergy specialist will perform a series of tests to monitor your child annually or every few years. These tests detect changes in the immune system, allowing us to determine whether your child has outgrown an allergy or if it is still present.

When these tests show that your child has almost no allergic reaction, they will be given an “oral food challenge” under medical supervision.

In a medical facility, for example, a child will be given increasing amounts of the food allergen. If the child tolerates the food (known as passing the challenge), it is reintroduced into the diet regularly.

Food challenge tests are also used to determine whether or not a child can tolerate foods in a modified form. For example, a child who is allergic to eggs or cow’s milk may be able to tolerate baked egg or baked milk.

In general, only a medically supervised oral food challenge can determine whether your child has genuinely outgrown their food allergy.