What is an allergy?

Egg allergies are common across children and teenagers, and often develop within the first year of life. Often, children who have an allergy to egg may also have eczema, asthma or hay fever.

Children can be allergic to all forms of egg, though some can tolerate highly baked egg products such as cakes and biscuits. 

Over time, we expect a high percentage of our egg allergic patients will outgrow this allergy. We will see your child in clinic, where a decision may be made to do a baked or lightly cooked egg challenge. 

With regards to raw egg products, we do not offer challenges to these. Instead we advise home introduction once your child has been tolerating lightly cooked egg for six months or longer.

Peanuts are one of the most common foods people can be allergic to. This page aims to tell you all about peanuts and peanut allergies.

The Facts About Peanuts

• Peanuts account for some of the highest numbers of severe allergic reactions.
• Contrary to common belief, peanuts are not nuts. They are, in fact, a type of legume. The category of ‘legumes’ also includes foods like beans and lentils. Peanuts come from the ground, whilst other nuts come from trees – hence the term ‘tree nuts’.
• Although peanuts belong to the same family as beans and lentils, this does not mean these foods are not safe to try. The cross-reactivity between these foods is extremely small, and we therefore would not routinely advise avoidance of other legumes unless your child is known to react to these.
• Being allergic to peanuts does not necessarily mean you will be allergic to all other nuts. This can be reviewed in the children’s allergy clinic. We have the facility to do testing to see if your child would be able to eat one, or a number of other nuts apart from peanuts.
• It is rare for children to outgrow peanut allergies, but not impossible. A small number of children have been known to grow out of their peanut allergies.

Avoiding Peanuts

If you have an allergy to peanuts, the best way of preventing an allergic reaction is by strict avoidance of all peanuts, and peanut-containing foods. This can become tricky with regards to vague food labelling, eating out and foreign travel.

Reading food labels:

As with any food allergy, we urge everyone with a peanut allergy to carefully check labelling on food and drinks, to ensure peanuts are not mistakenly consumed. Peanuts can be listed in various ways on packaging, including, but not limited to:

• peanut butter
• peanut flour
• peanut oil
• nuts
• ground nuts
• earth nuts
• monkey nuts
• arachis oil
• groundnut oil

 “May Contain Traces of nuts/peanuts” – This label can make life very difficult for those with a nut allergy. We strongly recommend exercising caution when it comes to such labels. The following foods are what we class as more high-risk; meaning the likelihood of cross-contamination with peanuts is far greater than other foods:

• spreads, such as peanut butter, or other nut butters
• bags of mixed nuts – the likelihood of cross contamination is extremely high
• Confectionery such as chocolates, cakes, biscuits
• ice creams – watch out for nut toppings
• vegetarian meals such as nut roasts and veggie burgers
• sauces such as satay sauce, some salad dressings (may contain unrefined peanut oil)
• breakfast cereals such as crunchy nut, muesli, granola

Some companies use the label ‘may contain nuts’ on all of their food packaging, regardless of whether there is any risk or not. In such instances we just advise using your judgement.

Eating out

Eating out at takeaways or restaurants can also cause some problems when it comes to nut allergies. You may feel unsure as to what meals contain peanuts, and whether there is a likelihood of contamination. When eating out, it is important that you always speak to the chef about your allergy, to ensure precautions are being taken. If the chef cannot guarantee that the food will not be contaminated with peanut, it is advised that you do not eat there. Some types of cuisine carry a higher risk of peanut contamination due to the nature of their dishes, these include (but are not limited to):

• Indonesian
• Chinese
• Malaysian
• Thai
• Indian

Always ensure you carry your child’s allergy rescue medication with you whenever you eat out.

Foreign Travel

All travel to foreign countries is done so at your risk. Whilst we can provide some advice, and direct you to useful websites to assist you in your travel, we cannot help you make the decision to travel. Please refer to our list of useful websites to find some further advice on travelling.

Some things to bear in mind before making the decision to travel:

•  If your child carries an adrenaline auto-injector device (EpiPen/Emerade/Jext), it is likely you will require a travel letter provided by your allergy nurse or consultant to allow you to carry your medications in your hand luggage. It is extremely important that all rescue medication is kept with you on the plane, and not stored with your checked-in luggage.

Cow’s milk allergy occurs when the body demonstrates an abnormal response to the proteins in cow’s milk. This allergy is particularly prominent in infants and young children. Cow’s milk allergies can either be IgE Mediated or Non-IgE Mediated. The meaning of each of these will be listed below.

IgE Mediated Cow’s Milk Protein Allergy

If your child suffers from this type of allergy to cow’s milk, they will display immediate symptoms which range from mild/moderate (swelling of lips/eyes, nettle sting rash, vomiting) to severe/anaphylactic (difficulty breathing, speaking, swallowing, floppiness, collapse). Such symptoms tend to occur immediately after consuming milk, or within one to two hours of consumption. See more information on types of immediate allergic reaction.

If your child has this type of allergy, we advise strict avoidance of all milk and dairy products unless told otherwise by your doctor. All food labels in the UK clearly highlight whether milk is an ingredient.

Non IgE Mediated Cow’s Milk Protein Allergy

This type of allergy consists of symptoms which are more delayed in onset. By this we mean symptoms which occur within 24 to 48 hours of milk consumption. Such symptoms can include a flare up of eczema, or diarrhoea/vomiting.

Treatment for this type of allergy can involve exclusion diets, although we advise seeking advice from your GP or Health Visitor. If your GP feels your child needs further input, they may be referred to the children’s allergy service.

The Facts About Milk Allergy:

• People commonly get milk allergy and lactose intolerance confused. Lactose intolerance is the body’s intolerance to the sugar lactose within cow’s milk, whereas a cow’s milk allergy is an allergy or intolerance to the proteins within cow’s milk. Lactose intolerance only can only cause delayed symptoms, whereas cow’s milk allergy can cause either immediate and/or delayed symptoms. See more information on lactose intolerance from NHS UK, or seek advice from your GP.
• We expect that most children with a non IgE-mediated allergy to cow’s milk will outgrow this by secondary school age.
• If your baby is breastfed and cow’s milk allergic/intolerant, it is important that the mother follows a strict dairy free diet, as the proteins can pass through into breast milk.