Food allergy

Data gathering

  • Speed of onset of symptoms
  • Which food(s) ingested?
  • IgE (usually minutes post exposure)
    • Skin: urticaria, angioedema
    • ENT: rhinitis, conjunctivitis
    • Respiratory: wheeze, stridor
    • GI: vomiting
  • Non-IgE (can be delayed)
    • Skin: atopic eczema
    • GI: GORD, abdominal discomfort, loose stools, vomiting
  • Reproducible reaction
  • Feeding history – breast fed, formula fed, timing of feeds changed
  • Allergic co-morbidities – atopy
  • FH – allergies, atopy

Clinical Management

  • Non-IgE
    • Elimination of allergen for 2-4 weeks
    • If symptoms do not improve, allergy unlikely, treat reflux / constipation / allergy specifically
    • Consider paediatric dietitian referral
    • Consider paediatric allergy clinic if child has faltering growth or multiple foods responsible
  • IgE
    • Refer to allergy clinic
http://rms.kernowccg.nhs.uk/rms/primary_care_clinical_referral_criteria/paediatrics/allergy/food_allergy
https://www.wandsworthccg.nhs.uk/aboutus/Referral%20Guidelines%20v20/GP%20Allergy%20Notes.pdf