How to Help Ease Your Child’s Food Allergies

By Punita Ponda, MD, FAAAAI, FACAAI, Chief, Division of Allergy & Immunology, Children’s Hospital at Montefiore 

Manhattan Voice 

May 1, 2025

NEW YORK - May is Food Allergy Awareness Month and as most of us see around us, childhood food allergies are increasing.

Most people know of, or have friends and family members, who have food allergies. Food allergies are very difficult for all the family members of a child with that diagnosis. Everything from grocery shopping to going out to eat, or visiting someone, becomes stressful.

A diagnosis of food allergies should be made with the guidance of your doctor, after they discuss your child’s history and perform a physical exam. This can involve doing skin testing or blood testing to check for the allergy after a child has a reaction upon eating the food. A typical allergic reaction to a food may look like hives, redness of the skin, itchiness, lip swelling, vomiting or in severe cases, breathing problems and coughing within minutes of eating a specific food. Severe food allergies can also be life threatening. The child is usually uncomfortable when the symptoms appear, and young children may be very fussy, crying and hard to console. Children may not experience all these symptoms, but they usually experience the same kind of reaction each time they eat the same food. Children could experience these symptoms for reasons unrelated to a food allergy, so, an allergist can help to clarify things.

Allergists at the Children’s Hospital at Montefiore see patients with a history of a reaction to a food and then determine if testing is needed, followed by recommendations on how to manage the food allergy. Sometimes, the test results are unclear, or if it is suspected that a food allergy may be outgrown, the doctors offer to do an oral food challenge in the office. This is a process where the child is given a food to eat in very small doses initially and then an increased dose followed by an observation period. This is the gold standard to determine if the child truly has a food allergy.

Once a food allergy is diagnosed, what next?

Until recently, the only thing the doctors could do for a child with food allergies was to ask them to avoid that trigger food and carry emergency medications, such as Benadryl and an auto-injectable Epinephrine (epi-pen) device at all times. However, in the last decade, there have been other therapies that have been approved to possibly help teach the child’s immune system to become tolerant to having small amounts of the allergic food. This is called oral desensitization and is a process that is done under the supervision of an allergist after full discussion of the pluses and minuses of this approach. There is an FDA approved product that is available now for desensitization for peanut allergy in children who are age 1 year or older where the goal is to enable a child to tolerate incidentally consuming small amounts of peanuts that may have contaminated the food due to the manufacturing or cooking process. So, although the child continues to avoid peanut, going to a restaurant and accidentally eating a bite of something with cross contaminated peanut will likely not cause a reaction, giving peace of mind. 

However, the first step in any treatment plan is an accurate diagnosis and management plan, followed by a discussion with your doctor about the available options for your child. The Allergy and Immunology Division at Children’s Hospital at Montefiore Einstein (CHAM) has special expertise in handling children with food allergies and provides a full array of diagnostic and treatment options for their patients including comprehensive services integrated with other specialists at the children’s hospital, depending on the individual needs of the child. 

Food allergies can have a major impact on the child and their families. The Division of Allergy and Immunology is ready and able to take care of the community’s needs in a welcoming environment with a knowledgeable, and comprehensive approach, including cutting-edge treatment options. Please contact us at the Division of Allergy and Immunology at the Children’s Hospital at Montefiore, (347) 498-2410 if your child needs to see our expert Allergist/Immunologists.