Allergy in Children

What is Childhood Allergy? Symptoms and Treatment

An allergy is a condition in which a child, adolescent, or adult has a sensitivity to a specific substance. When the person is exposed to this substance—by inhaling it, ingesting it orally, or receiving it through intravenous means—they may experience symptoms related to the skin, respiratory system, gastrointestinal tract, or cardiovascular system.

What Symptoms Can Allergies Cause in Children?

During an allergic reaction, it is common to see red, raised, and clustered rashes (hives, urticaria) on the skin—especially on the face, arms, legs, trunk, and neck. These rashes are often accompanied by itching. Swelling may also occur on the face, lips, eyelids, hands, or feet. In some children, eczema, also known as atopic dermatitis, may develop.

These red patches, hives, or eczema can either start in one part of the body and spread to other areas or remain localized.

In addition to skin symptoms, respiratory complaints may include sneezing, runny nose, nasal congestion, coughing, hoarseness, a deep or raspy voice, muffled speech, difficulty swallowing, shortness of breath, and wheezing.

Gastrointestinal symptoms may include severe abdominal pain, vomiting, and in infants, bloody stool or, less commonly, diarrhea.

As for the cardiovascular system, low blood pressure may occur, and in severe cases, dizziness, fainting or near-fainting, heart palpitations, and in very rare cases, loss of consciousness, seizures, or loss of bladder control may be observed.

What Substances Cause Allergies in Children?

Allergies in children can be triggered by various substances, including:

Airborne allergens: house dust mites, storage mites, grass, weed, and tree pollens, pet dander and saliva (cats, dogs, etc.),mold spores
Food allergens: milk, egg, nuts, and other food proteins
Medications: taken orally, applied to the skin, or administered intravenously
Insect venoms: bee or wasp stings
Other allergens: cosmetics, soaps, metals, chemicals used in clothing, shoes, jewelry, and additives in foods and medications

What Factors Increase the Risk of Severe Allergic Reactions?

The severity of an allergic reaction often depends on the amount and duration of exposure to the allergen. The longer or more intense the exposure, the more severe the reaction can be.

Therefore, it is crucial to immediately stop contact with the allergen when symptoms begin. For example, if a reaction begins during the intravenous administration of a medication, the infusion should be stopped right away.

Generally, intravenous exposure to an allergen poses a greater risk of a severe reaction compared to oral exposure. However, independent of these factors, an individual's genetic makeup can also predispose them to severe reactions.

How Soon Do Allergy Symptoms Appear After Exposure?

The onset of allergy symptoms depends on the type of allergic reaction. In immediate-type allergies, symptoms can develop within minutes to a couple of hours after exposure.

In contrast, some drug or food allergies, or contact with certain chemicals, may result in delayed reactions, with symptoms appearing several hours or even days later.

What is Childhood Allergy?

Childhood allergy refers to allergic diseases in children triggered by substances such as milk, eggs, and other protein-rich foods, medications, insect venom (e.g., bee stings),airborne allergens, or substances that come into contact with the skin.

Common childhood allergic conditions include:

Allergic asthma
Allergic rhinitis (hay fever)
Atopic dermatitis / eczema
Contact dermatitis
Dust mite allergy
Pollen allergy
Cat and dog allergy
Horsehair allergy
Cold-induced allergy
Food allergy
Drug allergy
Anaphylaxis
Acute urticaria (hives)
Chronic urticaria
Angioedema
Insect sting allergy
Frequent infections in children (possibly allergy-related)

These diseases are diagnosed and treated by Pediatric Allergy and Immunology specialists.

How Is Allergy in Children Different From Adults?

Allergic diseases cause similar symptoms in both children and adults. However, their frequency can vary by age group. For example, true food allergies are more common in infants and children, while drug allergies are more frequently seen in adults. Atopic eczema, also known as atopic dermatitis, is much more prevalent in babies and children than in adults.

Additionally, infants have narrower airways compared to older children and adults, making them more susceptible to wheezing and shortness of breath from even mild airway obstruction. Infants who experience recurrent wheezing episodes are at a higher risk of developing asthma later in childhood.

Since infants, children, and adolescents are still growing, the approach to diagnosing and managing their diseases differs from that of adults. Nevertheless, all allergic conditions seen in adults—such as asthma, allergic rhinitis, drug allergies, insect venom allergy, contact dermatitis, exercise-induced allergy, and various forms of urticaria—can also occur in children.

What Causes Allergies in Children?

Allergies in children result from both inherited genetic factors and exposure to various environmental allergens. In genetically predisposed children, the immune system is more likely to react in an allergic manner when exposed to allergens, leading to symptoms.

In patients with eczema, allergens can penetrate through cracks and gaps in the skin, triggering an actual allergic response and exacerbating the condition.

Types of Allergies in Children

1. Food Allergies

Common allergens in infants and young children are typically protein-rich foods.

Most common in babies: Cow’s milk and egg
Other common allergens (especially as children grow): Tree nuts (e.g., walnuts, hazelnuts, cashews, pistachios),sesame, peanuts, legumes (lentils, beans, chickpeas, peas),wheat, various types of fish, and beef.

In older children, allergies to raw fruits and vegetables can also occur.

2. Respiratory Allergies

These occur through inhalation of allergens such as:

House dust mites
Tree, grass, and weed pollens
Mold spores
Pet dander and saliva (cats, dogs)
Cockroach particles
These allergens can cause allergic rhinitis and allergic asthma.

3. Skin Allergies

Includes conditions like:

Eczema (Atopic Dermatitis): Common in infancy and early childhood, but may also appear in school-age children and adolescents.
Contact Dermatitis: Caused by chemicals in perfumes, toys, modeling clay, shoes, or clothing.
Urticaria (Hives): Can occur during infections, with food or drug allergies, insect stings, or bites (e.g., mosquito). It may last several days.

Triggers also include:

Cold or hot weather
Water contact
Exercise
Emotional stress
Pressure applied to the skin

4. Drug Allergies

Most common drugs causing allergies in children are antibiotics and pain relievers.

Reactions may appear:

Within hours after oral intake
Within minutes after injection or intravenous infusion

Symptoms range from skin-only (hives, widespread redness) to severe reactions like shortness of breath, wheezing, coughing, hoarseness, fainting, or loss of consciousness.

5. Insect Sting Allergies

Insects such as mosquitoes, horseflies, fleas, and bedbugs may cause skin reactions resembling hives or blisters.

Bee or wasp stings, on the other hand, can lead to both skin symptoms and severe systemic allergic reactions such as shortness of breath, wheezing, hoarseness, fainting, or even anaphylaxis.

What Are the Symptoms of Allergy in Children?

Allergic symptoms in children may include clustered red patches and raised bumps (urticaria, hives) on the face—especially the cheeks, forehead, and around the lips—as well as on the arms, legs, trunk, and neck. These are often accompanied by itching. Swelling can also occur on the face, lips, eyelids, hands, and feet. Eczema, also known as atopic dermatitis, may be present. These skin symptoms may start in one area and spread throughout the body or remain localized.

In addition to skin-related symptoms, respiratory complaints may include sneezing, runny nose, nasal congestion, coughing, hoarseness, a deep or raspy voice, muffled speech, difficulty swallowing, shortness of breath, and wheezing.

Gastrointestinal symptoms may include severe abdominal pain, vomiting, bloody stool in infants, and, less commonly, diarrhea.

Cardiovascular symptoms may include low blood pressure, and in severe cases: dizziness, fainting or near-fainting, palpitations, loss of consciousness, seizures, and loss of bladder control.

How Is Allergy Diagnosed in Children?

To diagnose allergies in children, a pediatric allergy specialist first evaluates the patient by obtaining a detailed medical history and conducting a physical examination. The doctor will review any previous allergic episodes, related medical records, and test results. Based on the evaluation, appropriate allergy tests will be ordered. These may include skin prick tests or blood tests. Diagnosis is made according to the results of these evaluations.

What Are the Allergy Tests for Children?

Allergy tests in children include skin tests and blood tests.

Skin tests may be used to detect reactions to respiratory allergens (such as house dust mites, pollen, molds),food allergens, drug allergens, and certain chemicals.

Blood tests can also detect sensitivity to airborne allergens, food allergens, certain medications, and insect venoms (bee or wasp stings).

Other tests include oral food challenges or drug provocation tests when necessary.

Lung function tests are used in children suspected of having allergic asthma.

Most Common Allergic Conditions in Children

In infants, atopic dermatitis (eczema) is the most frequently seen allergic condition. It may be related to food allergies.

After 6 months of age, during the introduction of solid foods, immediate-type food allergies may occur following feeding.

Recurrent wheezing episodes in infants may be related to asthma and should be evaluated. Allergic asthma is common in children and often presents with night-time coughing or waking due to cough.

In school-aged children and adolescents, allergic rhinitis (hay fever) is frequently observed.

Urticaria (hives) is also common in children and may occur during infections, food or drug allergies, insect stings, or bites (e.g., mosquitoes). It can sometimes persist for days.

Cold or hot weather, contact with water, exercise, emotional stress, or pressure on the skin can also trigger urticaria.

Allergy Treatment in Children

Treatment of allergies in children begins with avoidance of known allergens. In conditions like asthma, allergic rhinitis, and eczema, various medications are available. For eczema, moisturizing the skin, protecting it from the sun, and implementing proper skincare routines are essential parts of treatment.

In some cases, immunotherapy (allergy shots or drops) may be administered for food allergies, insect venom allergy, allergic asthma, or allergic rhinitis. This is considered a curative treatment that aims to desensitize the immune system over time.

How to Protect Children from Allergies

Children should be protected from allergens that trigger their allergic reactions. Therefore, it is important to identify the exact trigger. For example, to prevent allergic rhinitis and asthma caused by house dust mites, wool and feather-based items like wool mattresses, pillows, duvets, feather pillows, and stuffed toys should not be used.

Additionally, exposure to cigarette smoke, polluted air, exhaust fumes, strong detergent and perfume odors can provoke allergic symptoms and must be avoided.

Some studies have shown that in children at high risk for allergies (those with allergic parents),applying moisturizers during infancy can help prevent atopic dermatitis, which in turn may reduce the likelihood of developing food allergies in the following months or years. Other studies suggest that introducing a diverse range of foods during the first year of life may reduce the risk of food allergies later on.

Lifestyle Tips for Children with Allergies

The most important tip for children with allergies is avoiding exposure to the allergen. In addition to specific precautions, general protective measures should also be followed.

Children should be kept away from areas where smoking occurs. Smoking should not take place anywhere in the home—not even by a window, in the bedroom, under a kitchen hood, in the bathroom, or on the balcony.

They should also be protected from indoor irritants (like dust, insect sprays, perfumes, deodorants, hair sprays, paint) and outdoor pollutants (exhaust fumes, smog, smoke).

During periods of high air pollution or windy and stormy weather, children should remain indoors as much as possible. To prevent respiratory infections such as the flu, frequent hand washing and regular ventilation of the home are recommended.

Allergen Control in the Home

Common household allergens include house dust mites, pet dander and secretions, cockroach allergens, and mold. To reduce dust:

Keep bedrooms clutter-free.
Store books and clothes in closed cupboards.
Replace thick carpets with rugs or remove them altogether. If rugs remain, vacuum regularly.
Avoid wool or feather bedding.
Remove stuffed toys from the room.
Keep indoor humidity below 50%. Repair any leaks, and ensure proper insulation in bathrooms, kitchens, and windows to prevent mold.
Avoid activities that increase humidity such as drying clothes indoors, using humidifiers, or placing wet towels or bowls of water on radiators.
Use light curtains or blinds instead of thick, heavy drapes.

Seal cracks and holes in walls and floors where cockroaches might enter. Install proper seals around windows and doors. Use safe pest control if needed.

In cases of pet allergies, cats’ and dogs’ hair and secretions can stay airborne for a long time. If an allergy is diagnosed, pets should be removed from the home. Air conditioners should be regularly cleaned and maintained.

Managing Allergies at School

Most allergic reactions at school are related to food allergies. The most common food allergens in school-aged children are nuts, cow’s milk, sesame, and eggs.

If your child has a known food allergy, the school administration, class teacher, bus driver, and attendant must be clearly informed. Make sure your child avoids exposure to the allergen in the cafeteria, classroom, or school bus. Ideally, if meals contain the allergen, your child should have an alternative meal prepared.

School kitchens must prepare meals for allergic children separately and avoid cross-contamination with allergenic ingredients.

Utensils like plates, forks, knives, and spoons must not be shared if they have been in contact with allergens. Regular communication with the school staff is crucial.

Ensure kitchen staff and other personnel are aware of your child’s allergies. Review the monthly menu with your child in advance to help them make safe choices.

It is also very important to educate your child about their allergy in an age-appropriate way.

They should understand not only what foods to avoid but also how to recognize hidden sources of allergens.

Teach your child how to read food labels, and explain that they should never eat unknown or unsafe foods, even if offered by someone familiar.

Wearing an allergy alert bracelet or necklace that lists the allergen can be helpful.

Prepare your child for the possibility of accidental exposure—explain the symptoms of a possible reaction, how quickly it may progress, and what steps to take—without frightening them.

Teach them to ask questions before accepting food, and that even friendly offers from others can contain allergens. They should avoid any unfamiliar food, even if recommended by a trusted person.

Make sure they (and responsible adults) are trained on how to use an epinephrine auto-injector (EpiPen) in case of anaphylaxis.

Also, share written documentation from your doctor with the class teacher and school management that explains what to do during a reaction and how to recognize anaphylaxis.

Ensure teachers know how to respond in emergencies and that someone on staff is trained in first aid. This will offer peace of mind to both the child and the parents.

Nutrition Tips for Children with Food Allergies

Children with food allergies should have the allergenic foods completely removed from their diet. To prevent accidental exposure, everyone involved in the child's care (e.g., babysitters, grandparents, aunts, uncles, preschool or school teachers) must be informed about the allergy and made aware of the foods the child should avoid.

The most common allergenic foods—such as milk and eggs—are often used in the preparation of various meals. Therefore, extra care must be taken in the nutrition of children with food allergies. Packaged food labels must be read carefully. In some children, even trace amounts of an allergen can cause symptoms. Allergenic foods should be replaced with nutritionally equivalent, healthy alternatives. A list of appropriate, balanced foods that meet the child’s calorie and nutritional needs should be created in collaboration with a physician and dietitian to ensure proper growth and development.

Is It Possible to Prevent Allergies in Children?

Some studies have shown that in high-risk children (those with a parent who has an allergic condition),the development of atopic eczema in early infancy can be prevented by applying moisturizers. Preventing eczema in this way has been linked to a reduced risk of developing food allergies in later months or years.

Other studies have found that after starting complementary feeding in the first year of life, offering a wide variety of foods from different food groups can decrease the risk of food allergies after the age of one.

In high-risk infants (those with atopic eczema or allergic parents),even if they show mild sensitivity to peanuts, regular and small amounts of peanut consumption have been shown to reduce the risk of developing a true peanut allergy by age five, compared to complete avoidance. However, since these studies were conducted in different countries and populations, their results may not apply to individuals of different ethnic backgrounds or those living in other regions. Further research is needed.

Scientific Recommendations to Reduce Allergy Risk

Some research suggests that pregnant women who follow a Mediterranean diet—rich in antioxidants—may reduce the risk of atopic dermatitis in their babies. Additionally, as mentioned above, early application of moisturizers in infancy and introducing a wide variety of foods after starting solids in the first year may help reduce the development of food allergies later on.

Frequently Asked Questions About Allergies in Children

Can childhood allergies go away over time?

Childhood allergies can improve or resolve over time. This depends on the specific allergen involved. Food allergies, especially to milk and eggs, often improve significantly with age. However, the rate of resolution is lower for nut allergies. For children and adolescents with allergic asthma or allergic rhinitis, avoiding allergens such as dust mites, pollens, molds, and pet dander can greatly reduce symptoms, sometimes to the point where no symptoms appear at all. Additionally, studies have shown that penicillin allergy may also diminish over the years.

Can allergic children receive vaccinations?

Vaccinations during infancy and childhood are essential tools for protecting our children and community from life-threatening infectious diseases. If an allergic child has no known allergy to any components of the vaccines, they should receive vaccinations under the supervision of a doctor and nurse, just like other children.

Allergic children can be vaccinated. Some vaccines, such as the Measles-Mumps-Rubella (MMR) vaccine, may contain trace amounts of milk or egg proteins. Infants and children with immediate-type milk or egg allergies should be evaluated by their physician before receiving these vaccines. This evaluation does not prevent vaccination but ensures safety. As with all injections, vaccinations must be administered under medical supervision, and children should be observed at the healthcare facility for at least 30 minutes after vaccination.

Does having a pet trigger allergies?

Individuals allergic to cats or dogs will likely experience allergic symptoms such as sneezing, coughing, runny nose, shortness of breath, and other allergic complaints if they start living with pets they are allergic to.

However, if a pregnant woman lives in a home with pets and the baby continues living with the pets after birth, studies suggest that the risk of developing a true allergy to these animals may decrease as the child grows.

Which foods can reduce allergy risk?

There is no specific food that reduces allergies. However, a healthy, balanced diet rich in proteins, fats, and carbohydrates—free from additives—and full of vitamins and minerals supports balanced muscle and bone development and growth in babies, children, and adolescents. Like other chronic diseases, proper nutrition can also help reduce flare-ups of allergic conditions such as asthma and allergic rhinitis.

People with allergic rhinitis are more prone to upper respiratory infections like sinusitis, otitis, and pharyngitis. Proper nutrition helps these infections be overcome more easily.