Is your child's food making your little one sick?

From mysterious rashes after meals to sudden reactions at school, food allergies can turn everyday moments into a constant worry for parents.

The most common food allergens are:

• Eggs,

• Cow’s milk,

• Peanuts and tree nuts (such as cashew, pistachio, walnut, pecan, hazelnut, almond) and

• Shellfish

In this 'Ask the Specialist' Q&A forum, Dr Chong Kok Wee answers your questions about protecting your little ones from food allergies - whether when eating at home or eating out!

Dr Chong is one of the authors of Milly and the Milk Disaster, from The Baby Bear Paediatric Care Series.

Dr Chong Kok Wee is Head and Senior Consultant of the Allergy Service, Department of Paediatrics at KK Women’s and Children’s Hospital (KKH).

He specialises in paediatric allergy and his research interests include food and drug allergies in children, oral immunotherapy and allergy prevention.

Dr Chong is leading a team of doctors to develop a 12-book collection, The Baby Bear Paediatric Care Series, that blends engaging storytelling with practical medical advice, covering various common childhood conditions in Singapore including childhood food allergies.

1. Question by Frankie

Hi Dr Chong,

My grandchildren after consuming prawn have throat tightness and mouth swelling.  Pls advise. Thank you.

Answer by Dr Chong Kok Wee

Hi Frankie,

Your grandchildren's symptoms suggest a possible food allergy to prawns/shellfish. This occurs when the immune system reacts to proteins in these foods, causing symptoms like itchy rashes, mouth itching, facial swelling, vomiting, and abdominal pain. In severe cases, it can affect breathing and require emergency care.

Please seek immediate medical attention if these symptoms are occurring. For safety, avoid giving them prawns and shellfish, and consult their paediatrician for allergy testing. They may be referred to an allergist for evaluation. Do inform their school and caregivers about this allergy, as seafood allergies can be severe.

To help you and your grandchildren understand food allergies better, KKH has created a child-friendly book that explains allergies in a way that's easy for young ones to understand. More information here.

For more information about KKH's Allergy Service, please visit this link.

2. Question by Irene

Dear Dr Chong,

I have a very puzzling situation.

In his early childhood years, my son had an allergy to dry fit clothing, which he later outgrew as he entered primary school.

While it is thought to be a latex allergy, he is fine consuming okra, yam, kiwi, cheese, eggs and his formula milk.

He also has a severe reaction to Buckwheat (Soba) and Echinacea (herbal supplement). 

He is currently 14 years old and about 6 months ago, his skin flared up with severe hives.

His condition came under control using a variety of steroid creams for the body and protopic for the face, as prescribed by the doctor.

Additionally, fresh milk, UHT milk and dairy were removed from his diet where possible, although he is still consuming formula milk powder.

Will he outgrow his allergies? Over the same lifetime, do different allergies manifest at different ages? Does his condition warrant an allergy prick test and what is the cost?  

My family tree does have a history of seafood allergies but my spouse and I don't.

Thank you for your advice.

Answer by Dr Chong Kok Wee

Dear Irene,

I agree that your situation is puzzling.

Generally, a child is unlikely to develop an allergy to food that has been regularly tolerated in the past, such as cow's milk or dairy, especially if he/she is still taking formula milk. Cow's milk and dairy are important sources of calcium and should not be avoided unless necessary.

There are many other causes of hives besides food allergies.

Some food allergies, such as cow's milk allergy, have a good chance of being outgrown before the age of five to six years old, while certain allergies, such as those to nuts and shellfish, are less likely to be outgrown.

Allergies can manifest differently at different ages. Food allergies tend to occur at younger ages – below five – while environmental allergies, such as house dust mite allergies, tend to occur at an older age.

I would encourage consulting an allergist for further assessment as this would require a thorough evaluation involving a detailed medical history and investigations.

3. Question by Rachel

Hi Dr Chong! 

I have a soon to be 2-year-old who gets hives with redness around his mouth and sometimes eyes after taking egg/milk containing foods. 

He develops an itch around his neck and limb folds after taking normal toddler formula. This has resulted in us giving only hypoallergenic formula, breast milk and avoiding (as best as we can) fresh milk, yoghurt, yoghurt drink, cheese, milk, egg ingredients which are found in general food like biscuits, buns too. 

He has done a skin prick test and is found to be allergic to milk and egg, but is tolerant with nuts. 

How long will his food allergy persist? When should we try/explore this food? Thank you for your advice.

Answer by Dr Chong Kok Wee

Dear Rachel,

Egg and milk allergies generally have good chance of outgrowing naturally, by the age of five to six years old. 

Children with food allergies are advised to be followed up by paediatric allergists, to assess an appropriate time for reintroducing the food

Ref: G25