[Special aspects of food allergy in children]

IgE-mediated allergic reactions to foods represent the earliest and most important manifestation of allergic diseases in childhood. Sensitization to foods may happen very early in life. Basic options for alimentary allergy prevention are breast-feeding of at least 4 months and in case nursing is impossible, use of an alternative hypoallergenic formula. The most common food allergens in childhood are cow's milk, hen's egg, peanuts, tree nuts and wheat. The prevalence of food allergies in childhood is 2 to 6%. In up to 50% of infants and children with atopic eczema, food allergies play a role; vice versa 95% of children with an IgE-mediated food allergy have atopic eczema as an underlying disease. Diagnostic reliability in suspected allergic reactions to food is only achieved in most cases by performing controlled oral food challenges. The long-term prognosis is good for cow's milk and hen's egg allergy, while peanut and tree nut allergies often last life-long. The most important therapeutic option is a specific elimination diet; especially in infancy, a nutritionally adequate substitution diet has to be considered. Children who might inadvertently get into contact with their potentially life threatening food allergen, should be provided with an epinephrine autoinjector.