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Training Tip: Allergic Reactions in Children

Food allergies are becoming more prominent these days. In fact, about 32 million Americans have a food allergy, including 5.9 million children. Because it is becoming an increasing problem, food establishments should be familiar with the eight major food allergens identified by the FDA (milk, eggs, fish, shellfish, wheat, soy, peanuts, and tree nuts) and know what menu items could have them in it. Food workers should know about cross-contact and how to prevent it from happening.

In addition, if an allergic reaction does occur, it is important for food workers to recognize the symptoms of a reaction and respond appropriately.


Cross-contact occurs when an allergenic food comes in contact with a non-allergenic food. Because allergic customers typically react to the protein of an allergen-containing food, no amount of cooking or manipulation to the food can guarantee it will be safe for an allergic customer to consume. If a dish should be allergen-free, it is important to separate allergenic foods from non-allergenic foods during storage, preparation, and service. This will help reduce the risk of cross-contact.

It is also important for food workers to know their menu and what allergens are in which dishes. Because children are not as familiar with allergens and could be learning to cope with their food allergy, it is important that extra care is taken to ensure that their dish has not been cross-contacted with the allergen.

Communicate with the customer (or the adult with them), the cook, and any other coworkers who will be handling the dish to ensure the best course of action is taken. If a dish does come in contact with an allergen and the customer has a reaction, food workers should recognize what symptoms are associated with allergic reactions and know what to do.

Allergic Reaction Symptoms

Some children may recognize if they are having an allergic reaction and can tell the guardian or adult that is with them. However, most children, especially very young ones, may not know what is happening; just that they feel weird after eating. It is important to know what kids may say if they are trying to communicate that they are having an allergic reaction. They may say things like:

  • My tongue is hot, itchy, or heavy
  • There’s bumps or hair on my tongue
  • My throat feels thick
  • My lips or throat feel tight
  • There’s something stuck in my throat
  • My mouth feels funny
  • My ears feel itchy

In addition to what children say, they may have hives around their mouth, face, or torso of their body. If the reaction is more severe, the hives may appear on other parts of their body, such as their arms and legs. Their skin may also be red and itchy. Typically, these types of reactions are not life-threatening and can be treated with an antihistamine which the parent or guardian should administer as directed by a physician.

Children, or even adults, may also experience abdominal pain, nausea, vomiting or diarrhea. In more severe cases, their throat, tongue, or lips could swell up and they may have difficulty breathing, swallowing, or speaking. This is called anaphylactic shock and it could become life-threatening. If this occurs, call emergency services, such as 9-1-1, and alert the manager.

The child or adult may have an epinephrine auto-injector, which you could be directed to use from the emergency service operator. These are used to relax the muscles and reduce the swelling so a child or adult can breathe again. These types of allergic reactions can be very scary, but it is important to remain calm and do your best to help your customer.

Knowing how to handle allergens and allergic reactions can help you better serve your customers. To learn more about food allergen management, check out our Food Allergens Awareness training.

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