How food allergy risk changes as children grow

by Karl Landsteiner University of Health Sciences

edited by Sadie Harley, reviewed by Andrew Zinin

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Food allergy is an important health concern in childhood, and knowing whether an allergy is likely to persist or disappear can affect medical decisions. Sensitization, however, is not the same as an allergy: specific IgE antibodies may be detectable without a child developing symptoms after eating the food in question.

Detailed data on how such sensitization changes during early childhood have so far been scarce for North America. A study published in the journal Allergy, with major contributions from the Department of Pediatric and Adolescent Medicine at University Hospital St. Pölten, a teaching and research site of klu Krems, set out to examine these changes over time.

Allergies in motion

"Especially in young children, a positive allergy test is not necessarily the end of the story," says Thomas Eiwegger, head of the Department of Pediatric and Adolescent Medicine at University Hospital St. Pölten. "We need to know whether a sensitization persists, disappears or develops later. Looking at individual allergen components gives us valuable information for discussing risks and treatment options with families."

The researchers analyzed samples from 500 mother-child pairs taking part in the Canadian CHILD Study, working with colleagues from leading Canadian universities and pediatric research centers.

Blood samples were available from the mothers during pregnancy and from their children at ages 1 and 5. Around 300 individual allergen extracts and components were tested. At age 1, specific IgE sensitization was found in 25.3% of the children; by age 5, this had risen to 40.4%.

The allergens involved changed as well. Egg and peanut were among the main food sensitizers at age 1, while peanut and tree nuts predominated at age 5. Sensitization to environmental allergens such as cats, dogs, house dust mites and grass pollen also became more common.

Peanut and tree nuts showed notably different patterns. Around half of the children with sensitization to major peanut components already showed it at 12 months and remained sensitized at age 5. Important components of cashew, hazelnut, walnut and pistachio, by contrast, were often recognized only later.

Sensitization was not always permanent: around one in four children lost sensitization to important 2S albumins during the four-year period. These proteins include major allergen components of peanut, tree nuts and sesame and are useful markers for food allergies associated with systemic reactions.

Therapy with knowledge

These changes are particularly relevant as treatments for food allergies develop. Oral immunotherapy is now included in treatment guidelines and appears to work particularly well when started early. Knowing whether a sensitization is new, persistent or disappearing can therefore be useful when doctors and families discuss treatment.

The authors also point to an important limitation: the study did not include oral food challenges to confirm clinical food allergy. Its findings concern sensitization and do not mean that one in four children outgrow an established food allergy.

Publication details

Mary Asumta Anyango Kodydek et al., IgE Sensitization Patterns of Mothers and Their Offspring in the First Five Years of Life The CHILD Study, Allergy (2026). DOI: 10.1111/all.70516

Journal information: Allergy

Key medical concepts

Food Allergy

Clinical categories

Allergy and immunologyChildren's healthPediatricsCommon illnesses & Prevention Provided by Karl Landsteiner University of Health Sciences Who's behind this story?

Sadie Harley

BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries. Full profile →

Andrew Zinin

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