Natural history of food allergies

Infants and young children are more likely to develop IgE-mediated food allergies than are older children and adults. However, many of the affected young children will outgrow their food allergies in early childhood within a few months to several years after the onset of the food allergy (1,2). Some estimates suggest that 80-90% of food-allergic children are able to tolerate the offending food by 3 years of age (1). Allergies to some commonly allergenic foods are more likely to be outgrown than are allergies to other foods. For example, milk, egg, soybean and wheat allergies appear to be commonly outgrown. In contrast, peanut allergy appears to be much more persistent with only about 20% of peanut-allergic children outgrowing peanut allergy by adulthood (3). The mechanisms involved in the loss of sensitivity to specific foods are not precisely known, but the development of immunological tolerance is definitely involved.

Several recent studies have shown that milk- and egg-allergic children develop tolerance to milk and eggs in baked products before they develop tolerance to less heat-processed forms of milk and eggs (4,5). These studies seem to also point toward the identification of a sub-population who are unlikely to outgrow their milk and/or egg allergy - the ones who continue to be sensitive to baked products with milk and eggs. This finding confirms earlier observations that a sub-population of milk- and egg-allergic children exist who are unlikely to outgrow their allergies (6,7).

  1. Bock SA. Journal of Allergy and Clinical Immunology 1982; 69:173-7.
  2. Wood RA. Pediatrics 2003; 111:1631-1637.
  3. Skolnick HS, Conover Walker MK, Barnes-Koerner C, et al. Journal of Allergy and Clinical Immunology 2001; 107:367-374.
  4. Nowak-Wegrzyn A, Bloom KA, Sicherer SH, et al. Journal of Allergy and Clinical Immunology 2008; 122:342-347.
  5. Lemon-Mule H, Sampson HA, Sicherer SH, et al. Journal of Allergy and Clinical Immunology 2008; 122:977-983.
  6. Skripak JM, Matsui EC, Mudd K, et al. Journal of Allergy and Clinical Immunology 2007; 120:1172-1177.
  7. Savage JH, Matsui EC, Skripak JM, et al. Journal of Allergy and Clinical Immunology 2007; 120:1413-1417.