According to guidelines from the National Institute for Health and Care Excellence (NICE), paediatric allergies fall into following main categories.

Food allergies are one of the most common allergies in children. They occur when the immune system mistakenly identifies a specific food protein as harmful, triggering an allergic reaction. (1)

They are divided into two main types:

IgE-mediated Food Allergies: These involve an immediate immune response mediated by Immunoglobulin E (IgE) antibodies. Symptoms typically appear rapidly after ingestion and can include hives, swelling, vomiting, and, in severe cases, anaphylaxis. Common culprits include peanuts, tree nuts (almond walnut cashews), milk, eggs, and shellfish. Diagnosis often involves skin prick tests or blood tests for specific IgE antibodies. (2)

Non-IgE-mediated Food Allergies: These are characterized by delayed reactions not involving IgE antibodies. Symptoms may develop hours after consuming the allergen and can include gastrointestinal issues like vomiting, diarrhoea, and abdominal pain, as well as skin conditions such as eczema. Diagnosis typically involves an elimination diet followed by reintroduction to observe symptom changes. (3)

• Avoid the allergenic food.

• Read food labels carefully.

• Carry an epinephrine auto-injector (EpiPen) if severe allergies exist.

These allergies are triggered by inhaling airborne allergens, leading to respiratory tract inflammation. Common triggers include:

• Pollen (from trees, grass, and weeds) – Common cause of seasonal allergies (hay fever).

• Dust mites – Tiny insects that live in bedding, carpets, and upholstered furniture.

• Mould spores – Grows in damp areas like bathrooms and basements. (4)

• Pet dander – Tiny skin flakes from cats, dogs, or other furry animals. (5)

• Smoke & Air Pollution – aggravate allergic reactions and worsen asthma.

Symptoms often include sneezing, runny nose nasal congestion, red watery or itchy eyes, and coughing asthma symptoms (difficulty breathing, tightness in the chest).

• Limit exposure to allergens (e.g., keep windows closed during pollen season).

• Use air purifiers to reduce allergens indoors.

• Take antihistamines or nasal corticosteroids.

• Allergy shots (immunotherapy) for long-term relief.

 These occur when the skin reacts to direct contact with allergens like certain metals (e.g., nickel), latex, or specific chemicals found in soaps and detergents causing irritation or inflammation of the skin. Symptoms typically include localized redness, itching, and eczema.

Common skin conditions are:

• Eczema (Atopic Dermatitis) – A chronic skin condition triggered by allergens like food, pollen, or pet dander or environmental factors characterized by Dry, red, scaly patches of skin, sometimes oozing or cracking.

• Contact Dermatitis – A skin reaction caused by direct contact with an irritant or allergen like soap, detergent, fragrances, plants (poison ivy) causing are red, itchy, and blistering skin rash.

• Hives (Urticaria) – Raised, itchy welts on the skin triggered by allergens such as food, insect bites, or medications.

• Use hypoallergenic soaps and lotions.

• Moisturize regularly for eczema.

• Avoid scratching to prevent infections.

• Use Antihistamines or corticosteroid creams for symptom relief. (6)

These Reactions occur due to stings from insects such as bees, wasps, hornets and fire ants. Symptoms can range from localized swelling, redness, hives, rash and pain at sting site to systemic reactions like anaphylaxis, which includes difficulty breathing, swelling of the throat, drop in blood pressure. (7)

• Avoid known insect habitats

• Carry an adrenaline auto-injector if diagnosed with a severe allergy.

Adverse reactions to medications can occur in children, with antibiotics like penicillin being common triggers. Symptoms can range from mild skin rashes to severe reactions such as anaphylaxis. Accurate diagnosis is essential to avoid unnecessary avoidance of medications. (8)

Allergies can develop at any stage of childhood, but certain types are more common in specific age groups:

Infants (0-1 year)

In infants (0-1 year), food allergies are among the most frequent concerns, with cow's milk protein allergy (CMPA) being a leading cause of symptoms such as vomiting, diarrhea, and eczema.9 Other allergens, including eggs, soy, and wheat, may also trigger reactions, either IgE-mediated with immediate symptoms or non-IgE-mediated with delayed gastrointestinal issues.

 Toddlers (1-3 years)

As children grow into toddlers (1-3 years), food allergies remain prevalent, but environmental allergens begin to emerge. Exposure to house dust mites, pet dander, and mold may trigger allergic rhinitis or asthma-like symptoms. Additionally, atopic dermatitis (eczema) can persist, often linked to underlying food sensitivities or environmental irritants. At this stage, insect venom allergies can also start to appear, particularly in children who react strongly to bee or wasp stings.

 Early Childhood (3-6 years)

In preschool and early school-age children (3-6 years), allergic rhinitis becomes more noticeable, particularly in response to seasonal allergens like pollen. This is also the period when asthma symptoms, often linked to environmental allergens, can develop or worsen.  Drug allergies, such as reactions to antibiotics like penicillin, may become apparent when children are exposed to medications more frequently due to common childhood infections.

School-Age Children (7-18 years)

By late childhood and adolescence (7-18 years), allergies tend to stabilize, though some children may outgrow early food allergies, particularly to milk, eggs, and soy. However, nut allergies and shellfish allergies are more persistent and may continue into adulthood. Hay fever symptoms tend to peak in adolescence, particularly in response to grass and tree pollen. Additionally, adolescents may experience worsening asthma if not properly managed, especially when combined with physical activity or exposure to strong triggers like smoke or pollution.10

From the table below, we can see that allergies are influenced by climate, pollution, diet, and genetics. Some regions have higher rates of specific allergies than others.

Paediatric allergies are an increasing health issue, affecting millions of children worldwide. In the UK alone, approximately one in five children suffer from some form of allergic condition, ranging from food allergies to respiratory and skin-related reactions. (13)

Over the last few decades, the prevalence of childhood allergies has risen significantly, with conditions such as eczema, asthma, and hay fever commonly linked to allergic responses. Among food allergies, around 7–8% of children experience adverse reactions to common triggers like milk, eggs, peanuts, and tree nuts. (14)

Allergy awareness in UK schools has improved significantly, particularly in response to the growing number of children with severe allergies. Legislation since 2017 allows schools to stock spare adrenaline auto-injectors (AAIs) for emergency use, though this is not mandatory. Schools are encouraged to develop Individual Healthcare Plans (IHPs) for pupils with allergies, outlining prevention strategies and emergency protocols.

Staff training on allergy recognition and AAI use is widely available through charities such as Anaphylaxis UK and Allergy UK, but not all schools provide it consistently. While many implement allergy-friendly measures — like nut-free policies, food labelling, and lunchroom safety practices —guidelines can vary across schools and local authorities.

Parental involvement is essential in providing medical details and ensuring schools have access to up-to-date medication. Despite increased awareness, challenges remain, including inconsistent staff training, limited funding, and the emotional impact allergies can have on children, such as anxiety or social exclusion.

Organisations like BSACI,15 Allergy UK, and Anaphylaxis UK continue to support schools through training, resources, and advocacy. Ongoing efforts are needed to ensure every school provides a safe, inclusive environment for allergic children and responds effectively in emergencies.

World allergy week is just around the corner.it is scheduled for June 29 to July 5, 2025, with the theme focusing on Anaphylaxis. This annual initiative by the World Allergy Organization (WAO) aims to raise global awareness about allergic diseases and related disorders.

There will be planned activities like local and regional educational sessions, international webinars and resource dissemination to enhance understanding of anaphylaxis, its prevention and management strategies. (16)

1. scott H.Sichereer, C. M. W. C. D. G., 2020. food allergy from infancy through adulthood. 8(6), pp. 1854-1864.

2. al, A. F. S. e., 2023. EAACI guidelines on the diagnosis of IgE-mediated food allergy. allergy, 78(12), pp. 3057-3076.

3. Roxane Labrosse, F. G. J.-C. C., 2020. Non-IgE Mediated gastrointestinal food allergies in children:an update. nutrients, 12(7), p. 2086.

4. Kwok Wai Tham, M. S. Z. K. F. T. C. L. O., 2007. Associations between home dampness and presence of molds with asthama and allergic symptoms among young children in the tropics. petiatric allergy immunology, 18(5), pp. 418-424.

5. Elizabeth A Erwin, J. A. W. N. C., 2018. Animal Danders. Immunology And Allergy Clinics Of North America, 23(3), pp. 469-481.

6. Stephanie J Lax, J. H. E. A. L. H. M. S. S. L., 2022. Strategies for using topical cortcosteroids in children and adults with eczema. cochrane database systemetic review, 3(3).

7. John W Tan, D. E. C., 2013. insect allergy in children. J Paediatric Child Health, 49(9), pp. 381-7.

8. Cagla Karavaizoglu, A. S. R. y. A., 2024. drug allergy in children:adverse reaction after skin testing. Int Arch aAlergy Immunology, 185(1), pp. 56-62.

9. Julie D Flom, S. H. S., 2019. Epidemiology of Cow's Milk Allergy. Nutrirnts, 11(5), p. 1051.

10. Dr Ulrike, H. W. G. H. P. T. B., 2015. Exposure to air pollution and development of asthama and rhinoconjctivitis throughout childhood and adolescence:a population based birth cohort study. the Lancet Respiratory Medicine, 3(12), pp. 933-942.

11. Laura Perez, C. D. I., 2013. Chronic burden od near-roadway traffic pollution in 10 European cities(APHEKOM network). European Respiratory Journal, 42(3), pp. 594-605.

12. Eliabeth Huiwen Tham, A. J. L. H. V. B., 2016. Aeroallergen sensitizaztion and allergic disease phenotype in Asia. Asian Pac J Allergy Immun, 34(3), pp. 181-189.

13. https://www.allergyuk.org/

14. https://www.food.gov.uk/research/part-3-children-with-food-hypersensitivities. [Online]

    Available at: https://www.food.gov.uk/

15. https://www.bsaci.org/. [Online]

16. https://www.worldallergy.org/resources/world-allergy-week. [Online]
    Available at: https://www.worldallergy.org/