The 9 Major Food Allergens: What Every Caregiver Needs to Know

Food allergies affect roughly 1 in 13 children in the United States. For the caregivers, teachers, coaches, and family members in those children's lives, understanding the basics of food allergens is not optional. It is part of the job.

Here is what every caregiver needs to know about the nine major food allergens.

Milk.

Cow's milk allergy is one of the most common in young children. It is different from lactose intolerance, which is a digestive issue rather than an immune response. A true milk allergy can cause reactions ranging from hives to anaphylaxis.

Eggs.

Egg allergy is particularly common in children under five and many outgrow it by adulthood. Both the egg white and egg yolk can trigger reactions, though the white is the more common culprit.

Peanuts.

Peanut allergy is one of the most prevalent and most serious food allergies. Unlike many childhood allergies, most people with peanut allergy do not outgrow it. Even trace amounts can trigger anaphylaxis in highly sensitive individuals.

Tree nuts.

Tree nuts include almonds, cashews, walnuts, pecans, pistachios, Brazil nuts, hazelnuts, and others. A child may be allergic to one type of tree nut but not others, or allergic to all of them. Specificity matters here.

Wheat.

Wheat allergy involves an immune response to proteins in wheat and is different from celiac disease. Wheat appears in many foods that might not seem obvious, including sauces, soups, and processed foods.

Soy.

Soy allergy is common in infants and young children. Soy appears in many processed foods, including baked goods, canned soups, and meat products.

Fish.

Fish allergy is more common in adults than children and tends to persist for life. Reactions can be triggered not just by eating fish but in some cases by proximity to fish being cooked nearby.

Shellfish.

Shellfish allergy is one of the most common food allergies in adults. It covers two categories: crustaceans such as shrimp, crab, and lobster, and mollusks such as clams, oysters, and scallops. A person may be allergic to one category but not the other.

Sesame.

Sesame became the ninth major allergen recognized by the FDA in 2023. It appears in tahini, hummus, certain breads, and many Middle Eastern and Asian foods.

Hidden sources of allergens.

One of the most challenging aspects of managing food allergies is that allergens appear in unexpected places. Milk shows up in some medications. Soy appears in most processed foods. Wheat turns up in soy sauce. Peanuts are used to make some artificial flavorings.

Advisory labels like may contain or processed in a facility that also processes indicate a real risk of cross-contamination for highly sensitive individuals.

What caregivers should do.

Never assume a food is safe. If you are not certain about the ingredients, ask or skip it.

Read labels every time. Manufacturers change ingredients. A product that was safe last month may not be safe today.

Know where the medication is. If the child in your care carries an epinephrine autoinjector, know where it is and how to use it before you need it.

Know the emergency plan. Every food-allergic child should have a written emergency plan that explains what to do if a reaction occurs. Ask for it, read it, and keep it accessible.

NuriPass stores a child's complete allergy profile in a QR code that any caregiver can scan in seconds. It shows exactly which allergens to avoid, which foods are safe, and what to do in an emergency without any app or login required.

Understanding food allergies is not complicated. It just requires attention, preparation, and a willingness to take it seriously.