Diagnosis of food allergies in children

Due to the aspecific nature of their symptoms, food allergies cannot be diagnosed reliably based on the patient's symptoms alone. Many parents believe that their child is allergic to one or more types of food; however, this can be confirmed in only 20% of cases. A food allergy cannot be demonstrated by laboratory diagnostic tests because these tests detect sensitisation, rather than allergy. Many children who are sensitized to a certain type of food can tolerate the food without problems. The most commonly used type of diagnostic test for food allergies is open elimination and provocation, which, in the Netherlands, is primarily conducted in child healthcare clinics. This type of diagnostic test, however, is associated with a high rate (> 50%) of false-positive results. The most reliable way to diagnose a food allergy is to conduct a double-blind, placebo-controlled food provocation. This test is only available at a few centres in the Netherlands. Food allergies occur in 2.5% of children but are more often regarded incorrectly as the cause of symptoms in young children. Therefore, a critical attitude is warranted when parents suspect that their child is allergic to one or more types of food.