Food Reactions: Allergy, Intolerance or Food Sensitivity?

Adverse food reactions terms demystified -- the terms allergy, intolerance and sensitivity are often used interchangeably (and incorrectly!).

Sad child rejecting food. Could this be due to a food reaction?Understanding Food Reactions

When it comes to adverse food reactions, the terms allergy, intolerance and sensitivity are often used interchangeably (and incorrectly!). Here we demystify the language so that families and their healthcare providers can work together towards the most effective solutions for their children.

Adverse Food Reactions

Too often, the language used to describe symptoms associated with food consumption is inconsistent. The number of children affected, the intensity of their symptoms, as well as the underlying mechanisms of action, are different. Getting everyone on the same page is important – it may affect how healthcare providers talk with one another and deliver care, how patients communicate with their providers, and ultimately, the choices made in the grocery store or pharmacy.

Food Allergy

Food allergy is an immune reaction, which occurs each time there is exposure to a given food, and is absent during food avoidance. In food allergy, exposure to a trigger food most commonly brings about immediate symptoms, that is, within minutes to two hours. Some of the most common food allergy symptoms in children include: eczema or hives, difficulty breathing (asthma), sneezing, coughing, runny nose or itchy eyes, and stomach upset.

Food allergy is more common in children than in adults. While numbers vary, it’s been reported that almost 4% of US children have a food allergy. Cow milk protein allergy is one of the most common food allergies in early childhood and affects 2-3% of children under 1 year of age. Other common food allergens in childhood include egg, peanut, tree nuts, wheat, fish, shellfish, and soy.

Food allergy in children should be considered if there is anaphylaxis, symptoms that occur within minutes to hours of eating a food, or with certain disorders, such as moderate to severe eczema.

Children with a food allergy must avoid specific dietary triggers. For example, those with a confirmed cow milk protein allergy must avoid all milk proteins, regardless of source (cow, goat, sheep) – this is because of the risk of protein cross reactivity. Mothers of breastfed babies will need to remove dairy from the diet, and/or use an extensively hydrolyzed or elemental (amino acid) formula.

Food Intolerance

Food intolerance does not involve the immune system and may have a number of underlying causes. As such, it’s difficult to determine exactly how many children experience food intolerance reactions.

Food intolerance reactions may be divided into a number of ‘categories’. For example toxic food intolerance reactions may be associated with food poisoning; whereas pharmacological food intolerance reactions may result from a compound in a food, such as tyramine (found in some cheese, fermented foods and tofu).

Lactose intolerance, a disorder associated with inadequate breakdown and malabsorption of the milk sugar lactose with subsequent symptoms such as diarrhea, abdominal pain, gas, and bloating, is one of the most well known food intolerance reactions.

While the rate of lactose intolerance varies by ethnicity, lactose intolerance is uncommon across all populations before 2 to 3 years of age. For the majority of the population, the enzyme lactase does not start to decrease until 4-5 years of age.

Children with confirmed lactose intolerance must avoid lactose. Lactose-free and/or reduced lactose dairy products, or supplementation with lactase enzymes may bring digestive relief.

Food Sensitivity

Food sensitivity is an adverse food reaction, the mechanism of which is still not fully understood. Clinically, food sensitivity may encompass the delayed, mild to moderate symptoms associated with consumption of a food.

Some of the most common symptoms associated with food sensitivity in childhood may include tummy troubles such as gas, pain, colic, diarrhea, and constipation, chronic congestion, runny nose, and cough, as well as recurrent ear infections, and eczema.

Cow milk and gluten are two of the more common food sensitivities that may affect children. The exact number of children affected by cow milk sensitivity is unknown, but parental reports have suggested that up to 30% of young children may have delayed, mild to moderate symptoms associated with cow milk consumption. Whereas goat milk products must be avoided in cases of confirmed cow milk protein allergy, goat milk products may be a solution for children with cow milk sensitivity.

How Do I Know the Difference?

It may be difficult to tell the difference between food allergy, intolerance and sensitivity, especially when symptoms are moderate and because they may be similar.

When it comes to cow milk-related symptoms, lactose intolerance is uncommon in infants, and cow milk protein allergy is not as common as it may seem. The condition which may be responsible for the delayed, mild to moderate symptoms associated with cow milk consumption in early childhood may be cow milk sensitivity.

Healthcare providers will rely on a careful medical history, laboratory studies where appropriate, and possibly an oral food challenge to confirm an adverse food reaction diagnosis. For some children, a diagnosis of food sensitivity may be one of exclusion, meaning that allergy and intolerance-type reactions have first been ruled out.

Since every child is different, it’s always best to speak with your healthcare provider if you are concerned about whether your little one’s symptoms stem from allergy, intolerance or sensitivity, in order to arrive at the correct diagnosis and to make the optimal treatment plan.


Published on: July 11, 2016
About the Author
Photo of Annie Salsberg ND
Dr. Annie is a board-certified naturopathic physician and Nutritional Science and Education Manager for Kabrita USA. Dr. Annie’s passion for nutrition and natural health, along with her experience as a mother of two and educator of many, inspires her work.
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Recent Comments

Many MD’s and CAM practitioners find allergy incidence much higher than officially recognized.

In Natural Health, July 1994 Dr Mead writes; “At least 50% of all children in the United States are allergic to cow’s milk, many undiagnosed. Dairy products are the leading cause of food allergy, often revealed by diarrhea, constipation, and fatigue. Many cases of asthma and sinus infections are reported to be relieved and even eliminated by cutting out dairy.” (Natural Health, July, 1994, Nathaniel Mead, MD)

“Most formula fed infants developed symptoms of ALLERGIC rejection to cow milk proteins before one month of age. About 50-70% experienced rashes or other skin symptoms, 50-60 percent gastrointestinal symptoms, and 20-30 percent respiratory symptoms. The recommended therapy is to avoid cow’s milk.” (“Epidemiological and Immunological Aspects of Cow’s Milk Protein ALLERGY and Intolerance in Infancy.” Pediatric-Allergy-Immunology, August, 1994, 5(5 Suppl.)

“Formula-fed babies, at the age of three months, were secreting low levels of serum antibodies to bovine proteins contained in their formula.”
(“A Prospective Study of Humoral Immune Response to Cow Milk Antigens in the First Year of Life” Pediatric-Allergy-Immunology, August, 1994, 5(3)
And according to the Centers for Disease Control and Prevention, food allergies among children increased approximately 50% between 1997 and 2011.

Allergist such as Dr. Albert Rowe, Richard Mackarness, M.D, Philpott et all, and a host of other scientist claim that allergy is the underlying cause of all disease.

In an allergic reaction digestive organs shut down to allow more energy for emergency functions. This means heart rate increases, blood pressure increases, blood sugar levels increase, liver stops, gallbladder stops, peristalsis stops, leading to constipation, pancreas stops, stomach stops.

This can lead to any of these organs becoming a problem. Gall stones, stomach ulcer, high BP, diabetes, twisted bowel, toxicity, and a heap of other diseases.

Hans Selye, in his book ‘The stress of life’ mentiones three stages of allergic response. The first is ‘ALARM’. For instance, the first cigarette a person smokes causes coughing, sneezing, dizziness, possible nausea etc. After the initial shock the smoker will adapt, and will react less severe. This is the stage of ‘ADAPTATION’. Stage Three, ‘EXHAUSTION’ is eventually reached for all and this stage is marked by some disease.

An infant taken from breast milk to formula will, in the initial stage, vomit. This is stage one of an allergic reaction.
Then, after a while, stage two, the adaptation stage will be reached and the body gets “used to it”. Some organ is taking on the stress. Then stage three, exhaustion of resources is reached and illness or disease occurs.

Usually the body’s first line of defense, the mucus membranes, tonsils, adenoids (these were routinely removed when I was a kid, I hope the Medical fraternity has become wiser now) and the rest of the lymphatic system will become affected and more serious problems will manifest as the immune system is now totally exhausted.

Ingredients labels need to be studied to avoid the pathogen. It might be wise to remember that labels are glued on jars with casein, the cow’smilk protein. It can do the same with your lungs, arteries, liver and heart.

Good day, my daughter is 3 months old and I breastfed and bottle fed for the first 2 months she was on S26 but she makes a wheeze sound when she breaths and blocked nose. Now she is on goat milk but still the same and she is constipated now! !! Please help I don’t know what else to do.