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Multiple Food Allergies: 7 Real Nutrition Risks for Kids

According to the Food Allergy Research and Education (FARE), about 1 in every 13 kids under the age of 18 has a food allergy. Did you know that about 30% of children who have food allergy have what is called multiple food allergies?

In other words, 1 out of every 3 kids with food allergies is allergic to more than one food.

1 out of every 3 kids with food allergies is allergic to more than one food. Click To Tweet

My son is a good example of this. Initially diagnosed with a tree nut allergy (which for him includes cashew and almond), he later showed sensitivity to pumpkin.

multiple food allergies

It’s not uncommon to see children with an allergy to milk, egg, and peanut, or another combination of food allergens.  Some food allergens seem to go hand in hand, such as milk and soy allergy, and peanut and tree nut allergy.

Certain foods can “cross-react” due to the similarity of their protein structures, making the likelihood of having additional food allergies possible.

For example, in my son’s case, he’s allergic to almond, which can cross-react with hazelnut. He’s also allergic to cashew, which can cross-react with pistachios. We steer clear of all four of these for this reason.

Living with more than one food allergy presents a unique set of challenges, from possible growth problems to potential nutrient deficiencies.

If your child has more than one food allergy, you’ll want to take note of the real risks associated with multiple food allergies.

7 Real Nutrition Risks for Kids with Multiple Food Allergies

1. Restricted Diet

A food allergy requires complete elimination of the offending allergen from the diet. So, if your child is allergic to milk, all milk and milk products must be removed. The same goes for the other food allergens, and even the not-so-common ones. Whatever the food allergen is, all foods and products made from it or with it must be avoided.

Avoiding a food allergen, such as milk or egg, may significantly limit the variety of food that your child eats. Low food variety always increases the risk for nutrient deficiencies and poor growth.

2. Limited Nutrients

As mentioned above, avoiding certain foods and food groups may place some nutrients at risk. Here are some of the most common nutrients at risk, based on food allergy:

  • If your child is milk allergic, then calcium and vitamin D may be at risk unless you find alternate food sources, either natural or fortified, of calcium and vitamin D to include in the diet. [Read: The Calcium Handbook]
  • If wheat is out of the diet, you’ll need to ensure other sources of B vitamins and folate are included in the diet.

The bottom line is this: you need to know the ‘at risk’ nutrients associated with your child’s food allergy and find other foods that can fill those gaps.  


3. Poor Eating

Multiple food allergies may contribute to poor eating. I’ve seen many kids with multiple food allergies who are simply bored with their diet.

Add on a fear of an allergic reaction, and the normal stages of childhood eating, such as picky eating, and you’ll see they can negatively affect food variety, appetite and a willingness to try new food.

4. Inadequate Calories

Poor eating may mean your child isn’t getting enough calories and nutrients. This can lead to poor weight gain and growth. One way to avoid this is to make sure you offer a wide variety of foods. Also, keep a routine to meals and snacks so that opportunities to eat are available.

Generally, the biggest risk to health is that poor eating may lead to inadequate calories. Inadequate calories can lead to weight loss, lack of weight gain and/or stagnated growth in your child.

5. Food Boredom

Another risk associated with multiple food allergies is eating the same “safe” foods day in and day out.

While safe foods are essential for managing food allergies, truth be told, this may get boring for your child!

Food boredom can cause poor eating, inadequate nutrient intake, poor nutritional status, and weight disturbances.

6. Poor Growth

Multiple food allergies are a known risk factor in the development of nutrient deficiencies and inadequate growth in children. Especially, food allergies such as milk, wheat, egg and soy appear to be the most troublesome for children.

A study in the UK looked at children with food allergies and evaluated their weight status. The authors found that children with food allergies tended to be more underweight than the general, similar-aged population without food allergies. Those children with more than three food allergies were more likely to be underweight, presumably due to dietary restrictions and inadequate intake.

[Read: Feeding the Thin Child]

Another study reviewed six research articles looking at the impact of food allergies on weight and growth. The authors concluded that children with food allergies have a higher risk of growth failure and may have a higher risk of inadequate nutrient intake than children without food allergies.

For this reason, see your pediatrician regularly to evaluate growth and development, and make those routine appointments with your food allergy care team, including a registered dietitian to help with food balance and variety.

Make sure your child attends his regular food allergy appointments w/ his health care team. Click To Tweet

7. More Medical Problems

In addition to the above potential consequences associated with multiple food allergies, long-term medical conditions can develop when the diet is poorly managed.

For example, not finding a replacement for the bone nutrients calcium and vitamin D when a milk or soy allergy exists can lead to poor bone health and a vitamin D deficiency. Make sure to find other sources of calcium when a milk allergy exists, and paying particular attention to vitamin D foods while getting reasonable sun exposure.

What You Can Do

The good news is that these potential negative outcomes related to multiple food allergies can be prevented. With a variety of foods, adequate nutrients, and sufficient monitoring by your health care team, multiple food allergies can be managed healthfully.

I dive into this subject on my podcast with Marion Groesch — tune in to hear her sage advice and deep experience with kids who have food allergies.

Multiple Food Allergies: 7 Real Nutrition Risks for Kids Click To Tweet


Meyer R et al. Malnutrition in children with food allergies in the UK. J Human Nutr Diet. 2014; 27: 227-235.

Sova C. et al. Systematic review of nutrient intake and growth in children with multiple IgE-mediated food allergies. Nutr Clin Pract. 2013; 28: 669-675.

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