Food Allergy & Anaphylaxis


Food Labels

When it comes to food allergies, strict avoidance of the food is the only way to prevent an allergic reaction. To ensure foods are safe for your needs, reading food labels is a requirement.

No Label, Do Not Eat!

It is important that children learn from an early age that they must read labels. This practice will help the child to become his or her own advocate and navigate through life safely. 

The Food Allergen Labeling and Consumer Protection Act of 2004 requires that foods containing major food allergens be listed in plain English in the ingredient list, in parentheses within the ingredient list, or after the word “contains.” It does not require companies to declare that something “may” or “might” contain, or is “processed in a shared facility” with, any of the major food allergens. 

We recommend visiting the FAACT food allergens section of this Web site to learn more about your particular allergy, hidden ingredients, alternatives, and label reading. 

Be aware of “may contain” items on a food label. Research has shown that these products very often contain low levels of the listed allergen. Likewise, be aware that some goods are labeled as “may contain” because a company cannot guarantee the total absence of an allergen, not due to some real concern that the allergen is present in small amounts.  Quantification of the exact amount of allergen in these foods is not commercially available. 

Studies are ongoing to determine just how “safe” very low levels of allergens are. Many items that are labeled “may contain” do contain parts per million of the allergen (e.g., drops of liquid in an Olympic-sized swimming pool) but other products may contain higher levels. Some individuals may tolerate these low levels better than others. There is ongoing research to better understand the risk that such tiny amounts may pose for people with food allergies, called an allergen threshold. In a few years, the policy of “strict avoidance” may change as medical professionals learn whether patients might be able to tolerate trace exposure and threshold levels are better defined. For now, strict avoidance is the most conservative approach. 

Best Practices 

  • Familiarize yourself on current federal laws and resources that assist food-allergic individuals with product labeling: 

* Food Allergen Labeling and Consumer Protection Act of 2004
* Q & A – Food Allergen Labeling and Consumer Protection Act of 2004
* Food Allergens - FAACT
* Slideshow with Audio: How to Read an Ingredient Label (AllergyHome)
* Food Allergens – “How to Read a Label” (Kids with Food Allergies) 

  • If a product does not have a label, it should not be eaten.
  • Read labels each and every time before eating any food product.  Ingredients can change over time, or may vary depending upon the size of the product (e.g. jumbo vs snack size). 
  • Statements advising that products may/might contain or are made in shared facilities with a food allergen are purely voluntary. Most companies do try to be helpful and highlight where there may be a possible risk. However, a product should not be considered “safe” just because it does not list these “maybe’s.” 
  • Call the company to inquire about how their products are processed, their cleaning methods, and how items are packaged. 
  • Seeking out products produced in a “dedicated” facility can add an additional level of security to ensure that food is safe. 
  • Do a search on “allergy friendly” products to generate a list of allergy friendly food companies. 
  • Carefully check items that are labeled “nut.” The U.S. Food and Drug Administration (FDA) classifies several items as “tree nuts” that are fruits, not tree nuts. These include coconut, lichee nut, shea nut, and Ginko nut. If you have tree nut allergies, talk with your board-certified allergist about whether to avoid these foods. 
  • Only crustacean shellfish (e.g. crabs, shrimp, lobster, or crayfish) and not mollusks (eg. clams, mussels, scallops, or squid) are required to be labeled on packaged goods. 
  • The labeling law applies only to foods regulated by the FDA.  Meat products, poultry products, and egg products that are regulated by USDA are not required to follow these labeling guidelines.  Contact the manufacturer if there are any questions about possible allergens. 
  • Kosher labeling such as parve (or pareve) do not guarantee they are free of allergen and should not be relied upon in choosing allergy-safe foods. 
  • Educate teachers, family members, your child, and yourself on the dangers of candies and foods manufactured during the holidays. Often times, candies are manufactured on shared lines that process allergens or may actually contain the allergen itself. 
  • Pet foods often contain allergens, such as nuts, seeds, seafood, soy, etc. Use caution when feeding pets, and keep pet food out of reach of children with allergies. 
  • Shampoos, soaps, medications, and other personal care products can contain allergens or items derived from allergens. Use caution when purchasing these products and always check the ingredients prior to use. Many of these products do not pose harm to food-allergic individuals. If this situation arises, discuss this with your physician to see if it is safe to use these products.  
  • For products labeled non-dairy, check the ingredients list to ensure a derivative, or another form of dairy, is not present. 
  • Allow children to participate in label reading at the grocery store. This will help build their confidence and help them make informed decisions, as they get older. 

Data has indicated that many allergic individuals have unknowingly tolerated very small amounts of allergens that were not labeled (e.g., products that get labeled “may contain” after some time on the market).  If this happens, discuss this with your physician if it may be safe to continue to include the food in the diet.