Pediatric OAS: Diagnosis, Treatment, and Prevention Tips

Wyndly Care Team
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Can kids get oral allergy syndrome?

Yes, kids can get oral allergy syndrome (OAS). OAS is a type of food allergy caused by cross-reacting allergens found in both pollens and raw fruits, vegetables, or nuts. Symptoms include itchy mouth, scratchy throat, or swelling of the lips, mouth, tongue, and throat.

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What Is Pediatric Oral Allergy Syndrome (OAS)?

OAS, also known as pollen-food syndrome, is a type of allergic reaction that affects the mouth and throat after consuming certain raw fruits, vegetables, or nuts. OAS usually occurs in children who also have a pollen allergy, due to the similarities in proteins found in pollen and certain foods.

Despite its common occurrence, OAS is often underdiagnosed as its symptoms are usually mild and short-lived. However, it's essential to recognize and manage OAS effectively as it can significantly impact a child's nutritional intake and quality of life.

It's important to note that OAS is usually not dangerous, but it can be an uncomfortable condition. While many children might outgrow it, others might develop more severe food allergies over time. Therefore, understanding OAS and knowing how to manage it is crucial for parents whose children have been diagnosed with this syndrome.

What Causes Oral Allergy Syndrome in Kids?

Oral Allergy Syndrome in kids is typically caused by cross-reactivity between certain proteins in fresh fruits, vegetables, or nuts and those found in pollen. When a child with a pollen allergy consumes a food with similar proteins, their immune system can mistake the food proteins for pollen, leading to an allergic reaction.

Children with pollen allergies, particularly to birch, grass, and ragweed pollen, are more likely to develop OAS. The syndrome can occur at any age but is more commonly observed in older children and teenagers. This is likely because OAS usually develops after a child has been sensitized to pollen, which often takes several years of pollen exposure.

While it's not fully understood why some children with pollen allergies develop OAS while others do not, it's believed that the cooking process can degrade the allergenic proteins in food, reducing their similarity to pollen proteins. This is why children with OAS can usually tolerate cooked versions of the foods that trigger their symptoms. However, the raw forms of these foods can cause an immediate allergic reaction, which is typically localized to the mouth and throat. Understanding these allergy symptoms in kids can help parents identify potential triggers and manage their child's OAS effectively.

What Are the Signs and Symptoms of OAS in Kids?

OAS in kids usually occur immediately after eating raw fruits, vegetables, or nuts. They are typically localized and mild, affecting the mouth and throat. However, severe reactions can occur, especially during peak allergy seasons.

Children with OAS often experience itching, tingling, or swelling in the mouth, lips, tongue, throat, and ears shortly after eating raw fruits or vegetables. These symptoms usually last only a few minutes or up to an hour. However, in some cases, they can last longer, making the child uncomfortable. The specific foods that trigger symptoms can vary from child to child, but some common triggers are apples, peaches, plums, cherries, carrots, celery, and peanuts.

In rare cases, OAS can cause more severe systemic reactions, such as hives, vomiting, difficulty breathing, or anaphylaxis. These symptoms are more likely to occur if the child chews the food thoroughly or swallows it whole. If your child experiences any severe symptoms, seek immediate medical attention. Remember, understanding these signs and symptoms is crucial to managing your child's OAS effectively and ensuring their safety.

How Do Doctors Diagnose Oral Allergy Syndrome in Kids?

OAS in kids is primarily based on the child's clinical history and physical examination. Your doctor will consider your child’s reported symptoms, timing of their onset, and any relation to eating specific foods.

To confirm the diagnosis, an allergist may perform a skin prick test using the fresh foods suspected of causing the reaction. In this test, a small amount of the food is pricked onto the child's skin using a tiny needle. If the child is allergic, a raised bump or hive will appear at the test location within 15 to 20 minutes.

Sometimes, a blood test may also be recommended to measure the level of specific IgE antibodies, which are proteins the immune system makes in response to allergens. This can help confirm the diagnosis and identify potential cross-reactive foods. However, the results should always be interpreted in the context of the child's symptoms and clinical history.

Lastly, an oral food challenge, where the child is fed small increasing amounts of the suspected food under medical supervision, might be performed to confirm the diagnosis. However, this test is usually reserved for cases where the diagnosis is uncertain, as it carries a risk of causing a severe allergic reaction.

Remember, early diagnosis is crucial to effectively manage your child’s OAS and prevent severe reactions. Therefore, if you suspect your child has OAS, seek advice from a healthcare professional or an allergy specialist as soon as possible.

What Are the Treatments for Pediatric OAS?

OAS typically involves managing symptoms and avoiding triggering foods. However, in some cases, allergen immunotherapy may be an effective treatment option.

Management and Treatment

Management and treatment of OAS in kids generally involve the avoidance of raw foods that cause symptoms. It's important to note that the proteins causing OAS are heat-sensitive, meaning cooked or processed versions of the food might not trigger symptoms. Antihistamine medications can also be used to help manage symptoms if accidental exposure occurs. For severe reactions, an epinephrine autoinjector may be prescribed. Parents should be aware of the best allergy medicines for kids and understand the appropriate dosages and side effects.

Sublingual Immunotherapy

Sublingual immunotherapy is a form of treatment where small doses of an allergen are placed under the tongue to boost tolerance. The aim is to decrease sensitivity to allergens over time, thus reducing the severity of allergic reactions. This treatment modality, however, is usually reserved for severe or persistent cases of OAS and should only be initiated under the guidance of a healthcare provider. It's important for parents to understand the benefits, risks, and alternatives of allergy immunotherapy for kids and whether their child is a suitable candidate for this treatment. Check out this relevant article for more insights.

Remember, treatments should always be tailored to the individual child's symptoms, severity, and triggers of their OAS. Regular follow-ups with your healthcare provider are essential to monitor your child's progress and adjust the treatment plan as necessary.

How Can One Prevent Oral Allergy Syndrome in Kids?

OAS in children can be challenging, as it involves avoiding foods that trigger symptoms. However, with careful management, education, and in some cases, allergy immunotherapy, it is possible to reduce the occurrence and severity of OAS symptoms.

Firstly, education is key. Teach your child about their allergy and the foods that trigger their OAS. Make them aware of the difference between raw and cooked or processed foods, as the former is more likely to cause symptoms. Encourage them to communicate openly about their food allergies, especially when they are not eating at home.

Secondly, consider allergy immunotherapy if your child has a severe or persistent OAS. As discussed earlier, sublingual immunotherapy involves placing small doses of an allergen under the tongue to increase tolerance. This treatment method may help prevent the onset of OAS symptoms. However, it should be initiated under the guidance of a healthcare provider, and parents should understand the potential side effects and alternatives before pursuing this treatment route. Check out this helpful article for more insights.

Lastly, regular follow-ups with your healthcare provider can be beneficial in preventing OAS symptoms. Changes in your child's condition can be monitored closely, and treatment plans can be adjusted as necessary. For more tips on managing your child's allergies, refer to this guide. Remember, prevention methods should always be personalized based on your child's specific triggers and symptoms.


OAS involves managing symptoms, avoiding triggers, and consistently monitoring your child's condition. This can be achieved through a combination of dietary modifications, education, and regular follow-ups with a healthcare provider.

Start by ensuring that your child avoids food triggers. This can be challenging, especially when the triggers are common foods. However, it's important to note that many children with OAS can tolerate the cooked or processed form of the food that causes their symptoms. Experiment with different preparation methods and always have a prepared plan if an allergic reaction occurs.

Education is another crucial aspect. Encourage your child to communicate openly about their allergies, especially when eating outside the home. Teach them to read food labels and to always ask about the ingredients when someone else is preparing their food.

Lastly, schedule regular follow-ups with your child's healthcare provider. This allows you to monitor any changes in your child's condition and adjust their management plan accordingly. Remember, OAS symptoms typically go away quickly, but it's still essential to have an action plan in case of severe reactions. Living with Pediatric OAS is manageable with the right strategies and support.

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Frequently Asked Questions

Does OAS ever go away?

Oral Allergy Syndrome (OAS), can't be permanently cured, but its symptoms can be managed or potentially lessened. Regularly avoiding trigger foods might reduce reactions. Some people have also found that immunotherapy or allergy shots can help diminish OAS symptoms over time.

What foods trigger OAS?

Oral Allergy Syndrome (OAS) triggers vary based on the specific pollen allergy. Birch pollen allergies can trigger OAS with foods like apples, cherries, peaches, plums, and carrots. Ragweed pollen allergies can trigger reactions with bananas, cucumbers, melons, and zucchinis. Cooking these foods may reduce symptoms.

Do kids grow out of oral allergy syndrome?

Yes, many children do grow out of Oral Allergy Syndrome (OAS). However, it's not guaranteed. The body's response to allergens can change over time. While some children may see their symptoms lessen or disappear as they age, others may continue to experience OAS into adulthood.

What is the prevalence of oral allergy syndrome in children with allergic diseases?

Prevalence of oral allergy syndrome (OAS) in children with allergic diseases varies, but studies suggest it ranges from 5% to 10%. The syndrome is more common in older children and adolescents. The prevalence can increase in children with more severe allergic rhinitis or asthma.

What are the symptoms of OAS?

Oral Allergy Syndrome (OAS), also known as pollen-food syndrome, causes symptoms immediate upon eating certain raw fruits, vegetables, or nuts. Symptoms include mouth or throat itching, tingling or swelling, skin rashes, nasal congestion, and in rare cases, anaphylaxis, a severe allergic reaction.

What are common OAS triggers?

Oral Allergy Syndrome (OAS) triggers are typically fresh fruits, vegetables, and nuts that cross-react with specific pollens. Common OAS triggers include apples, cherries, peaches, plums, celery, carrots, almonds, and hazelnuts, which can cause allergic reactions in those sensitive to birch pollen.

How do you know if your baby has oral allergy syndrome?

Identifying Oral Allergy Syndrome (OAS) in babies can be challenging. Signs include itchiness, redness, or swelling around the mouth or throat shortly after eating certain raw fruits, vegetables, or nuts. If such symptoms appear, it's crucial to consult a pediatric allergist for evaluation and management.

How do you treat oral allergy syndrome OAS?

Oral Allergy Syndrome (OAS) is often managed by avoiding trigger foods, especially raw versions. Cooking or peeling the food can sometimes prevent symptoms. Antihistamines may provide relief, but severe cases may require immunotherapy. Always consult a medical professional for personalized treatment advice.

What medication is used for oral allergy syndrome?

Oral Allergy Syndrome (OAS) is usually treated with antihistamines to alleviate symptoms. If symptoms are severe, an epinephrine auto-injector may be prescribed. Avoidance of triggering foods is also advised. For long-term management, allergy immunotherapy may be recommended to reduce sensitivity to allergens.

What is the best medicine for mouth allergies?

The best medication for mouth allergies, commonly known as oral allergy syndrome, often includes antihistamines, like cetirizine, fexofenadine, or loratadine. In some cases, topical steroids may be prescribed. Always consult your healthcare provider for the most suitable treatment options for your unique case.

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