Shellfish Allergy Diet for Children

General guidelines for shellfish allergy

When your child has a food allergy, he or she must follow an allergy-free diet. This means your child can't have the food they are allergic to, or any products containing that food. The items that your child is allergic to are called allergens.

A shellfish allergy is the immune system's abnormal response to the proteins found in shellfish. People allergic to one type of shellfish are often allergic to other types. To stay away from foods that contain shellfish proteins, it's important to read food labels.

For foods regulated by the FDA, the federal Food Allergen Labeling and Consumer Protection Act (FALCPA) requires packaged foods to state clearly on the label if a product has shellfish. Some companies may also include statements such as "may contain shellfish" or "may be made in a facility that processes shellfish." But these kinds of advisory statements are voluntary. Companies are not required to put this on the food label.

Some foods and products are not covered by FALCPA. These include:

• Foods that are not regulated by the FDA

• Cosmetics and personal care items

• Prescription and over-the-counter medicines and supplements

• Toys, crafts, pet foods

The lists below shows foods and products that could contain shellfish. It is not a complete list. But it can help guide your decisions. It is up to you to carefully read all food labels.

How to read a label for a shellfish-free diet

Stay away from foods with any of these ingredients:

• Abalone

• Barnacle

• Clams (cherrystone, littleneck, geoduck, pismo, quahog)

• Cockle, periwinkle, sea urchin

• Crab

• Crawfish, crawdad, crayfish, ecrevisse, krill

• Cuttlefish

• Limpet (lapas, opihi)

• Lobster, langouste, langoustine, Moreton bay bugs, scampi, coral, tomalley

• Mollusks

• Mussels

• Octopus, squid (calamari) 

• Oyster

• Periwinkle

• Prawns

• Scallops

• Sea cucumber (often used in Asian soups) 

• Sea urchin

• Shrimp, prawns, crevette, scampi

• Snail (escargot)

• Squid (calamari)

• Whelk (turban shell) 

The following foods may mean that shellfish protein is present:

• Bouillabaisse

• Cuttlefish ink

• Fish stock

• Glucosamine

• Seafood flavoring (crab, clam extract)

• Surimi

When you are not at home

For your child's general safety:

• Always carry 2 epinephrine auto-injectors. Make sure you and those close to you and your child know how to use it.

• If you don't have epinephrine auto-injectors, talk with your healthcare provider to see if you should carry them.

• Have your child wear a medical alert bracelet or necklace with their allergy information.

When you are eating out:

• Any food that is made in a seafood restaurant could be cross-contaminated with fish or shellfish. This includes nonseafood items.

• Some people who are allergic to fish may react to cooking odors or from touching shellfish or fish.

• Be careful when eating in Asian restaurants. Fish sauce is often used as a flavor enhancer.

• Shellfish protein can be spread in the air, in the steam released during cooking. Don't eat at steam tables or buffets where seafood or shellfish is displayed and served. This can also help to avoid cross-contamination of foods with shared utensils.

• In a restaurant, food may be cross-contaminated with shellfish. Always read food labels and ask about ingredients at restaurants. Do this even if these are foods your child has eaten in the past.