“…In addition to visible signs of a reaction (eg, hives, eczema, swelling of the lips or face), children in this age group may manifest an allergic reaction as an immediate aversion to the food-either by refusing to eat or by spitting food out-or may place their hands in their mouths or pull or scratch at their tongues [13]. Furthermore, many young children present with immediate vomiting or cough as a symptom of allergic food ingestion, which can be extremely difficult to clarify in a child care situation.…”