General guidelines for shellfish allergy

When your child has a food allergy, they must strictly stay away from the food that they are allergic to. They can't eat that food. And they can't eat 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. Shellfish allergies are among the most common allergies in children. People allergic to one type of shellfish are often allergic to other types. This is often a lifelong condition. So it's important to know how to manage it. 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 aren't required to put this on the food label.

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

• Foods that aren't regulated by the FDA.

• Cosmetics and personal care items.

• Prescription and over-the-counter medicines, vitamins, and herbal supplements.

• Toys and crafts.

• Pet foods.

The list below shows foods and products that could contain shellfish. It's not a complete list. But it can help guide your decisions. Be sure 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, écrevisse, 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 or fish sauce

• Glucosamine

• Seafood flavoring (crab, clam extract)

• Surimi

When you're not at home

For your child's general safety:

• Always carry 2 doses of epinephrine. Make sure that you and those close to your child know how to use them.

• If you don't have epinephrine, talk with your child's health care provider. Find out if you should carry it.

• Have your child wear a medical alert bracelet or necklace. This will have their allergy information on it.

• Be sure that your child's teacher, school nurse, and other caregivers are educated about your child's allergy. This includes knowing what to do in an emergency and having immediate access to epinephrine.

When you are eating out:

• Tell your server about your child's allergy.

• 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 they may react to 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, from 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 prevent 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.

• Be careful about fried foods in restaurants that serve shellfish. Shrimp or other shellfish may be fried in the same oil as french fries or chicken fingers.