Allergy pass for children: diagnosis and treatment of food allergies

Allergy-Pass for children in Germany: a vital safety tool

In Germany, an Allergy-Pass (allergy passport/card) is considered a very important medical document – especially for children who suffer from food allergies or environmental allergies.

It enables parents, doctors, childcare staff, teachers and schools to react quickly in emergencies and to consistently avoid known allergens in everyday situations.

What is an Allergy-Pass?

An Allergy-Pass is a standardised booklet or card issued by an allergy clinic or paediatric practice. It typically contains:

a list of the child’s confirmed allergens
(e.g. milk, egg, nuts, peanuts, fish, soy, pollen, house dust mites, etc.)
the severity of the allergy
(mild – moderate – severe / with risk of anaphylaxis)
key results of allergy tests
(e.g. blood tests for specific IgE antibodies, skin tests)
clear emergency instructions explaining what to do in case of a reaction
a list of emergency medication that should always be carried
(e.g. EpiPen or other adrenaline auto-injectors, antihistamines, possibly corticosteroids)

Food allergy in children – how is it diagnosed?

The diagnosis of food allergy usually takes place in several steps:

Visit to the paediatrician (Kinderarzt)
- Discussion of symptoms and medical history.
- Assessment of typical reactions (rash, vomiting, breathing difficulties, swelling, etc.).
Blood test (IgE antibodies)
- The laboratory measures specific IgE antibodies to certain foods.
- This shows whether the immune system is sensitised to particular proteins.
Skin prick test (Pricktest)
- Small amounts of allergen extract are placed on the skin and the skin is gently pricked.
- Redness and wheal formation indicate a possible sensitisation.
Provocation test (oral food challenge / Provokationstest)
- Performed only under strict medical supervision in a clinic or specialist practice.
- The child is given small, gradually increasing amounts of the suspected food while being closely monitored.
- This test is considered the gold standard to confirm or rule out a food allergy.

Important: Home “experiments” with suspected allergens (e.g. deliberately giving peanut at home in high risk children) are strongly discouraged and may be life-threatening, especially if there is a risk of anaphylaxis.

Why is an Allergy-Pass so important for children?

A well-completed Allergy-Pass:

clearly shows what the child must avoid – very important in daycare, school and on trips
helps emergency services or doctors to understand the situation quickly and treat appropriately
supports childcare centres and schools in creating a safe nutrition plan
is useful in restaurants, at birthday parties and on holidays, helping to prevent mistakes
provides a sense of security for everyone involved – parents, caregivers and, most importantly, the child

What treatment options are available for food allergies?

Treatment depends on the type and severity of the allergy. In principle, it includes:

Strict avoidance of the allergen
- This is the cornerstone of management.
- Parents must read all ingredient lists and allergen labels very carefully.
Adrenaline auto-injector (e.g. EpiPen)
- Prescribed for children at risk of anaphylactic reactions.
- Can be life-saving in emergencies and must be kept with the child at all times.
Antihistamines
- Used for milder reactions, such as itching or hives.
Allergen immunotherapy (desensitisation / Hyposensibilisierung)
- Well established for some allergens, e.g. pollen, house dust mites, insect venom.
- For food allergies, options are more limited and only available in selected cases; they must always be discussed individually with a specialist.

How do you obtain an Allergy-Pass?

The typical process:

Consult a paediatrician or allergist (Allergologe)
- Describe your child’s symptoms and suspected triggers.
Undergo the necessary tests
- Blood tests (IgE), skin tests, possibly oral provocation/challenge tests.
Issue of the Allergy-Pass
- Once the diagnosis is confirmed, the doctor fills in the Allergy-Pass
  – either by hand or using a digital template.
- Frequently, standardised forms are used, for example based on templates from the
  DAAB (Deutscher Allergie- und Asthmabund) or other professional organisations.

Practical tips for parents

It is advisable to keep several copies or versions of the Allergy-Pass:

in the child’s school bag or daycare backpack
in the kindergarten/daycare or school office (emergency folder)
at the grandparents’ home or with the childminder/babysitter
possibly in the parents’ car

Additional suggestions:

Teach older children to understand
- what their allergy means,
- which foods are strictly off-limits,
- and how to use their EpiPen in an emergency (according to age and medical guidance).
Record the allergy in
- health apps,
- emergency cards,
- or medical ID bracelets/necklaces.

Summary – common questions about the Allergy-Pass

Question: Is an Allergy-Pass compulsory?
Answer: No, it is not legally mandatory, but it is highly recommended once an allergy has been confirmed.

Question: Who issues the Allergy-Pass?
Answer: Usually the allergist or paediatrician who has diagnosed the allergy.

Question: Is it free of charge?
Answer: If there is a confirmed diagnosis, the necessary tests and the issuing of the Allergy-Pass are generally covered by statutory health insurance (GKV).

Question: Is it only for food allergies?
Answer: No. It can also document pollen allergies, insect venom allergies, drug allergies and other types of allergy.

The editorial team of this website aims to provide accurate information based on thorough research and multiple sources. However, errors may occur or some details may not yet be fully confirmed. Therefore, please use the information in these articles as an initial guide only and always consult paediatricians, allergists or other competent medical professionals and authorities for binding, up-to-date advice.