Focus on Children’s Food Allergies

FOOD ALLERGIES
Food allergies can start even as early as in infancy and are caused by an immune system malfunction. Unlike a food allergy, an intolerance to a particular food does not involve the immune system. However, the majority of people react to foods due to their body simply having an intolerance for that food item and can include unpleasant symptoms like diarrhea, bloating and gas.

For example, a person with lactose intolerance may be able to drink milk in coffee or a single glass of milk, but become sick if he or she drinks several glasses of milk.
Though allergies can be hereditary, they are not a certainty. An allergic reaction can range from a simple runny nose or a bout of sneezing, itching, swelling and asthma to serious illness or in extreme rare cases an anaphylactic shock and death.

What are the different types of food allergies?
Most common food allergies are:
Milk, egg, soy, wheat, peanut, tree nut, fish, shellfish.
If your child has a food allergy, the best treatment to follow is by avoiding the food in question. This isn't always as simple as it sounds. If your child is allergic to eggs, for instance, you have to avoid everything containing eggs. This includes carefully checking the labels of all commercially packaged foods, and speaking to your doctor about vaccines made with egg residues, such as some childhood vaccinations and the flu shot.
Symptoms:
Food Allergy Symptoms
Food Intolerance Symptoms
Red rashes
Nausea, vomiting
Blisters
Gas, bloating
Stomach cramps
Diarrhea
Nausea
Headaches
Vomiting Fussy
Difficulty breathing  
Lowered BP  
Severe cases- anaphylactic shock  

MILK ALLERGY (Severe) - LACTOSE INTOLERANCE (Milder)
A Milk Allergy is due to an immune disorder. and is much more severe than milk intolerance. It is often passed down from a family with a history of allergies. Milk allergy can be found in both formula fed and breast fed infants. The good news is that most infants outgrow a milk allergy by age 5.
Latest studies from Journal of Allergy and Clinical Immunology “Seventy-five percent of children with cow's milk allergy will be able to tolerate it if it is heated extensively.” Talk to your pediatritian about this new study.

Milk/ Lactose intolerance is an inability to digest the main sugar found in dairy products (lactose) due to the lack of a specific digestive enzyme (lactase)

Milk (Lactose) intolerance on the other hand can be managed adequately with adjustments in the child’s diet and supplements to ensure nutrient deficiencies do not occur.
TIPS for kids with
milk allergy
  		• Always know what
    your child is eating
    and drinking.
  		• Always check the
    label ingredients
    before you use a
    product. Sometimes
    manufactured foods
    recipes can change
    to include a milk
    product.
  		• Teach your child
    not to accept food /
    drinks from
    classmates or
    friends.
    Milk Allergy / Milk Intolerance / Lactose Intolerance
    Milk in all forms- condensed, evaporated
    Cheese
    Butter, Ice cream
    Cream, Half and half
    Buttermilk
    Cottage cheese,
    paneer
    Soy cheeses
    Ghee
    Sour cream, yogurt Custard pudding
    Some mithais Creamy desserts

    CAN IT AFFECT GROWTH? Yes, due to inadequate intake of calcium and other nutrients that milk provides.
    Deficiencies associated with consuming less milk:
  		•  Calcium
  		• Vitamin D
  		• Riboflavin
  		• Protein
    Steps to alleviate symptoms, and prevent vitamin & mineral deficiencies:
  		• Infants younger than 2 years - soy formulas are good substitutes.
  		• Toddlers - soy or rice milk
  		• Older children - lactase-treated cow's milk.

    Goat's milk is low in lactose, but should only be used in children if it is properly supplemented with essential amino acids and vitamins.

    All foods which are labeled with the symbols “D” or “DE” should be avoided. The symbol “D” indicates that the product contains milk protein and symbol “DE” indicates that the product was produced on equipment that is shared with dairy products.
    EGG ALLERGY
    It occurs in Infancy but children outgrow it by the time they are 5-6 yrs of age. The most common is to egg whites.

    Typical symptoms include itchiness, rash, hives, stomach cramps, nausea and respiratory problems. it is not always easy to avoid these foods since many unsuspecting products contain eggs.
    The most effective remedy is to take eggs and egg products out of your child's diet and after a while slowly reintroduce parts of it in very small amounts so as to desensitize your child or check if they may have outgrown the allergy.

    Sticking to an egg–free diet can be rather difficult as a large number of foods use eggs or parts of it as an ingredient like baked goods, pastas, sauces, salad dressings, drinks and desserts.

    Egg products to avoid:
    Egg whites,
    Egg yolks
    Egg substitutes
    Dried egg powder

    Egg-Containing Ingredients (Talk to your pediatritian about these ingredients)
    Globulin
    Albumin

    FOODS TO AVOID
    Creamy pastries
    		 Breaded foods
    Cake
    Custard
    		 Creamed foods
    Cookies (specially chocolate chip)
    Creamed pies
    		 Crepes
    Doughnuts
    Egg rolls
    		 Egg noodles
    Cake frosting
    Ice cream Mayonnaise Marshmallows
    Muffins Meringue pies Batter for meat and fish
    Pretzels Puddings Pancakes
    Tartar sauce Waffles Ovaltine
    Sherbet Crackers Cream sauces
    Jelly beans Root beer Souffles
    NUT ALLERGIES

    Allergic reaction to nuts are progressive in nature and can rapidly escalate to anaphylaxis. Peanut allergy being the worst is responsible for the most food allergy related deaths.

    A lot of children are found to be allergic to the proteins found in these nuts. This group can also include peas, beans and lentils, as they also share a common protein.

    The symptoms are similar to the milk allergy and can range from mild, to severe or even deadly.
    FOODS TO AVOID
    Cereal & granola mixes
    		 Chinese, Thai, ethnic cuisines
    Ice creams
    Chex mix, flavored nut mixes
    		 Candy, nougat
    Multi-grain breads
    Packaged bars, energy bars
    		 Cookies, cakes, pastries
    Salad dressings
    Ground nuts, nut mixes
    		 Health dried fruit mixes
    Marzipan
    Artificial nuts Chocolates Egg rolls/ spring rolls
    Hydrolyzed plant protein Hydrolyzed vegetable protein Fiberts (Tree nut)
    Caution:
    Maximum precautions must be taken to avoid contact with any of these foods or food products containing these nuts.

    Sometimes even containers that have been used to cook these foods in. Some kids may also be allergic to fumes that are given out during the cooking process. Parents of kids with these severe forms of the nut allergy are advised to carry an epinephrine injection with them at ALL times.

    SEAFOOD ALLERGIES

    If you suffer from a fish allergy, avoiding the fish and food containing fish products is the best way to prevent a reaction. If however, your doctor is able to identify and confirm exactly which type of fish causes your child's allergies, than you only need to eliminate that type of fish from your child’s diet.

    For the majority of fish allergy sufferers all fish must be avoided.
    Seafood allergies must be monitored by your child's pediatritian and allergist. Coming in contact with dishes cooked could also be a problem. In extreme cases, this can also include avoiding inhaling fumes produced during cooking these seafoods.
    FOODS TO AVOID
    Shrimp and prawns
    		 Chinese, Thai, ethnic
    cuisines
    Clams, crabs, cockle,
    conch
    Pomfret, sole,
    		 Tuna, canned and fresh
    Lobster, oysters, mussels
    Calamari, snails, caviar
    		 Natural & artificial flavorings,
    Imitation shellfish
    Avoid all fried foods in restaurants
    		 Worcestershire sauce
    Bouillabaisse
    Caesar salads, Stuffings Egg rolls Fish oil supplements
    Foods containing gelatin Foods containing anchovies Tempura
    GLUTEN INTOLERANCE is also known as Celiac’s Disease With this disorder children become sensitive to “gluten,” which is a protein found in some varieties of grains such as wheat, barley, oats and rye. Gluten protein sensitivity can lead to a variety of digestive problems such as vomiting, diarrhea, or abdominal cramps. As it is a form of malabsorbtion, it may cause symptoms of malnutrition (fatigue, weight loss, loss of feeling in toes, sores in the mouth, or cause bones to break easily) as the child's body is not absorbing the nutrients it needs. Sometimes this condition can also trigger a red rash called dermatitis herpetiformis or blisters.
    Some children with a milder form of this disorder are sometimes able to tolerate a small quantity of oats in the diet, but you should discuss this with your pediatritian. Gluten sensitivity is a lifelong condition so children must be taught awareness and how to protect themselves from inadvertently consuming foods with gluten. In situations where they have consumed the gluten product, children must be taught to cope with the ensuing symptoms.

    Bottom line, children with gluten sensitivity must avoid the following foods:
    FOODS TO AVOID
    Wheat, barley, oats, rye
    		 Wheat germ, wheat starch
    Bran
    Certain medications (ask pharmacist,
    pediatritian)
    		 Modified food starch
    Hot dogs, sausages
    Most breakfast cereals
    		 Spelt
    Farina
    Semolina grain
    		 Tomato sauces
    Non dairy creamers
    Some yogurts & ice creams Hot cocoa mixes Graham flour
    Canned soups, soup mixes, bouillion Peanut butter, cheese spreads Salad dressings
    All pastas, noodles made from wheat Fried chicken, batter fried foods  
    Foods containing bread crumbs, Pancakes, fritters  

    SO WHAT MUST A PARENT DO ABOUT THESE ALLERGIES
    NutritionVista recommends you first talk to your doctor or one of our registered dietitians before eliminating any food from your child’s diet or beginning a special diet. You may need to adjust your infant, child or teen’s meal plan or take a nutritional supplement to replace any nutrients lost by eliminating the triggering foods.

    Additionally, the lists of foods and products that we have charted here are intended to provide examples and are NOT complete. Please do seek the advice of your pediatritian to learn more about your child’s particular allergy or intolerance.

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