Ask the Expert – Food Allergy and Multivitamins

Ask The Expert is a weekly column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.

If you have a child with food allergies, naturally you worry if he is getting proper nutrition from his somewhat restricted diet. Perhaps you have considered giving a multivitamin but found yourself worrying about safety of those vitamins. This week, Registered Dietitian Brooke Schantz offers a few tips on what to look for when selecting a multivitamin for your child with food allergies.

Brooke Schantz, MS RD LDN
  • B.S. in Dietetics with Honors from Purdue University
  • M.S in nutritional sciences from University of Illinois at Urbana-Champaign.
  • Experience: Outpatient Clinical Dietitian II at Loyola University Medical Center, Private Practice, The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), North Shore Pediatric Therapy, and Camp Calcium at Purdue University
  • Expertise: Pediatric Nutrition, Adult Weight Management, Cardiovascular Health, Prenatal and Postpartum Nutrition, Type 1, 2, and Gestational Diabetes, and Allergies and Intolerances
  • Website: Bitchin’ Nutrition
  • Twitter: @BitchnNutrition
  • LinkedIn: Brooke Schantz MS RD LDN
  • Contact: via Website or Twitter

Question: What kind of multivitamins are safe for my child with food allergies? What should I be concerned about?

Answer:

First, let me review the difference between a food allergy and food intolerance.  A food intolerance is an abnormal physiological response to food. Symptoms can affect the skin, respiratory tract, gastrointestinal tract (GIT) either individually or in combination. Some examples of symptoms of a food intolerance are gas, bloating, diarrhea, etc.  It can be difficult to determine the food that causes an intolerance because if the immune system is involved, the response takes place slowly. A food allergy is an immunological hypersensitivity which occurs most commonly in response to food proteins that are mistaken as harmful and therefore a defense system is created to fight them off. These allergic reactions have an acute onset (from seconds to one hour) and may include:  soft tissue, severe swelling of the tongue, hives, itching, nausea, vomiting, diarrhea, stomach cramps, nasal congestion, wheezing, shortness of breath, or anaphylactic shock.

Children with various food allergies would not be allergic to vitamins or minerals in supplements themselves; but rather to a possible ingredient used in the making of the multivitamins.  The Food Allergen Labeling Consumer Protection Act (FALCPA) was passed by the Food and Drug Administration (FDA) in 2006 to require manufacturers to identify the use of the top eight allergens.  These allergens are eggs, dairy, soy, tree nuts, peanuts, fish, shellfish, and wheat.  Unfortunately, vitamins fall under the category of “dietary supplements” which are not included in this law.  A dietary supplement is defined as products taken by mouth that contain a “dietary ingredient” intended to supplement the diet.  This is important to note, because vitamins are not meant to be a substitution for a healthy diet or justify consuming a poor diet.

The FDA does not approve dietary supplements prior to being put on the market.  Therefore, if your child is allergic to a specific allergen it is important to familiarize yourself with all the derivative names for that allergen.  For example, if your child has a milk allergy, you would also want to look for words on the ingredient label that include but are not limited to: calcium caseinate, casein, caseinate, rennet, curds, hydrolyzed casein, hydrolyzed milk protein, lactalbumin, lactalbumin phosphate, lactate, lactose, lactoferrin, and lactoglobulin.

What you can do:

  1. Check the ingredients label for the specific food allergen and its derivative names.  Some vitamin labels even include information on common allergens, even though the manufacturers are not required to list this information. Below is an example children’s vitamin ingredients list.
    Ingredients: Sucrose, Sodium Ascorbate, Stearic Acid, Maltodextrin, invert sugar, Vitamin E Acetate, Corn Starch, Gelatin, Niacinamide, Magnesium Sterate, Natural Flavors, Yellow #6, Riboflavon, Thiamine, Folic Acid, Vitamin D3, Vitamin B12
    Contains: Soy
  2. Look for the USP seal.  The U.S, Pharmacopocia (USP) is a non-profit organization that has established standards of quality for prescritpion and nonprescription drugs.  Using vitamins and other supplements with the USP seal indicates some quality of control.  Vitamins that have the USP seal can be found here.
  3. Follow the dosage directions correctly!  Your child doesn’t need more than the recommended daily dose.  Some parents believe that if their child has eaten really poorly for one day giving an extra vitamin is better and this is not the case.   An overdose of certain vitamins could be dangerous and also lead to the preventing other vitamins from being properly absorbed.
  4. Discuss the use of all supplements with your doctor and registered dietitian.

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Disclaimer – Information provided in Ask The Expert column on Littlestomaks.com is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by Littlestomaks.com.