This is a guest post by Lauren Morgan to support the National Nutrition Month® along a theme of Nutrition From the Ground Up.

One of my favorite topics is food allergies because it is so personal to me.  My parents discovered I was allergic to peanuts when I found the peanut butter in the cupboard, and then they found a little girl who was swollen as could be.  Soon after, I found that I was allergic to tree nuts (all of them), green peas, salmon, and soy.  Even though my parents had to steer me away from all of these dangers, they were still able to feed me a wholesome, nutritious diet.  For those of you who have children, grandchildren, or loved ones with food allergies you know just how hard this can be!

Based on what I have learned from my own life living with food allergies and now that I am in the field of nutrition, I have developed some building blocks for developing healthy, nutritious lifestyles in children with food allergies:

• Eliminate the allergens.  This one seems like common sense, but it is very important.  Completely eliminate the food allergen(s) from your child’s diet, and if necessary, their home environment.
• Look for balance.  Check out the great resources at MyPyramid.gov (check out the section for preschoolers) to see what a balanced diet looks like and compare what your child can eat.  Try including foods from as many of the food groups as you can.  If your child has multiple allergies this may not be possible, so include as many foods as they can eat from each group.
• Keep it interesting.  Children like foods that look interesting to them, so try to have variety to keep your kid interested and feeling like they get to eat many foods.  One great way to do this is to add different colors.  Try doing red, yellow, and orange peppers sometime- the colors are so bright they just stick out to kids!
• Talk with your kids.  It is so important to talk with your children about their food allergies.  They should know what foods to avoid, why they should avoid them, and how to share this information with teachers, friends, and out at restaurants as they get older.
• Have fun!  Children can feel deprived when their diets are limited and they can’t eat the same foods as their friends.  Try cooking together with them to make some fun dishes.  For example, if your child cannot have pizza, make your own!  Try a fruit pizza and let them pick the fruits that they add.  There is so much room to be creative and kids will have fun with it, too!

Here are a few useful websites for more information on food allergy:

The Food Allergy and Anaphylaxis Network
FoodInsight.org Resources on Food Allergy
American Academy of Asthma Allergy & Immunology

What has worked for you? Share your tips in comments below.

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.

This week, Dr. Douglas Husbands provides an update on nutritional supplements with practical application for the health of your children.

Question: What is the latest development in nutritional supplements for children?

Answer:

Hello everyone!  I’m delighted for my second opportunity to guest post here.  Since I just recently came back from the 2009 International and American Associations of Clinical Nutritionists Scientific Symposium, I’d like to share some information on nutrition supplements with practical application for the health of your children.

Vitamin D3

• Adequate to optimal levels of serum vitamin D levels in infants and children (between 30 to 60 ng/ml) are associated with decreased asthma and allergies, better brain development and healthy bone development.
• When visiting your pediatrician or Functional Medicine doctor, serum 25-hydroxyvitamin D levels should be measured.
• It is estimated that between 50,000 to 70,000 deaths per year from various causes could be prevented by having adequate blood vitamin D levels.
• Many infants and children could benefit from supplementing with 1000 to 2000 IU of vitamin D daily, particularly during the winter months, if they cannot tolerate fatty fish, if they are darker skinned, or if their serum vitamin D levels are below 30 ng/ml.

Probiotics

• Probiotics help decrease abnormal intestinal permeability, or “leaky gut”.
• The appendix’s function is now known.  It is a repository for beneficial bacteria (probiotics) for the GI tract.  Supplemental probiotics help replenish the repository after antibiotic use or from use of corticosteroid creams or inhalers.
• Abnormal intestinal permeability allows gut-derived antigen exposure to the bloodstream; thereby distant, seemingly unassociated autoimmune symptoms can arise from a “leaky gut”.
• Due to immature GI tract development, it is best that infants are breastfed for at least his/her first 12 months.
• Many pregnant women and breastfeeding mothers would do well to supplement with the probiotic strain Lactobacillus GG (aka Lactobacillus rhamnosus) at a dose of 4 billion/day and Vitamin D3 at a dose of 4000 IU/day for potentially decreasing likelihood of asthma, eczema, allergies, type 1 diabetes, and autoimmune disorders in their babies.

Curcumin

• Curcumin, a component of turmeric, has powerful anti-inflammatory properties to inhibit inflammatory mediators, exhibiting therapeutic potential in asthma (and other inflammatory disorders)

©2009 Littlestomaks.com. All Rights Reserved
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.

I got interested in reviewing this book by Jan Gambino when I connected with her on LinkedIn and she mentioned that some of the picky eating habits of toddlers may be due to gastroesophageal reflux (GER) or gastroesophageal reflux disease (GERD). This peeked my interest because in most cases we assume that picky eating is a behavioral problem. In some cases, the underlying reason may be physiological leading to a behavioral issue. Parents of infants and toddlers with GERD are probably already sensitized to that, but for a lot of other parents this may not be so obvious.

GER is defined as the backwashing of food from the stomach into the esophagus (food pipe) and throat during or after a meal. GERD, on the other hand, is considered to be symptoms or complications of gastroesophageal reflux. Clinical signs of GERD in children include vomiting, poor weight gain, dysphagia (difficulty swallowing), abdominal pain, esophagitis and respiratory disorders.

Overview

Jan has written this book out of a personal struggle with her youngest daughter’s severe asthma and reflux problem, which took a lot of time to diagnose, treat and control. She even calls herself a Reflux Mom! The wisdom of her personal experience and what she learned working with other parents can be clearly seen in this book. What I really liked about this book was the Question-Answer format in a lot of sections which directly addressed common concerns. It is full of practical tips and relevant comments from parents, yet it manages to cover a lot of ground on advanced medical topics and medications for GERD. Amazingly, Jan has been able to pack a lot of details in just over 250 pages!

10 things I learned from this book I did not know before

One way for me to evaluate a book is to step back and think about new actionable knowledge I gain by reading it. Luckily we did not face any major problems with reflux when our twins were still infants. There were a couple of incidents of forceful vomiting when we were introducing solids, but then we backed off, took it slow and avoided problem foods. In that way, this book gave me a lot of new information which I did not know before from personal experience. Here are 10 nuggets I gleaned from my reading:

1. Reflux (GER) is common in infants and babies and usually disappears in early toddler years. But GERD is a chronic condition which needs treatment.
2. There are several million children with GERD in the US.
3. Reflux can cause ear infections in babies.
4. Reflux can be triggered by food allergy.
5. Reflux is very common in children with autism.
6. Reflux during infancy can lead to picky eating in toddlers.
7. There is something called a silent reflux when food and acid from the stomach enters the esophagus but doesn’t come out as vomit. It can cause a lot of pain, irritation or discomfort to the child.
8. Some babies and children with reflux can even get overweight.
9. Colic and reflux can occur together but they are not the same.
10. Breast milk minimizes reflux since it is easy to digest.

What I wish this book had more of

Although this book is very well organized and there is a lot of useful information, it could use a few pictures or visuals to make its contents more appealing and not so dry. It is more of a personal preference as I am a very visual person. I like to see charts, graphs and tables to quickly understand the data. I also like pictures or photos to make it even more personal.

Recommendation

Here are a few reasons you may want to consider getting this book:

1. You would like to know more about reflux so you can be prepared to handle your baby’s needs and are not surprised by normal episodes of reflux.
2. You feel exhausted by excessive fussiness at feeding times, sleep issues and slower than expected weight gain and suspect that you need to see a doctor about these problems.
3. Your child has been diagnosed with GERD and you feel completely at a loss about how to care for him.
4. You feel isolated, constantly challenged, emotionally drained and feel you are not able to cope with the needs of your child with GERD.
5. You would like to learn more about tests, medications, surgery options and resources about GERD.

Overall, I give it a big thumbs up!

Visit RefluxMom.com for more information on GER, GERD and how to purchase this book.

Having read about the Food Allergy Awareness Week while researching for last week’s Five for Fridays, I wanted to dig into this topic a little more. This is a problem that an increasing number of parents are worried about these days. If you are one of them, I would love to have you share your personal experience and tips in the comments below. Here is a summary of my research from several good sources on food allergies.

I am also glad to announce that this is my 100^th post!

First the numbers

The Centers for Disease Control and Prevention (CDC) published a report on Food Allergy Among US Children in October 2008. Here are few interesting, and in my opinion a little worrisome, statistics from this report -

1. Almost 4 in 100 children less than 18 years old were reported to have some form of food allergy in 2007. This corresponds to a total of 3 million children. The rate of food allergy in children less than 5 years old is nearly 5 in 100.
2. Compared to 10 years ago, this represents an increase of 18%.
3. Children reporting an allergic response to food were 2 to 4 times more likely to develop asthma or other allergies compared to children without food allergies.
4. Eight types of foods account for over 90% of food allergies - milk, eggs, peanuts, tree nuts, fish, shellfish, soy and wheat.
5. Hospitalizations with diagnosis of food allergy have increased nearly 4 times compared to 10 years ago.

Why food allergies are on the rise

The exact reason why a child develops allergy to various foods are not well known. However a lot of experts believe that poor quality of early childhood nutrition may be a factor. In his book Disease-Proof Your Child, Dr. Joel Fuhrman writes that apart from non-dietary factors, following nutrition related issues are responsible for increasing the risk for asthma and food allergies -

1. Lack of breastfeeding
2. High ratio of omega-6 acids to omega-3 fatty acids. People on meat rich diets in the Western world typically get ratios around 10 to 1 and some get as high as 30 to 1. This ratio should be around 4 to 1 or lower.
3. High ratio of omega-6 to omega-3 in mother’s diet during pregnancy
4. Low vitamin E intakes
5. Lack of fruits and vegetables

The immune system of young children is not fully developed, which makes them more likely to develop food allergies especially if they do not get good nutrition. But the good news, according to Dr. Fuhrman, is that it is also easier for them to recover from food allergies when a program of good nutrition is adopted.

It is easy to confuse food intolerance with food allergies

Sometimes the first symptoms of a mild food allergy may be similar to food intolerance, so it is easy to get confused. The main difference is that food allergy is a response from the immune system while food intolerance is a problem with digestion. For example, people with lactose intolerance cannot digest milk because their bodies do not have an enzyme called lactase. Lactose intolerance can result in discomfort, gas, bloating or nausea or diarrhea, but is not life threatening. Allergy to cow milk on the other hand is a result of antibodies produced by the immune system as a reaction to milk protein and can cause a very severe reaction. Similarly, intolerance to gluten causes the celiac disease which affects the small intestine, but it is not the same as wheat allergy.

Diagnosing food allergies

It is good to take any reaction to food  seriously and consult with your doctor who can run tests to confirm if your child has food allergies. Physical examination and a comprehensive medical history is usually the first step. Use of blood tests to detect food related antibodies is becoming very common, but without a good interpretation and link to the medical history, these can be very misleading. In fact there is an increase in the number of misdiagnosis of food allergies based on blood tests which I wrote about recently in my Five for Fridays column. This can result in unnecessary over restriction of foods. Skin testing with known food allergens is another option but this is not routinely done. In some extreme cases, your allergy specialist may decide to do food challenges to find out which specific foods cause an allergic response. Do not try it at home! The key is to keep a watchful eye on the reaction of your child, and if you suspect food allergies or intolerance, contact your physician as soon as possible.

Tips for managing nutrition of children with allergy

In his book, Dr. Fuhrman provides examples of how food allergies and asthma can be managed, and in some cases, completely reversed by good nutrition. I like one example of 3 year old twin boys who had severe allergic reactions to almost anything like soy, milk, peanuts, corn, strawberries, cats, dogs, and how within a few years of his nutritional therapy he was able to resolve most of these problems. In general, he recommends a diet rich in vegetables, walnuts and fruits with DHA supplements and multivitamins and no processed foods, dairy fats or trans fats. Not that this can guarantee to result in reversal of food allergies, but it makes good sense to me.

I would love to hear your experiences and tips if your child is suffering from food allergies. I am sure it is very hard for you as a parent, and it is my sincere hope that things get better for you in time. Please leave a comment below if you want to share.

Photo source – laffy4k on Flickr
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