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 Registered dietitian Jill Weisenberger offers ideas for foods that can help your child build a stronger immune system.

Jill Weisenberger, MS, RD, CDE  Education: M.S. Food Science & Human Nutrition, University of Florida Degree in Communications, University of Florida Nutrition consultant, writer, speaker, educator Expertise in diabetes nutrition Writer for Eating Well, Diabetic Living, Her Sports and Fitness magazines Twitter: @nutritionjill Website: All That’s Nutrition LinkedIn Profile Contact via email: jill@allthatsnutrition.com

Question: What kinds of foods will keep my child’s immune system as healthy as possible?

Answer:

Winter colds and flu are making the rounds. In some households, it seems that just as one family member is well, another gets sick. A well-running immune system can mount a powerful attack against viruses and other invaders, so paying attention to diet is especially important now. An apple a day is a good start to keeping the doctor away, but it’s the total diet – not any individual food or supplement – that stokes the immune system and keeps it humming.

The types of foods your child needs to fend off colds and illnesses are the same ones you need. Don’t fall for the hype of immune-boosting supplements and fortified foods. Simply eat a balanced diet. For most, that means a stronger emphasis on fruits, vegetables and whole grains. Try to eat a whole grain and at least one fruit or vegetable at every meal. Here are a few to try, but again a balanced diet is required – not any specific food.

Beans: Baked beans, kidney beans and others are a powerhouse of nutrients including zinc which may reduce some upper respiratory infections. Smash up some white beans to thicken soups and stews. No one will ever know they’re there. Add red or black beans to salads and pasta.

Oats: another good source of zinc and a perfect breakfast food. Instead of using breadcrumbs, you can also add oats to meatballs and meatloaf.

Bell peppers, broccoli, citrus, kiwis and berries: These are all good sources of vitamin C. Research isn’t clear that extra vitamin C helps treat or prevent colds, but vitamin C-rich foods are packed with other antioxidants and nutrients, so it’s a good idea to include them daily. Clementines are especially nice for children because they are small, seedless, easy-to-peel, delicious and not as messy as other citrus fruits.

Mushrooms: Researchers at Tufts University suspect that the simple white button mushroom may enhance immune function by increasing the production of antiviral compounds. If your kids aren’t used to eating mushrooms, introduce them with foods they already like such as pastas and casseroles.

Finally, don’t forget that frequent hand washing and other good hygiene habits are also necessary to protect your health and your family’s health. Oh and get outside in the sunshine too.

©2011 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.

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, registered dietitian Kerry Robinson clarifies the difference between milk allergy and lactose intolerance and offers advice on how to deal with both.

Kerry Robinson, RD B.S. Virginia Tech – Human Nutrition, Foods and Exercise with concentration in Dietetics Dietetic internship at Virginia Tech Expertise in food and health communication at IFIC Analyzes trends in food and health issues on traditional and social media Twitter – @IFICmedia Contact via email – robinson@ific.org

Question: How can I be sure if my child has milk allergy or lactose intolerance?

Lactose intolerance is an inability to digest and absorb the sugar in milk (lactose) that results in gastrointestinal symptoms such as nausea, vomiting and diarrhea when milk or milk-containing products are consumed.

Unlike lactose intolerance, a milk allergy is caused by an immune system response in which milk proteins (casein and whey) are mistakenly identified as being dangerous and antibodies are created to fight them off in an effort to protect the body.

For example, a child with a lactose intolerance, can consume  lactaid (lactose –free milk) or yogurt without symptoms but a child with milk allergy can not. The difference between milk allergy and lactose intolerance is not only the cause, but also the severity of the symptoms.  While a child with a milk allergy can display similar gastrointestinal symptoms as one who suffers from lactose intolerance, it is important to understand that the symptoms of an allergic reaction can be much more severe, and even life threatening at times.

The following are the most common signs and symptoms of a reaction to a food allergen, like milk

• Skin rashes, itching, swelling or hives
• Vomiting or other gastrointestinal symptoms
• Respiratory distress, such as wheezing or breathing difficulties
• Anaphylaxis, which is a systemic allergic reaction that can involve multiple symptoms at once and can range from mild to fatal

Once you suspect that your child or loved one has a reaction or intolerance to milk you should consult your health care provider, pediatrician and/or a board-certified allergist.  He or she may ask you detailed questions about signs and symptoms, perform a physical exam, request a detailed food diary, and perform a combination of skin prick or blood sample tests to confirm an allergy or intolerance.

Should a milk allergy be confirmed, you will need to eliminate all milk and milk-containing products from your child’s diet.   While this can seem like a daunting task, a registered dietitian can provide expertise in helping to ensure your child receives adequate nutrition, especially calcium to foster proper growth and development.  Since strict avoidance of the offending food allergen (in this case, milk) is the only way to prevent a food-allergic reaction, a registered dietitian can work as part of the healthcare team to:

• Review how to avoid specific food allergens
• Ensure nutrient adequacy (especially calcium and Vitamin D)and add variety to your child’s diet
• Provide suggestions for meals and snacks and strategies to enjoy dining out
• Assist in label reading
• Monitor growth and development
• Share resources related to food allergies

Whether your child is lactose intolerant or allergic to milk, it is important to engage your healthcare team, especially a registered dietitian to help guide you in making sure your child eats and stays healthy.

For more information on allergies, join IFIC and Food Allergy and Anaphylaxis Network for a Twitter chat on Tuesday May 11, 2010 at 8 p.m EST using hashtags #foodinsight and #FAAW

©2010 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.

In her recent article Vaccine for ear infections soon to be on the market,  Chicago Family Health Examiner Jasmine Jafferali, MPH, wrote that the underlying cause of chronic ear infections in children could be milk allergy. I was so intrigued by this suggestion that I contacted her to address this idea in a Question-Answer format for my blog. If your child is suffering from chronic ear infections and you are concerned about excessive use of antibiotics, this article is a must read for you! Let me know what you think!

Question: You have said that milk allergy is an underlying cause for chronic ear infections. Can you provide a credible reference to support this?

Jasmine: Dr. Greene, a prominent pediatrician,  has discussed a link to milk allergies and ear infections.  Up to 40 percent of kids who suffer from chronic ear infections has a milk allergy.  In fact a 1997 report on food allergies in the Journal of the American Medical Association found that cow’s milk allergies tend to hit children in their infancies, showing up as colic, acid reflux or eczema.  However many pediatricians are overlooking the possibility of food allergies, especially milk allergies to chronic ear infections.

Question: How can parents recognize the signs of food allergy and dairy allergy in particular?

Jasmine: Although a child can develop an allergy to almost any food, well over 90 percent of food allergies in children are caused by one of only six foods: milk, eggs, peanuts, wheat, soy, and tree nuts. The immediate symptoms of food allergies in babies and toddlers are irritability, colic, wheezing (sometimes asthma), a minor rash, chronic runny nose, or itchy eyes. These more immediate symptoms are less likely to occur than slower onset symptoms, which your baby can experience seven to 10 days after exposure to cow’s milk.  These more common symptoms include diarrhea (possibly with blood), abdominal cramps, vomiting, coughing, gagging, acid reflux, ear infections, runny nose, eczema and colic.

Food allergies is becoming more and more common in our children.  Parents are fearful and the information out there is confusing.  These findings are all consistent with the 2008 American Academy of Pediatrics guidelines that overturned previous recommendations by declaring that there is no evidence that delaying any food beyond 4 to 6 months helps prevent allergies at all — for healthy term children who are not already allergic.  However, many parents get quite excited introducing solids to their infants.  Remember, the main source of nutrition for an infant is breastmilk or formula for the first year of life and solid food is meant to be the supplement.  Look for signs that your baby is ready to eat solids.

Question: What kind of questions should parents ask when an antibiotic is prescribed?

Jasmine: If an antibiotic is prescribed some questions to ask are:

1. Is the infection bacterial or viral?  If viral, then antibiotics will not improve symptoms of the ear infection.  It is like being prescribed antibiotics for a cold.  Ask for possible alternatives.
2. Where is the location of the infection?  If the infection is in the middle ear, ask if waiting it out is an option and what you can do to help minimize their pain.  Eighty percent of ear infections will resolve on its own within 4 to 7 days without antibiotics.  WebMD wrote an article on this study back in 2005.
3. If my child must take antibiotics, can I give them some probiotics after the finished antibiotics to help replenish their good bacteria?  (remember antibiotics kills BOTH good and bacteria and you have replace the good back into the body)  Studies are showing the benefits of taking probiotics after antibiotic treatment and during cold and flu season.

Question: How can parents tell if they are exposing their child to excessive antibiotic use?

Jasmine: If you are in the doctor’s office for the third time in one year getting another round of antibiotics it is time to ask the long term effects of getting the antibiotics and start looking into the underlying cause for the chronic condition.  If your child is an infant, you may want to switch formulas where the formula is more broken down and easier for your baby to digest.  Or if you are breastfeeding looking at your own diet as possible issues.

Question: Can ear infections be treated without the use of antibiotics?

Jasmine: Often, an antibiotics is prescribed to treat the ear infection. According to the June 2009 British Medical Journal article, prescribing antibiotics leads to more ear infections.  In fact, if the children had taken antibiotics, there was a 63 percent chance they’d had at least one subsequent infection. The risk was only 43 percent for children who’d been given an inactive placebo.  Other studies show that it takes children only three days longer to recover from the middle ear infection without antibiotic treatment.  (see the WebMD article)

There are alternate treatments to chronic ear infections.  In fact, my own grandmother used some of these home remedies on us when we suffered from ear infections.

1. Warm compresses with a warm washcloth. Do not put the water in the ear and make sure the washcloth is not too hot.
2. Hyland’s ear drops is used with a confirmed diagnosed ear infection.  This can be purchased at your local drugstore or health food store.
3. Warm olive oil, or warm garlic infused olive oil: In test tube studies garlic has been found to have antibacterial, antiviral, and antifungal activity-garlic is a natural antiseptic!  Chop 2 garlic cloves and allow the small pieces to marinate in a half cup of olive oil for a day (if you can’t wait proceed to warming the oil over the stove).  Warm the oil slowly over the stove, it should be warm to your touch.  Get an ear dropper and put a few drops into the ear.  You may add a few more drops later in the day, the first round should do the trick.  This mix will last for about two weeks.  Many parents are turned off by this home remedy, however, there are plenty that use and swear by this method.
4. Echinacea – this is an herb which can safely and effectively boost the immune system.  Click on Dr. Greene’s guide to using Echinacea properly.
5. Chiropractic care – chiropractic adjustments to the skull and neck can improve middle ear drainage and decrease ear infections.  Many parents are finding relief going this route

Using a combo of the above will be helpful such as warm compresses and whichever remedy you choose.
WARNING – if you see any liquid or pus draining out of the ear, DO NOT PUT ANY OF THE ABOVE DROPS INTO THE EAR.

Question: Can you give suggestions to dairy alternatives if dairy allergy is found to be the cause of ear infections?

Jasmine: If you child has a confirmed milk allergy with an ELISA allergy testing, then eliminating all dairy can be a difficult transition for your child.  Finding the right dairy substitute is tricky.  Often kids allergic to dairy are often or have a hard time digesting soy.  As rice cereal was probably your child’s first food, rice milk is a nice alternative and easy to digest.  If there are no tree nut allergies, almond milk is another great substitute.  If you are concerned about your child getting the fat from the milk, you may add up to 1tsp of flax oil to the milk substitute.   There is now coconut milk yogurt and coconut milk ice cream which is both delicious and provides some great health benefits.  So Delicious is a wonderful brand and your child will not miss out.

©2009 Littlestomaks.com