Allergy vs. Food Intolerance
Food allergy and food intolerance are not the same things, although the terms are sometimes used interchangeably. The difference is colossal:
- Food intolerance is an adverse reaction occurring as a result of deficiencies in enzymes digesting sugars such as lactose or fructose. Food intolerance does not activate the immune system.
- Food allergy is an adverse reaction resulting from the activation of the immune system. The body then mistakenly recognizes the protein of a given product as hostile and strives to liquidate it.
Besides, some children also have cross-allergy reactions. Similar symptoms that occur after contact with the primary allergen (e.g., birch) also occur after contact with an allergen of different origins, e.g., celery, carrot, plum, tomato, or apple. This is the result of the structural similarity of proteins, even of different origins.
What Is an Elimination Diet?
An elimination diet is the basic method of food allergy treatment. Most children with food allergies do not require additional medications when following an elimination diet, although it is often necessary to add dermatological treatment, inhaled medications, or supportive use of probiotics and/or prebiotics. A properly balanced elimination diet causes the disappearance or at least significant alleviation of allergy symptoms and ensures the child’s proper development.
If the elimination diet is introduced as a diagnostic test when allergies are suspected (most often in infants with suspected cow’s milk allergy), it is recommended that after improvement, the patient is re-challenged with the product that was eliminated. The sequence of symptoms improving upon elimination and worsening upon re-challenge is usually sufficient to establish a diagnosis of food allergy without additional laboratory testing.
The time of elimination diet treatment is individually determined for each patient. It is usually recommended that after approximately 6-9 months of treatment, a first re-introduction of the sensitizing product is made to assess tolerability. Do not prolong treatment with an elimination diet unnecessarily. Around 80% of children with cow milk protein allergy acquire tolerance to dairy products within 1-3 years of diagnosis and the start of appropriate treatment.
Food Allergy in Infants
During breastfeeding, you should watch your baby’s reactions, as sometimes exclusively breastfed babies develop symptoms of food allergy. This may be due to the transfer of cow milk proteins consumed by the mother into breast milk. Allergy in breastfed babies is several times less frequent than in artificially fed babies, but about 0.5% of naturally fed infants show symptoms of allergy to cow milk consumed by their mothers.
If you notice disturbing symptoms, consult a doctor. If for some reason breastfeeding is impossible, choose an organic baby formula tailored to the needs of the baby and as close as possible to the breast milk composition. Your doctor or midwife will explain to you the differences in the composition of various formulas for feeding babies with specific nutritional needs.
A Baby from Allergy Risk Group
If the baby’s mom or dad is allergic or the elder sibling has allergy symptoms, the baby is in the allergy risk group. The best way to prevent food allergies in infants from this group is to breastfeed for as long as possible. If it is necessary to feed a baby with a formula, the doctor may recommend the use of special hypoallergenic milk (usually marked with the abbreviation HA).
How to Replace the Eliminated Products?
The overriding principle of the elimination diet is to replace each eliminated nutrient with another one, well-tolerated by the baby and having a similar nutritional value. Other components of the diet should remain unchanged, as the unnecessary elimination of additional components does not provide any benefit, but only increases the risk of nutritional deficiencies.
How to Compose an Elimination Diet for a Child?
Children are most often allergic to cow milk proteins, egg whites, strawberries, apples, peanuts and citrus fruits, and fish. They are also often intolerant to lactose and gluten, however, another mechanism is responsible for these ailments: the lack of enzymes necessary to digest these substances.
A food allergy or food intolerance can only be diagnosed by a doctor. If the diagnosis is confirmed, an elimination diet is necessary, which is the basic treatment. Everything harmful or potentially harmful to the child is then removed from the menu.
However, there is another threat: a poorly balanced elimination diet may result in a deficiency of vitamins and minerals (especially calcium), necessary for proper development. Therefore, the diet should be arranged in such a way that the products the baby cannot eat, are replaced with equivalent ones in terms of nutritional value that the toddler will tolerate well.
For this reason, it is best to compose a diet in consultation with a doctor or a dietitian who deals with arranging diets for small allergy sufferers and will arrange the menu, considering not only the child’s food preferences but above all the need for specific nutrients.
Here are some pieces of advice that may help you compose a balanced diet for your little one with a food allergy.
Milk-Free Elimination Diet
Babies who are lactose intolerant or allergic to cow milk proteins cannot consume milk, even milk-based baby formulas, but special milk replacers available on prescription.
Older children cannot get regular milk or milk-based products, such as cheese, yogurts, milk porridges, products containing powdered milk (e.g., cookies and cakes), bread, and sweets (milk proteins in them may be hidden under a different name: whey, casein).
They also cannot eat beef or veal, since up to half of children with this type of allergy react allergically to these two types of meat.
An allergic person can safely eat poultry, rabbit, lamb, and goose meat. You can give your baby fish, eggs, cocoa, and dishes containing gluten, but very carefully and always with the consent of the doctor. These are allergens, so there is a possibility that they will also sensitize the baby.
Gluten-Free Elimination Diet
Gluten is only found in some grains: wheat, rye, barley, oats, triticale, and spelt. However, it is not found in millet, corn, amaranth, or rice. The fact that a child can eat a given product safely is the easiest way to know by the international mark of a crossed ear of corn on the packaging, which means that the product is free of gluten.
If your baby is allergic to gluten, ordinary wheat flour must disappear from your kitchen. Rice, corn, or special gluten-free flour is safer. You also need to check the labels of food products very carefully, because gluten is often found in thickeners (e.g., in yogurts or ice cream).
You also have to give up ordinary porridges. Some great alternatives to them for allergy sufferers and children who are lactose or gluten intolerant are gluten-free cereal products based on rice flour and locust bean gum. They contain both minerals (including calcium and iron) and a set of vitamins. They can be served alone or used as a base for other dishes: pancakes, noodles, pancakes, meat sticks, or to thicken soups.
Egg-Free Elimination Diet
Eggs are found in many foods. They are a valuable source of protein and iron, so you can’t just eliminate them. In the daily menu of allergy sufferers, they should be replaced by equally valuable and tasty quail eggs, which can be used to make scrambled eggs, homemade pasta, cakes, or dumplings.
Nut-Free Elimination Diet
If your baby has a nut allergy, watch out for peanut butter, marzipan, nougat, candies, and cookies. Even products processed in the same factory as nut products may contain traces of them.
Helpful Tips for Composing a Diet for an Allergic Baby
How to prepare meals so that they are not only healthy and tasty but also safe for a small allergy sufferer? The condition for success is the introduction of certain rules for shopping and preparing meals:
- Make a list of allowed and prohibited products. For example, children allergic to cow milk proteins cannot eat not only milk but also any products that could contain milk and some products that apparently do not contain milk (e.g., veal and beef). Products with trace amounts of allergens should also be blacklisted. Both lists should be placed in a visible area.
- Read the composition carefully. Even if a product does not contain an allergen, potentially allergenic products may be used in the factory where it was produced (if the same machines are used to produce different items). Then such information is provided on the label.
- Separate shelves for food. If the child reacts very severely to even a small amount of the allergen, it is better if the products that sensitize them do not come into contact with those that they can eat. Therefore, it is better to designate separate shelves in the fridge and the kitchen cabinets, intended only for food for allergy sufferers. If this is not possible, baby products must be stored in tightly closed and carefully labeled plastic containers.
You can also try Kendamil Organic Stage 2
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