Keeping Your Little One with Food Allergies Safe & Thriving

Every three minutes, a food allergy reaction sends someone to the emergency room. So how do we keep your little one safe, while still ensuring that they are able to take part in social events, eat out at restaurants, and thrive developmentally?

By Kerry Jones, MPH, RDN, LDN

If you have a child with food allergies, you are not alone. As many as 32 million Americans, including 6 million children, have food allergies.1-3 That means that 8% of children have at least one food allergy.1-3 That is 1 in 13 children or roughly two in every classroom. 


However, among the children that have food allergies, 40% of them are allergic to multiple foods.4 If you are the parent of a child with food allergies, you know how serious food allergies can be. Every three minutes, a food allergy reaction sends someone to the emergency room.5 So how do we keep your little one safe, while still ensuring that they are able to take part in social events, eat out at restaurants, and thrive developmentally?

How to Keep My Child Safe

Managing your child’s food allergy can be difficult and overwhelming. However, the only way to keep your child safe and avoid allergic reactions is to have your child avoid all of their known food allergens and be prepared for the worst. Here are the five most important steps to keeping your child with food allergies safe:
  • Read every food label every time. Food labels are the only way to know whether or not a food is safe for your child to eat. Even if you tend to purchase the same foods every time you shop at the grocery store, manufacturers can change ingredients on packaged foods without warning. Therefore, it is crucial to check every food label every time you shop and every time you serve food to your child.
  • Be aware of cross-contact. Cross-contact occurs when a food allergen comes into contact with a safe food. Even if the amount of food protein exchange is small, it can still cause an allergic reaction. If you are preparing food at home, prepare the allergy-safe foods for your child first prior to preparing any food that contains your child’s food allergens. Make sure to wash everything that comes in contact with allergy-containing foods, including hands, well with soap and water. When eating out, avoid restaurants where cross-contact is higher, such as buffets and ice cream shops.
  • Ensure your child is always carrying their epinephrine auto-injector. Epinephrine is the only way to stop life-threatening allergic reactions. Make sure that your child always has their non-expired epinephrine auto-injector (e.g., EpiPen) on them and that at least one of the adults caring for them to know when and how to use it.

It is important to empower your child to advocate for their health and well-being. By teaching them about their food allergy, you are decreasing the likelihood of food allergic reactions and increasing the likelihood that if a reaction occurs it will be properly managed.

- Kerry Jones
  • Complete the Food Allergy & Anaphylaxis Emergency Care Plan. It is important to prepare for the worst and know how to react if an allergic reaction occurs. The Food Allergy & Anaphylaxis Emergency Care Plan from Food Allergy Research & Education (FARE) is the perfect document to store with your child’s epinephrine auto-injector to help yourself and all caregivers know when and how to respond if your child has an allergic reaction. 

 

  • Teach your child about their food allergy. It is important to empower your child to advocate for their health and well-being. By teaching them about their food allergy, you are decreasing the likelihood of food allergic reactions and increasing the likelihood that if a reaction occurs it will be properly managed. One of my favorite ways to teach younger children about their food allergies is through books. Below are some of my favorites:
    • Mangos for Max by Jessica St. Louis (ages 2-5; to reassure children that food allergies do not have to damper their fun)
    • Nutley the Nut-Free Squirrel by Stephanie Sorkin (ages 3-6; to teach children that having a food allergy is okay)
    • The Princess and the Peanut: A Royally Allergic Tale by Sue Ganz-Schmitt (ages 4-8; to teach children about food allergies and that they are still extraordinary despite having a food allergy)
    • My Food Allergies: A Children’s Book by Amber DeVore (ages 3-6; to educate children about food allergies, including symptoms, food labels, not sharing food, and EpiPens)

How to Ensure My Child is Growing & Thriving

Research has found that children with food allergies are at an increased risk of inadequate nutrient intake, which can lead to poor growth and vitamin & mineral deficiencies.(6-8)  One study found that children with multiple food allergies were significantly shorter than children without food allergies.(6)

 

In extreme cases, research studies have also reported that allergen elimination diets have caused children to develop rickets or Kwashiorkor (a severe form of malnutrition).(6-7) Luckily, research also tells us that if children with food allergies find appropriate ways to replace the nutrients they are missing, they can still continue to grow and thrive.(6-7) Below is a list of common nutrients found in the big 9 food allergens and alternative sources:

 

  • Omega-3 Fatty Acids: fatty fish (such as salmon & tuna), DHA-fortified products (such as some milks & eggs), nuts (such as walnuts), & seeds
  • Protein: beans, edamame (soy), dairy products, eggs, fish, lentils, meat, nuts, nut butters, seeds, seed butters, seitan (wheat), tempeh (soy), & tofu (soy)
  • Calcium: dairy products, green leafy vegetables (other than spinach), & fish eaten with bones (such as sardines)
  • Iodine: dairy products, eggs, fish, seaweed, & shellfish
  • Iron: beans, fortified breakfast cereal, meat, & seafood
  • Zinc: beans, dairy products, fortified breakfast cereal, meat, nuts, some seafood (such as oysters, crab, & lobster), & whole grains
  • Vitamin B12: dairy products, eggs, fish, fortified breakfast cereal, meat, & nutritional yeast
  • Vitamin D: eggs, fatty fish (such as salmon & tuna), vitamin D-fortified dairy products and dairy alternatives

 

Since childhood is a time of rapid growth and development, it is important that your child is getting all of the nutrients they need. However, this can be hard! This is especially true if your child has multiple food allergies or is experiencing other factors that are impacting their food intake, such as picky eating or consuming a vegetarian/vegan diet. 

 

If you are struggling to figure out how to make sure your child is getting the nutrients they need to grow or if you child is having issues with growth or weight, then it is important to seek professional help from your pediatrician and a registered dietitian with training in food allergies. It is also perfectly okay to seek professional help even if you just have questions about how to manage your children’s food allergies or want to triple check your child is getting everything they need to thrive. Healthcare professionals, such as myself, are always here to support you and your family!

References:

  1. Gupta RS, Warren CM, Smith BM et al. Prevalence and Severity of Food Allergies Among US Adults. JAMA Network Open. 2019; 2(1): e185630.
  2. United States Census Bureau. Quick Facts (2015 and 2016 estimates).
  3. Gupta RS, Warren CM, Smith BM et al. The Public Health Impact of Parent-Reported Childhood Food Allergies in the United States. Pediatrics 2018; 142(6): e20181235.
  4. Jackson KD, Howie LD, Akinbami LJ. Trends in allergic conditions among children: United States, 1997-2011. NCHS data brief, no 121. Hyattsville, MD: National Center for Health Statistics. 2013. http://www.cdc.gov/nchs/products/databriefs/db121.htm.
  5. Clark S, Espinola J, Rudders SA, Banerji, A, Camargo CA. Frequency of US emergency department visits for food-related acute allergic reactions. J Allergy Clin Immunol. 2011; 127(3): 682-3.
  6. Mehta H, Groetch M, Wang J. Growth and Nutritional Concerns in Children with Food Allergy. Curr Opin Allergy Clin Immunol. 2013; 13(3): 275-9.
  7. Gargano D, Appanna, Santonicola A et al. Food Allergy and Intolerance: A Narrative Review on Nutritional Concerns. Nutrients. 2021; 13(5): 1638.
  8. Pavić I, Kolaček S. Growth of Children with Food Allergy. Horm Res Paediatr. 2017; 88(1): 91-100.

Kerry Jones, MPH, RDN, LDN is a Registered Dietitian with a Master’s degree in Public Health who is passionate about helping growing families navigate life and achieve all of their milestones along the way. She works with women who are trying to conceive, pregnant, breastfeeding, or postpartum and children to help manage medical conditions, tackle picky eating, and establish a good family relationship with food. With an overload of nutrition information available, Kerry understands how difficult it can be to know which foods are best for you and your family. Kerry owns a private practice called Milestones Pediatric & Maternal Nutrition.

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