Does My Child Have a Food Allergy or Sensitivity (and what’s the difference)?

                           

The gastrointestinal tract is uniquely suited to digest all the different foods we eat to help our children grow and thrive. However, there are times when the body reacts to certain foods and cause discomfort.

 A food allergy occurs when the body sees food as harmful and the immune system reacts to the allergens. When the response involves antibodies known as immunoglobulin E (IgE), symptoms such as hives, trouble breathing, or vomiting can appear quickly. Other times, non-IgE mediated allergies may cause symptoms such as abdominal pain or diarrhea that are delayed up to three days. The most common food allergens in children include milk, soy, egg, wheat, peanuts, tree nuts, fish, and shellfish.

 A food intolerance or food sensitivity occurs when the body has trouble digesting certain foods, but the immune system is not involved. A common example is lactose intolerance where the intestinal enzymes cannot completely process the ingested milk sugar. Food intolerance can lead to similar symptoms as food allergies, but the reactions tend to be less severe.

In many cases, treatment of allergies and intolerances involves removing certain foods from the diet. However, overly restricting a child’s diet could have a negative impact on their nutrition and growth. In certain situations, medications may be useful as well. Your child’s pediatrician or pediatric gastroenterologist can help guide you through the diagnosis and treatment of these conditions.

Picture retrieved April 30, 2016 from www.fix.com/blog/food-allergies/

5 Most Common Causes of Constipation in Kids Ages 2+

  1. Inadequate Hydration – Aside from losing fluids by using the bathroom, most children are very active and sweat quite a bit. These “insensible losses” force the colon to draw out more water from digested food leading to incredibly hard poops! Keeping them hydrated especially on warm days is important! Beginning in toddler-hood, kids should be getting about 1 liter a day minimum.
  1. Stool Holding – Kids are some busy people! They are engaged in school, after-school activities, playing with friends, video games etc. Making the time for them to sit on the toilet is important. Toilets at schools are gross. “Toilet Time” at home is particularly important in toddlers and young children learning to develop healthy stooling habits. The colon is naturally squeezing 20-30 minutes after breakfast and dinner making these good times to encourage sitting.
  1. Diet – Getting the right proportions of food can be challenging in early childhood. Kids are picky – and lets be honest, most parents don’t have time to plan an elaborate meal. The key to a balanced diet is allowing for adequate fiber in the form of whole grains, fruits or vegetables at least 5-9 servings per day (a serving is the size of your child’s fist). You can also calculate how many grams of fiber your child is getting a day. For children >2 years old, the goal is: Age + 5 = Grams of Fiber Per Day. See my list of fiber rich foods here.
  1. Milk-Protein Allergy and Other Food Allergies – Food protein intolerances (different from classic anaphylactic allergy) often result in abdominal pain, occasional nausea/vomiting and diarrhea. The constipation is secondary to the limited variety of foods available to those children suffering from allergies. Using food diaries and coming up with a comprehensive nutrition plan with your pediatrician or pediatric gastroenterologist is important to prevent vitamin deficiencies and constipation.

These area some less common but more insidious causes of constipation and cannot be missed! They include: celiac disease, IBS, thyroid disease, medication-related constipation, and anal fissures. If you worry that there may be an underlying reason for your child’s constipation that isn’t listed above, we are here to help!

Are FODMAPs causing your child’s abdominal pain?

One new diet trend that is becoming increasingly popular is the low-FODMAP diet. FODMAPs (Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols) are foods that are poorly absorbed by the human intestine and are very easily digested by bacteria that normally line our gut. The bacteria feed on these sugars and sugar substitutes allowing them to grow out of control and produce and excessive amount of gas. The high-FODMAP foods can cause inflammation along your intestine, excessive gas, bloating and discomfort. A well-balanced, low-FODMAP diet is recommended for some children with chronic unexplained abdominal pain. Consult your pediatrician or pediatric gastroenterologist before instituting any restrictive diet such as low-FODMAP.

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Picky Eaters 101

One of the most common questions we get in our office is, “How can I get my child to eat more healthy foods?” While there is no magic pill, we will be posting some of our favorite tips over the next few weeks. Keep in mind, this is just a phase, things will get easier!

Quick Tip #1: It is normal for small children are afraid of trying new things, including trying new foods (food neophobia). Reassurance does not always work. But… the more familiar they are with a food the more likely they will try it and like it. It may take several exposures to new foods before the child will accept them and eat them – sometimes as many as 15 attempts! Neophobia peaks at age two years old. It is less of a problem at three, four and five years old. Continue to offer your child to foods they don’t want to eat, but never force them to eat it.

Remember parents are responsible for providing healthful food that is appropriate for the age of the child. Children are responsible for how much they eat or if they eat at all.

If all else fails, follow #mykidcanteatthis for some sympathy and a good laugh.

Perry RA, Mallan KM, Koo J, Mauch CE, Daniels LA, Magarey AM. Food neophobia and its association with diet quality and weight in children aged 24 months: a cross sectional study. Int J Behav Nutr Phys Act. 2015 Feb 13;12:13. doi: 10.1186/s12966-015-0184-6. PubMed PMID: 25889280; PubMed Central PMCID: PMC4335451.