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Children With Special Dietary Needs

Get the facts about your kids’ food allergies and intolerances.

Food Allergies: Causes, Symptoms, Diagnosis, and Treatment

Q. What causes food allergies?

A. A true allergic reaction to a food is produced by a mistaken immune response. These are called IgE-mediated allergies, because they are triggered when immunoglobulin E antibodies are produced in response to a specific food the child is sensitive to.

There are also other food sensitivities and reactions that are not IgE-mediated. For example, some young children have a condition called enterocolitis, an intestinal inflammation. In these cases, they have gastrointestinal symptoms after ingesting milk or soy formula, but no respiratory or skin symptoms. These are not IgE-mediated allergies, and kids usually outgrow this condition by age 2 or 3.

Q. What are the symptoms of a food allergy?

A. Food allergy symptoms include skin, gastrointestinal, and respiratory symptoms. Skin symptoms include hives or an itchy red rash; respiratory symptoms include coughing, wheezing, and laryngoedema (a swollen throat); and the gastrointestinal symptoms include significant vomiting, intestinal pain, and diarrhea.

These symptoms are always temporally related to ingestion -- that means, very close in time. Often it's seconds to minutes after ingestion, but always within hours. If you drink milk today and have symptoms tomorrow, it's not related.

Q. How are food allergies diagnosed?

A. An allergist or primary care provider can do allergy testing. They will run either a skin test or draw blood, and in either sample, they'll look for IgE antibodies to particular foods. If there are no IgE antibodies to the foods, the child is likely not allergic.

Q. How do I treat a food allergy?

A. The only way to treat a true food allergy is to avoid the food in question.

Food Allergies: A Safe and Healthy Diet

Q. If my child has special dietary needs, how do I replace in their diet the foods they can't eat?

A. Generally, milk and egg allergies are fairly manageable. For example, you can boost your child's calcium intake with calcium-enriched orange juice and supplements, and there are ways to make egg-free foods. Wheat and soy are more problematic, because soy, in particular, is in so many foods.

Some of the best tools to help you replace these foods in your child's diet (and to know what's in the food you're shopping for) are from the Food Allergy and Anaphylaxis Network (FAAN) (http://www.foodallergy.org/). They have sample recipes on their web site, and several great cookbooks, as well as tips for shopping and cooking, notices about changes in ingredients to particular foods, and resources for understanding food labels.

Q. How can I make sure my child with special dietary needs eats safely at school, in restaurants, and at parties?

A. Have a healthy respect for the allergy. Don't live in fear of what they're going to eat, but don't be cavalier. Help the child to know that it really takes ingestion of the food, for the most part, to cause a life-ending reaction -- not smelling or touching, it's ingestion. If you're on an airplane, it can be different because the air is recirculated, but at the park or in a restaurant, it's not going to harm your child if someone opens up a jar of peanut butter.

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