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,
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
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
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