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Children With Special Dietary Needs

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

Fast Facts About Food Allergies continued...

Q. What other kinds of food sensitivities are there?

Two common kinds of food sensitivities are lactose intolerance and gluten intolerance. These are not "allergies" in that they are not IgE-mediated, but they can cause problems with certain foods.

Lactose intolerance is not typical in young children. It happens more in adults, and when we do see it in children, it's more in school-age kids than in babies and toddlers. Lactose intolerance is caused by the relative lack of an enzyme that helps to digest the lactose in the milk product. Because it's not caused by the immune system, it just involves gastrointestinal symptoms like abdominal pain, bloating, diarrhea, and sometimes vomiting. It's really related to how much milk you ingest and is usually fairly manageable.

It takes a fairly large amount of lactose to cause significant symptoms, like about a glass of milk on an empty stomach. Management is just avoiding lactose-containing products to a significant degree.
Gluten sensitivity is also not an IgE-mediated allergy. It's caused by a T-cell in the body that reacts to gluten proteins. (Gluten is a highly complex protein found in wheat, rye, barley, and oats, and therefore in baked goods made from these grains, like bread, cookies, and pizza.) Again, it's more seen in adults and is relatively uncommon in children, and the typical symptoms are gastrointestinal -- you don't have the hives and wheezing you see with a classic wheat allergy.

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.

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