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YOUR FOOD ALLERGIC CHILDA parent's guide Updated resources, recipes and more
By Janet E. Meizel
iUniverse, Inc.Copyright © 2010 Janet E. Meizel
All right reserved.
Chapter OneCHILDREN'S SPECIAL
It has been reported that there is a major growth in the food-allergic population in the United States. The reasons for this have not been discovered although there are many theories.
Scientists have discovered some genetic involvement in the transmission of allergic tendencies from one generation to the next. If you or your spouse have allergies, your children have a greater chance of developing allergic problems than if neither of you are affected. There are some things you can do to at least delay the onset of symptoms and give the baby's digestive system more time to develop. (Some physicians feel that the younger infant's less-developed digestive system allows more antibody-producing material to enter the baby's bloodstream, beginning the allergic process.)
Most authorities recommend that a mother nurse her baby if at all possible. No known cases of allergy to mother's milk have been found. It is wise, however, to keep track of what the mother eats. Some of the protein which the mother ingests can pass through her milk and cause symptoms in the baby. For example, if the mother eats fish and after nursing notices that the baby has more colic than usual, or has diarrhea, or is unusually stuffy, it is a good idea for her not to eat that same type of fish during the months she is nursing. This applies to all foods - and even to vitamins and medication which the mother might take. For questions about medication, consult the physician who prescribed it, or an allergist.
Physicians who deal extensively with allergic babies often recommend that they not be given solid food too early, and that once solid food is given, the introduction should be gradual. Introducing each food separately, with ample time between additions, makes it much easier to detect any existing sensitivities. It is much easier to do this with an infant than to try to put a school-age child on an elimination diet when he already has strong opinions about foods that he does or doesn't like.
It is also important to keep the young child's diet simple. By this I mean that each food given to the infant should have as few ingredients as possible. Some prepared baby and toddler foods contain many ingredients, which make careful label-reading a "must" for the parents of either an allergic baby or one who is suspected of having allergies. Also note that there are often ingredients that are considered to be so common in certain foods that they are not required to be on the label. Finally, keep track of the note on packages that say that an item was produced in a facility that also processes nuts, wheat, soy or other common allergens.
Perhaps the most important hint for parents is to choose a physician with whom you have good communication, with whom you are comfortable, and most important, who is knowledgeable in the field of allergy- especially pediatric allergy. It is a relatively new field, and many physicians have not received sufficient training in diagnosing and treating the less frequent manifestations of allergic disease. If you feel that you are not receiving adequate assistance with your baby or child, seek more qualified help.
Toddlers learn everything very quickly, and it is amazing to see the level of responsibility a two-or-three-year-old can accept for her own diet. If a child has had several allergic episodes, she will usually be willing to avoid the things she associates with that discomfort, and some gentle reinforcement by parents will do wonders. For example, when the offending food is offered, simply saying "that makes your tummy hurt" or "that makes you wheeze" or "that makes you itch" gives the child a direct association which can easily be remembered between the food and a symptom.
At this stage, if the toddler is cared for at home, her opportunities to make dietary mistakes are limited, and most playmates' mothers are willing to make the necessary provisions for snacks. If this is not possible, however, it makes good sense to the toddler to bring her own refreshments.
When your child is a bit older and actually plays with other children or goes to nursery school, sharing becomes a major theme in his life. Protecting him from the foods to which he is allergic becomes more complicated. Sometimes it is a good idea to prepare a snack for the entire group so that the allergic child does not constantly feel stigmatized. There will still be some rough moments. A lunchbox is a real status symbol for this group, and often several children will bring them to nursery school or to play group. Your child may be the first to actually use the lunchbox for carrying food and a beverage, and may view carrying it as a privilege.
It is important that the teacher or day-care mother be aware of any dietary limitations and to be able to deal with them without embarrassing the child. A major part of the nursery school curriculum includes experimenting with the five senses, including both taste and smell. If a child is violently allergic to wheat, the teacher must understand that it is not appropriate to allow him to taste salt by licking it from a pretzel simply because the others are eating pretzels. It may help to discuss alternatives with the teacher before a planned activity.
Often "sense" themes are carried over into snack time in nursery school, and can create problems. It may be quite difficult for a small child allergic to orange juice to associate it with the "green juice" the teacher made by adding blue food coloring to the juice of an orange for Saint Patrick's day. Both the teacher and parents need to be aware that there is little abstract reasoning at this age. The child will not or can not always stop to evaluate a new situation, and instead relies heavily on the judgment of a trusted adult.
There are other situations at nursery school which may provoke food-allergy problems. Here is one of the most popular play dough recipes for school use:
Generic play dough
1 cup (wheat) flour 1 cup water 1/2 cup salt Food coloring 2 tablespoons oil
Mix dry ingredients. Mix water and coloring. Then add oil and water to dry ingredients and stir over medium heat until stiff.
Playing with this medium, assisting in its manufacture, or even being in the room where it is being mixed can cause problems for a wheat-allergic child. This problem may be avoided by asking the teacher to use commercially prepared play dough which does not contain wheat or by providing the school with it. If your child can tolerate being in the room with the wheat-based play dough, she can wear size small "rubber" or plastic gloves. These are available at most pharmacies.
If the school budget does not allow for the purchase of commercial play dough and you don't want to supply it for your child's class, this formula for hardening play dough is available from Argo.
Cornstarch Play dough
1 cup Argo cornstarch 2 cups baking soda
Mix the cornstarch and baking soda in a saucepan. Add 1 1/2 cups cold water and heat, stirring, until it reaches a "mashed potato" consistency-then turn out on a plate. Cover with a damp cloth and cool. It can then be kneaded like dough. Author's note: Color may be added while stirring.
Commercial glue or paste can substitute easily for flour and water paste. If the children are making papier-mâché constructions, rice flour and water make a good binding liquid in which to soak the paper strips.
Birthdays are important celebrations in nursery school, and many children bring a treat for the class. Usually the teacher will ask parents for the dates of birthdays, and armed with a copy of this list, you can send a treat with the child on the appropriate day. If the school has a freezer, it is a good idea to keep a reserve supply of home-made cupcakes, cookies, or even ice pops there, since parents have been known to surprise teachers by bringing unexpected snacks.
ELEMENTARY SCHOOL AGE
Most of the preceding suggestions are appropriate for elementary school. However there are a few additional complications in this setting due to the fact that elementary schools are somewhat more impersonal than nursery schools.
The first problem encountered by parents of allergic children is how to notify the teacher of the child's problem without making an issue of it. Some school districts will not permit the parents to know the teacher's name before the first day of school. Other districts do not give the teachers complete student records to avoid "prejudicing" the teacher. In both cases, you should try to convince school officials of the necessity of changing these regulations. A complete list of restrictions and emergency procedures should be given to the teacher before he/she comes in contact with the child as the most effective teaching situation. Then the teacher should be allowed to ask you any questions that he/she feels are pertinent. Most teachers are anxious to help their students learn to cope, and this includes helping children develop a positive attitude about whatever problems they may have.
Once in a while, you will find a teacher who "does not believe" in allergy (there are even physicians who share this attitude). At the other extreme is the teacher who creates a stressful situation by placing too much emphasis on a child's "handicap." Both extremes cause additional problems, and it is imperative to speak to the teacher and correct the situation. If the problem cannot be solved by this method, change the child's class placement.
Due to budget cuts, many schools are without nurses, and other personnel are not allowed to administer medication in any form. While an unusually responsible child may be given her own medication and instructions for taking it, many schools object to this solution, and it is sometimes not practical. It is often better to provide the school with a list of several alternate adults who may be called in to take responsibility for administering medication to the child. If the allergy is so severe that there is a time element involved for successful treatment, be sure that all school personnel are informed. A copy of emergency procedures, in the order in which they must be carried out, should be attached to the student's permanent record and to the emergency card, which is always kept in the school office. Be sure to inform the teacher, as he or she is the "first responder" in most school situations.
Many elementary schools allow parties for the holidays (usually Halloween, winter vacation, Valentine's Day, and year-end) and an important feature of the parties is food. The teacher will provide you with the dates and times so that your child can have a treat along with the others. Cookies cut in special designs and rock candy (crystallized sugar) are usually acceptable treats. Some teachers even prefer fruit (any tolerated fruit, cut up, will do) and fancy vegetables. Most children like to share their things with the class, and I have found that bringing apple juice (or another juice) or fruit makes the children feel very good about themselves and their ability to contribute.
Another area which frequently presents problems to parents of food-allergic children, is what to do when traveling. While most restaurants will make accommodations for babies and toddlers, they are not always receptive to a school-age child bringing his own food. However, a simple request before entering the restaurant (along with a small purchase) with food for the allergic child usually suffices, and I have found most people to be willing to assist. When possible, I ask if they can prepare a plate for the child with what she can eat, explaining the reason. Naturally, we usually go to restaurants where they can provide us with this courtesy. We also travel with a supply of those foods the children can tolerate tucked into an ice chest "just in case." When traveling by air with an infant, I have found it advisable to be prepared with enough ready-to-serve formula for the length of the trip plus at least two feedings. If you must make up the formula at home, place it in a cold pack and carry it aboard with you. You wouldn't want it to be lost in the luggage bay of a 747. This method also avoids the possibility of any problems arising from use of the local water.
- Ordering a special meal on an airliner is quite risky, so it is much safer to provide your own. After requesting a special meal on day-long flight, my three-year-old was served her chicken and vegetables at 8:00 AM. and the airline provided nothing else for the rest of the day. Luckily we had brought other food with us, just in case our test run didn't work. Now that many airlines are not serving meals, carrying on your child's meal only requires an explanation when going through the security checkpoints. To avoid problems, a doctor's letter can be most helpful
Most hotels and motels have rooms equipped with small refrigerators. If they don't, you can replace the ice in a cooler from the ice machine . Some have hot-plates or even stoves in suites on which you can at least prepare breakfast in the room. Vacation is not the time to experiment with foods. Most restaurateurs are glad to answer questions about food preparation. For example: if your child loves french-fried potatoes, in what fat are they fried? (The answer may be peanut, corn, soy, sunflower or safflower oil, lard, etc.) If your child is sensitive to sulfites, is the salad, potato or fruit dipped in a sulfite solution to keep it fresh-looking? It might be safer to settle for broiled chicken and a baked potato.
Take with you any medication your child normally takes and enough of any emergency medication which the doctor recommends. Don't rely only on a written prescription, although carrying a doctor's copy of prescriptions can be helpful. Finding an open pharmacy in a strange place or getting an out-of-town prescription filled can be difficult. We also had the children wear a "Medic-Alert" tag on a necklace or bracelet when we traveled. In case of an accident, each tag lists their major sensitivities and has a phone number (with instructions to call collect) from which in an emergency, a physician can get all the child's pertinent information. While we never needed to use the tags, I was much more comfortable knowing that the children wore them.
Since food-related activities are so numerous in the pre-school and elementary school years, it is very important to find ways to keep a child from feeling different. One of the best ways is to provide him with enough food substitutes so that he doesn't feel left out and include the child in as many of the family meals as possible.
In this chapter, you will find many children's favorites recipes and alternative ingredients to substitute for allergenic ones. Included in these recipes are some commercially available products, so that when possible, these foods can be made at home. If these products are not available locally, the manufacturers' addresses are listed in the Resources section so that you can write to them or to the distributor for purchasing information.
To begin at the beginning, I have listed the various infant formulas currently available, their contents and restrictions. This is not meant to take the place of medical consultation, but to make the search for a formula easier. Since diagnosis of food allergy relies to a great extent on parental observation, comparison of a baby's reaction to a different formula (colic, irritability, stuffiness, digestive problems, etc.) will help to single out the offending elements.
NOTES ON FORMULAS
In 1980, the Federal Government passed the Infant Formula Act, which regulates the minimum amounts of nutrients which must be present in all infant formulas. (Public Law 96-359) These are the requirements as stated in that Act.:
Nutrient Recommended Minimum (per 100 kcal) Vitamin A 250.0 I.U. Vitamin D 40.0 I.U. Vitamin E 0.7 I.U. Vitamin K 4.0 mcg Vitamin C 8.0 mcg Thiamine 40.0 mcg Riboflavin 60.0 mcg Vitamin B1 35.0 mcg Folic Acid 4.0 mcg Vitamin B2 .15 mcg Pantothenic Acid 300.0 mcg Biotin 1.5 mcg Calcium 50.0 mg Phosphorus 25.0 mg Magnesium 6.0 mg Iron 0.15 mg Iodine 5.09 mcg Zinc 0.5 mcg Copper 60.0 mcg Manganese 5.0 mcg Sodium 20.0 mg Potassium 80.0 mg Chloride 55.0 mg
Excerpted from YOUR FOOD ALLERGIC CHILD by Janet E. Meizel Copyright © 2010 by Janet E. Meizel. Excerpted by permission of iUniverse, Inc.. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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