MS, RD, LDN, CSSD, CBS
Rachel holds a Master’s in Nutrition Communication from Tufts University and is also a Board Certified Specialist in Sports Dietetics. She works as a nutrition and wellness coach with focuses on infant and maternal nutrition, and mindful eating.
Raising a child with food allergies can be daunting and definitely requires extra time, attention, and effort. There are, however, a number of measures you can take to alleviate stress while maintaining a safe eating environment for your baby. Know that you are not alone in this effort. According to the Center for Disease Control (CDC), food allergies are on the rise, with about 1 in 13, or 8 %, of children being allergic to at least one food. The good news is that the rise in food allergies has led to increased allergy awareness, education, regulation, and labeling; as well as more allergy friendly restaurants and food allergy policies in schools and daycares.
First and foremost, always be your own detective when it comes to food allergens, and never make assumptions based on word of mouth or past experiences. Reading labels (when available) is critical but know that food ingredients and menu items can change, even in longstanding products. Keep in mind that allergens may not be obvious – they can (and do) hide in coatings, thickeners, spices, natural flavors and other ingredients found in fresh, frozen, refrigerated and shelf-stable foods, salad bars and restaurant meals. Did you know that germ, seitan, and tabbouleh all contain wheat? When in doubt, ask! Ask the staff of grocery stores, restaurants and food manufacturing companies to get all the facts.
Also keep an eye open for market recalls due to cross contact, which is when an allergen comes into contact with, and therefore contaminates, another food or food product. Cross contact can occur in manufacturing facilities, restaurant deep fryers, deli meat blade slicers, ice cream scoops, prep bowls, even the cutting boards in your own home. Cross contact is a serious issue, as even a tiny amount of an allergen is enough to cause a reaction in some people.
Strategies for eating at home
Preparing more foods at home is a smart strategy for maintaining greater control over your child’s food sources, minimizing cross contact, and limiting her processed food consumption. Not to mention that limiting processed foods is generally an additional boost to her good health since processed foods tend to be higher in salt, sugar, and fat.
When food shopping, read labels carefully. Foods containing major allergens must now clearly declare those allergens on the label, thanks to the Food Allergen Labeling and Consumer Protection Act (FALCPA), effective January 1, 2006. The allergen will be stated either in parenthesis after a particular ingredient (for example, albumin (egg), lecithin (soy)) or listed at the very end of the ingredient list proceeding the word “contains” (for example, “Contains egg and soy”). FALCPA applies to all packaged food sold in the United States after 2006, regardless of where the food was originally manufactured.
FALCPA, does NOT apply, however, to labels on meat, poultry and certain egg products. Nor does FALCPA require food labels to note any potential cross contact of food allergens during manufacturing. Though know that the potential for cross contact during manufacturing is a real risk and is often a reason for recalls. Many manufacturers have electively chosen to include the statement “May contain (allergen)” or “Produced in a facility that also uses (allergen)” as a courtesy to consumers, but these warnings are not regulated, nevertheless they should not be ignored. Also, it is best to avoid products you suspect could be cross-contaminated or mislabeled.
Strategies for eating out
When eating out, there is no shame in speaking with your server about your child’s dietary restrictions and asking for a detailed ingredients list. If a server cannot answer your questions, then ask to speak with the chef or a manager. We also recommend, when feasible, calling a restaurant in advance, during slower service times – such as at 11am before the lunch rush, or 5pm before the dinner rush – to plan ahead.
Remember you can always chat with a Happy Family Milk Mentor to create an individualized plan based on your child’s specific allergies.
Avoid your child’s known food allergens
Read food labels
Always check ingredient lists. Don’t hesitate to ask chefs, servers and manufacturers about any unfamiliar or ambiguous ingredients (like spices or natural flavors).
Inform anyone handling your child’s food about specific allergies
Educate caregivers and schools about your child’s specific allergies and be ready to strategize with them.
Be prepared to combat exposure to an allergen
Keep antihistamine and epinephrine (if prescribed by your physician) with you (or with your child if she is away from you) at all times. Consult with your pediatrician and/or allergist to have a plan of action in place should exposure to an allergen occur.
Avoid riskier food choices
Buffets, bakeries and restaurants with pre-made foods are full of potential allergy pitfalls. Ask questions, or avoid these establishments altogether.
Spread the word
Carry cards that list your child’s food allergies and hand them out to caregivers, waiters, chefs, family members and more!
Plan ahead! And take special precautions when traveling
Call restaurants in advance and speak to the manager to find out if your child’s food needs can be accommodated. Pack safe, non-perishable foods and snacks just in case. Also be sure to notify airline attendants, hotel agents, and visiting family members of any allergies when traveling. (If traveling abroad, you can purchase translation cards made for this purpose).
Stay tuned to market recalls due to cross contact with allergens. The Kids with Allergies organization has a useful blog of food recalls.
Cook more at home and eat fewer processed foods
Taking these steps alone will lessen the risk for exposure and cross contact with allergens while also improving your family’s overall diet.
Keep the most common food allergens in mind if you suspect your child is experiencing additional allergies
FALCPA has identified these eight food items as being the culprits behind the majority of food allergies: milk, eggs, peanuts, tree nuts, soy, wheat, fish and crustacean shellfish. Also be aware that certain seeds, including sesame and mustard seeds, are common food allergy triggers and are considered a major allergen in some other countries.
Most importantly, never make assumptions – always ask!
“Kids with Food allergies.” A division of the Asthma and Allergy Foundation of America. Gupta, Ruchi S, Elizabeth E Springston, Manoj R Warrier, Bridget Smith, Rajesh Kumar, Jacqueline Pongracic, and Jane L Holl. “The prevalence, severity, and distribution of childhood food allergy in the United States.” Scholars Northwestern. Volume 128. Issue 1 (2011).