Food Allergy and Intolerance
Allergy and intolerance to foods are more common in young children because their bodies are not yet fully developed. The good news is that most children grow out of their food allergies. The incidence of food allergy is low and tends to run in families.
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What is a food allergy or intolerance?
Food allergy and food intolerance are different. Food allergy is a reaction to a protein involving the body's immune system, which causes antibodies to form in the blood. A reaction usually occurs within minutes or hours of consuming a particular food and can be serious.
In contrast, food intolerance is generally a reaction to a chemical found naturally in a group of foods but does not involve the body's immune system. Food intolerance can be more difficult to diagnose, as it results from a build-up over several days of a particular chemical found in a range of foods.
Allergic reactions can be severe and usually occur in young children, whereas food intolerance may come and go at any age. The good news is that most infants will grow out of their food sensitivity by the age of four or five, although allergies to certain foods such as nuts and seafood can last a lifetime.
Symptoms
Symptoms of food allergy can include swelling, itching, wheezing, diarrhoea, vomiting and eczema. Food intolerance may produce similar symptoms, but are dose related -there is a critical amount of food or food component that must be consumed before symptoms appear. Because all these symptoms can be due to a variety of reasons, it is important to see your doctor if you suspect your child has an allergy or intolerance to foods.
Common causes
Foods that can cause reactions include nuts (in particular peanuts), milk, eggs (especially the white), fish, shellfish, wheat or other gluten-based cereals, nuts, seeds, chocolate, honey, tomatoes, some fruits and meats.
The diagnosis of a food allergy or intolerance is complicated and can only be made after appropriate tests from a trained professional to exclude other causes.
What do I do?
- If there is an immediate family history of food allergy, breastfeeding is important. Exclusive breastfeeding for the first six months may help protect your baby from allergy. It is also wise not to introduce solids until six months of age.
- Peanut allergy can be severe. If there is a family history of peanut allergy, peanut products should not be used until your child is three years old. Breastfeeding mothers should also avoid peanuts, as peanut allergen can pass from breast milk to the baby.
- Introduce new foods to your baby slowly to minimise the possibility of food allergy or intolerance. When starting solids, select bland foods that are less likely to cause a problem. Introduce a new food no more than every five to ten days and begin with just a teaspoonful. This way you can determine the cause if there is a reaction.
- Cheese, yoghurt, ice cream, fish, and wheat cereal should be delayed until 12 months of age if there is a strong family history of allergy.
- Foods that cause problems need to be replaced with nutritious alternatives. If a special diet is required, it is advisable to seek the advice of a dietitian to ensure that your child's diet is nutritionally balanced and adequate for your child's growth and development.
What you need to know about food allergy and intolerance
What foods are most likely to cause a food allergy or food intolerance?
Foods that are often the cause of allergies include nuts (especially peanuts), eggs, milk and milk products, wheat and seafood. Common foods that can cause intolerance include lactose, cheese, oranges, chocolate and tomatoes.
Your range for food sensitive infants includes two products that contain soy. Isn't soy an allergen?
It can be for some people. However, for those infants with a dairy intolerance, soy is sometimes a good alternative. The Golden Circle soy products have been developed with these children in mind.
What are the symptoms I should look out for, and what should I do?
With an allergic reaction, symptoms to look out for include itching and swelling around the mouth, vomiting, cramps and diarrhoea. Seek help from your doctor should these symptoms occur. Symptoms of food intolerance include recurrent hives, stomach pains, mouth ulcers and bowel irritation. However, it may be that your baby is unwell for reasons unrelated to food, so you shouldn’t jump to your own conclusions. Check with your specialist health professional.
How important is professional diagnosis?
Very. Your own diagnosis could be inaccurate and you could be limiting your baby’s diet unnecessarily, which could lead to them missing out on important nutrients. Your specialist health professional can provide accurate diagnosis and advice for on-going management.
For more information on food allergy and intolerance, check out Nutrition Australia’s website on www.nutritionaustralia.com.au. Remember, if you suspect your child has a food allergy or intolerance, consult your health professional.
Lactose Intolerance
This is a condition where the body is unable to break down the milk sugar lactose. Symptoms can include bloating, stomach cramps, flatulence or diarrhoea.
What do I do?
- See your doctor to confirm a diagnosis of lactose intolerance.
- Seek professional advice from a dietitian when planning your child's diet. Because milk is an essential source of calcium and protein, a nutritious substitute needs to be found.
- Soy (except soy formula), rice & other vegetarian beverages are not recommended as alternatives to breast milk or formula in the first two years of life.
Vegetarian Diets
However, the exclusion of all animal products is not recommended for young children as this type of diet can inhibit normal growth. Always seek advice from your doctor, dietician or child and family health nurse if you plan for your baby to be vegetarian.
What do I do?
- A fortified soy infant formula is recommended from the time of weaning. After your baby is a year old, calcium-fortified soy drink should be included. Because young children have small stomachs, they may not be able to eat sufficiently large amounts of high fibre foods (that form the bulk of a vegetarian diet) to obtain sufficient energy or calories for growth. Including several snacks and some higher fat foods such as peanut butter and cheese will help overcome this.**
- After six months, ensure you offer your baby iron rich foods such as iron fortified infant cereal and legumes (eg lentils and beans). It is important to include fruit or vegetables containing vitamin C at the same meal to maximise iron absorption. After eight months, egg yolk and smooth nut butters** are nutritious foods that supply iron. In addition to protein, legumes are also good sources of iron, zinc and soluable fibre.
- From about eight months, ensure your baby receives sufficient protein by including foods such as:
- legumes or beans with bread or cereal (eg lentils with rice or baked beans on toast)
- dairy food or eggs with bread, cereals, legumes or nut butter **(eg iron enriched cereal with milk)
- bread or cereal with nuts (eg peanut butter sandwich**).
- It is recommended that vegetarian mothers breastfeed their baby for as long as possible - preferably for two years.
** Note: If there is a family history of allergy, avoid peanuts until your child is three years old.
Overweight and Obesity
One of the most alarming health problems in Australia and New Zealand is the increasing incidence of overweight and obesity in children. These contribute to the risk of immediate and long-term problems including diabetes, high cholesterol, high blood pressure, sleep apnoea, musculoskeletal problems, liver disease and psychological problems.
Evidence suggests that overweight children and adolescents have a greater risk of obesity in adulthood.
What do I do?
- Never force-feed your child - they are well equipped to detect when they are full. If your child is not hungry, try again at the next meal or snack time.
- Using food as a reward can increase a child's preference for that food and create problems later. When children observe adults consuming a food, it's likely the child will do the same. So it's important that your child sees the whole family eating nutritious healthy foods.
- When trying to introduce a new food eg a green vegetable, don't give up after just one or two attempts. It can take eight - nine tastings over a relatively short time (eg three weeks) of a new food before our tastebuds are familiar enough with the food to be able to decide whether we like a food or not!
- Low fat diets are not suitable for babies because fat provides both a concentrated energy source, essential fatty acids required for the development of the nervous system, and fat soluble vitamins necessary for healthy growth. Peanut butter and avocado contain a good mix of healthy polyunsaturated and monounsaturated fatty acids.
- Reduced fat products such as skim milk are only recommended from two years of age.
- If you are concerned about your child's weight, seek professional help. A dietitian will help plan a suitable, nutritious diet.
- Encourage children to be active - involve them in plenty of outdoor activities. Aim to be an active family.
Iron Deficiency
Iron is particularly important for the development of your baby's brain and nervous system. Iron deficiency, or anaemia, is the most common nutritional problem in babies worldwide, and can have long-term effects.
Iron deficiency rarely occurs before four -six months because the baby is born with its own stores. However, after six months of age it is important to include iron rich foods in your baby's diet.
What do I do?
- Breastfeed or use iron fortified infant formula until your baby is at least a year old.
- Introduce an iron fortified infant cereal at about 4-6 months (but not before four months). This can be used up to two years of age.
- Introduce meat, chicken and fish from six months as well as beans and lentils from nine months. Talk to your doctor, dietician or child and family health nurse if your baby is vegetarian.
- Cow's milk is a poor source of iron and should not be used as the main milk source until your baby is a year old.
- From two years, iron fortified adult cereals can replace baby cereals.
- Include fruits and vegetables which contain Vitamin C (apple, pear, potato, banana) to enhance the absorption of iron from other foods.
