Food Allergy Living Blog

Page 1 of 72 pages  1 2 3 >  Last ›

How to Travel with Neocate

Posted 2.27.15 | Rob McCandlish, RDN

by Kathleen Smith, RDN, LDN

As the weather starts to warm up and you start to consider travelling, you have lots to consider: where to go, how to get there, and what to pack. Whether you travel by car, bus, train or plane, an advance plan for the transportation and amount of Neocate you or your family member will need for your trip will save you from additional trip stress.

First things first, calculate exactly how much formula you will need for the entire trip. You don’t want to underestimate and run out of formula, as the chances of a local pharmacy having Neocate are small! (Check here if you find yourself in that situation.) We recommend packing an extra can just in case your travel plans change unexpectedly.

Next you will want to plan the amount of prepared formula to bring with you. Neocate powdered formulas can be prepared ahead of time and kept in a refrigerator for up to 24 hours. Neocate can be kept at room temperature for up to 4 hours as long as the bottle or container has not been “touched” (i.e. no formula has been consumed). So if you have a long flight or car trip, consider bringing a little cooler for your bottles; the cooler should be maintained at a temperature of less than 40°F. Also, pack some extra Neocate powder in your formula bag in case of lost luggage or spillage of formula.

If you are flying, the Transportation Security Administration (TSA) has regulations about flying with liquids for you or your family member. Formula, breast milk and juice for infants or toddlers are permitted to be brought on board the aircraft. Older individuals (older child, teen or adult) may also travel with Neocate. Travelers must tell the TSA officer at the beginning of the screening process that they wish to bring formula, breast milk and juice in excess of 3.4 ounces in their carry-on bag. These liquids do not have to fit within a quart-sized bag like other liquids. The formula, breast milk and juice are typically screened by X-ray, and any of these liquids in excess of 3.4 ounces will receive additional screening.

Travelers are encouraged to travel with only the amount of formula, breast milk and juice needed to reach their destination. Ice packs and other accessories required to cool formula, breast milk and juice are also permitted through the screening checkpoint but may be subject to additional screening. We’ve learned from Neocate families that some TSA officers may not have encountered an older individual requiring a medical food like Neocate before. If you or your loved one is older, it may also help to bring a doctor’s note explaining that Neocate is medically necessary. TSA recommends that if you plan to travel with large quantities of medically necessary liquids you should coordinate your screening by contacting a Passenger Support Specialist prior to your flight.

For more detailed information from TSA about flying with formula, visit prior to your flight.

For more information about the screening of passengers with disabilities and medical conditions, go to Here, passengers will find information about the TSA Cares program, how to secure the services of a Passenger Support Specialist (who is trained in assisting passengers with disabilities and medical conditions through the checkpoint screening process), and what to expect during the security screening process. In addition, passengers may ask to speak to a Passenger Support Specialist or a Supervisory TSO while at the checkpoint if they need assistance. Passengers also may report concerns by emailing TSA’s Disability and Multicultural Division at

We hope you and your family have a safe and wonderful trip!


Image 1
Image 2

Neocate Shipping and Storage

Posted 2.24.15 | Rob McCandlish, RDN

It’s a cold, blustery evening on your drive home from a long day at the office. As you approach your front door you notice the Nutricia North America box sitting at your doorstep. Your initial thought is, “Oh no, can we use this after it’s been sitting here in these cold temperatures all day?”

During these cold winter months (as well as those hot summer days that will soon be upon us) it is not uncommon to wonder if our products are safe after the temperatures they have been exposed to during shipping and delivery.

Short-term exposure to temperature extremes that our products experience during shipping (e.g. being left on a porch in cold or hot weather) typically does not pose a risk to product quality or stability. Those extreme temperatures would become a concern if the product is left at those temperatures for an extended period of time, for example several days or weeks.

The temperatures that are printed on our product labels are recommended storage temperatures, which cover long-term storage of the product. They are based on the effects that extreme temperatures can have on the products over extended periods of time, typically much longer than those experienced during shipping. (With this said, Nutricia’s products are not required to be shipped in a temperature-controlled environment.)

Of note, freezing Nutricia's liquid products may affect the product's consistency, as the thawing process can affect the ability of emulsifiers to maintain a stable solution. In addition, freezing of our liquid products could also have an impact on the water-soluble vitamins (specifically Vitamin C and the B vitamins) which is certainly important to take into consideration for those individuals who rely on our products as their sole source of nutrition.

If you are ever unsure as to whether or not the Nutricia product you have received is safe to use, please do not hesitate to call a member of our Nutrition Services team to discuss your concerns.

-Kendra Valle, RDN, LDN


Image 1 source

Image 2 source

Neocate Splash Donut Holes

Posted 2.19.15 | Rob McCandlish, RDN

Recipe by Raquel Durban, MS, RD, CSP, LDN
Yield: About 28 one-inch donut holes

Oil or non-hydrogenated shortening for frying
1¼ cups white rice flour* (or other approved flour substitute) (200 g)
1 drink box Neocate Splash, Unflavored*
2 Tbsp granulated sugar, optional (25 g)

1. Fill a shallow, heavy saucepan or Dutch oven with oil or shortening to at least ¼ inch deep (or up to 1 inch deep*). Place on stove over medium heat until oil is hot, but do not allow oil to smoke. If you have a kitchen thermometer, oil should be between 350-370’ F. If you do not have a thermometer, dip tip of wooden skewer or strand of spaghetti into oil: it’s ready when you see a lot of small bubbles.

2. While oil heats, mix all remaining ingredients in a medium bowl with a whisk until well combined. Dough consistency will resemble thick cake frosting.

3. Once oil is hot, drop dough by rounded teaspoonful into oil in small batches of a few at a time. Fry for 1-2 minutes, gently stirring continuously and flipping at least once halfway through cooking using a heat-safe spatula or fork, until golden brown on all sides. Remove donut holes from oil with a slotted spoon and drain on a plate lined with paper towels or a drying rack set over a baking sheet.

4. Repeat with remaining dough, frying in small batches, allowing oil to reheat between batches. Let donut holes cool a few minutes before enjoying.

5. Optional: Toss or dip freshly cooked donut holes in toppings such as powdered sugar, sugar + cinnamon, sugar + cocoa powder, non-dairy glazes or dessert sauces, or even a savory combination of salt and spices. Creative cooks can even fill donut holes with jam!

*Notes: Recipe can be halved. Uncooked dough can be refrigerated for up to 24 hours and cooked the following day. Can substitute ½ cup non-dairy beverage for ½ cup of Neocate Splash, Unflavored for a lighter flavor.

Recipe tested using Bob’s Red Mill Stone Ground White Rice Flour, which many gluten-free home cooks rely on for baking due to its fine consistency, which absorbs water well. Using another flour substitute can affect consistency, cooking time, and nutritional composition. For a different flour, you may want to “rest” the dough for 30 minutes to absorb moisture before frying.

Frying in deeper oil yields donut holes with a more rounded shape. Make sure oil is the right temperature: Donut holes cooked in cold oil can stick to the pan and will absorb a lot of oil, becoming greasy. Oil that’s too hot will smoke (which affects taste) or even catch fire.

To bake instead of frying: Place a non-stick, metal donut hole pan (or similar mold shape) into a cold oven and preheat oven to 350’ F. While oven heats, mix all ingredients. Optional: for best consistency, add 1 tsp of allowed baking powder to the dough. Once oven is preheated, pull the pan out and carefully distribute dough among wells. Bake 5-10 minutes until puffed and bottoms are golden brown, rotating pan halfway through cooking. Donut hole tops will be light in color.

Nutrition Information per Serving:
Serving Size: About 4 one-inch donut holes
Servings per Recipe: About 7

Calories: 220
Protein: 2.7 g
Fat: 9.9 g
Carbohydrate: 30.0 g
Calcium: 42.9 mg
Vitamin D: 27.1 IU (0.67 mcg)

Nutrition information provided for fried donut holes, with optional sugar included but without toppings. Nutrition information will vary if recipe is baked instead of fried, if ingredient substitutions are made, and if toppings are included.

This recipe comes from Raquel Durban, a Registered Dietitian specializing in immediate and delayed food allergies in Charlotte, NC. Raquel is a medical advisory board member for the Food Allergy and Anaphylaxis Connection Team (FAACT) and Parents of Allergy Kids (PAK) Charlotte and an active participant in the American Academy of Asthma, Allergy and Immunology (AAAAI). We would like to thank Raquel for this recipe.​

It only takes a cupcake…

Posted 2.13.15 | Nutrition Specialist

…to cause a cascade of unfortunate events for a child with a food allergy. Besides having to say “NO” to the tasty treat due to potential allergy-triggering ingredients, the student may encounter taunting and teasing from classmates for having an allergy- insult icing!

Both the number of children with food allergies and bullying incidents of these kids are on the rise. According to a 2013 study by the Centers for Disease Control and Prevention, food allergies have increased in children approximately 50% between 1997 and 2011, estimated at nearly six million children, or 8% of kids in the U.S and roughly two in every classroom. Unfortunately about one-third of these kids are bullied because of their allergies. This can run the gamut from being barred from activities involving food by teachers to name calling by peers or even threats to the allergic child using the potential food allergen. Faced with this, the allergy-challenged child experiences increased stress and anxiety. This may lead to their not eating during school, avoiding school or even succumbing to peer pressure and forgoing the off-limits food, in spite of possible harmful side effects. Bullying can be both emotionally and physically damaging.

Parents, teachers, and the community can be instrumental in curbing food allergy bullying. Scripting responses, role playing scenarios and running interference with school personnel are ways parents can help. Kelly Huth writes about these and offers suggestions and supporting information for parents on this website.

Guidelines for schools and training materials are available through the Food Allergy & Anaphylaxis Network (FAAN) on their website. The School Nutrition Association has training available to members on their School Nutrition University website. Online training for non-healthcare school personnel developed by FAAN and the Food Allergy Initiative can be found on their website.

 The Food Allergy Research & Education (FARE) has an online public campaign - “It’s Not a Joke” - that has sparked a lot of media attention to food allergy bullying. Their PSA, along with other materials, are available on the campaign website

What Every Parent Must Know about Managing Food Allergies at School: Must-know facts for establishing a safe and inclusive school environment.

CDC Guidelines: The Gold Standard for Food Allergy Management in Schools: Highlights from the CDC Guidelines: Developing a Food Allergy Management and Prevention Plan (FAMPP); Following Federal Laws; Recommendations for Safety and Inclusion; Actions for District and School Administrators and Staff

For additional information and resources consider:

Sharing information and resources on the serious nature of food allergies and increasing awareness of the dangers of food allergy bullying is a way to be a change agent for kids with allergies. Spark some attention to this- spread the word. Be the icing on an allergy-free cupcake!

-Jody Benitz


1.        Allergy statistics. American Academy of Allergy, Asthma, and Immunology website.
2.       Food allergies: what you need to know. US Food and Drug Administration website.
3.       Lieberman JA, Weiss C, Furlong TJ, Sicherer M, Sicherer SH. Bullying among pediatric patients with food allergy. Ann Allergy Asthma Immunol. 2010;105(4):282-286.

Image source

Tube Feeding: Troubleshooting Tips

Posted 2.3.15 | Mallory West

Many Neocate babies and children receive their formula through a feeding tube. Common Neocate formulas that are received through feeding tubes include Neocate Infant DHA/ARA, Neocate Junior, Unflavored, and Neocate Splash, Unflavored. Enteral tube feeding provides nourishment to individuals who are unable to consume adequate nutrition by mouth. If your child uses a feeding tube, you know that there may be some occasional tube feeding complications. This blog will provide some general troubleshooting tips for the most common tube-feeding problems.

Clogging of the Feeding Tube:

Sometimes a feeding tube will become blocked so that no food can go through.

How to Fix Clogs:

  • First, using a syringe to gently remove the liquid on top of the blockage, if possible (throw away the fluid removed).
  • Next, gently flush the tube using lukewarm water, using at least a 30 mL (1 oz) syringe. Gently plunge the water back and forth to clear the blockage.
  • Unless directed by a healthcare professional, do not use acidic solutions such as fruit juices or cola as they may curdle the formula.
  • If the tube is still clogged, clamp the tube for around 10 minutes and then try flushing it again.
  • If the tube the clog remains, gently squeeze the tube between your fingers along the length of the tube as far as possible.
  • If you are still unable to clear the blockage, contact your healthcare professional for advice. Sometimes, the physician will prescribe a special enzyme which can dissolve the clog. If the clog cannot be cleared, the tube will have to be replaced.

How to Avoid Clogs:

  • Tube flushing is the most important factor for preventing the feeding tube from clogging. Use a syringe to flush 20 mL of warm water through the feeding tube before and after feedings and medications (or as directed by your healthcare team). If your child receives a continuous feed, your healthcare provider may recommend flushing with water during the feed to prevent clogging.
  • Use liquid medications whenever possible. If pills are necessary, crush them well and mix them with a small amount of warm water. Use a syringe to draw up the solution and insert it into the feeding tube. If pills are coated or time-released, discuss this with the physician because these types of pills are typically not meant to be crushed.
  • Do not mix medications together and do not mix medications in formula unless instructed to do so by your healthcare provider.

Tube Site Irritation or Infection:

Redness, pain, swelling or unusual/excessive drainage, as well as fever, can all be signs of an infection at the stoma site (the surgical opening through which a gastrostomy tube (g-tube) or jejunostomy tube (j-tube) enters the stomach or small intestine).

How to Avoid Irritation or Infection:

To avoid infection, it’s important to keep the stoma site clean and dry. Your healthcare provider should give you specific recommendations for how to clean the stoma site each day. For more information on keeping the stoma site clean (from a parent’s point of view), check out this informative article from Complex Child E-Magazine.

A Dislodged Feeding Tube:

If the feeding tube comes out, call the doctor and go to the hospital right away. The stoma can close up very quickly so the tube needs to be replaced promptly. Cover the site with clean dressing or bandage to prevent leakage and immediately seek medical attention.

Sometimes the healthcare provider will train you to replace the feeding tube yourself (temporarily or permanently) but you should ONLY do this if directed and properly trained by your child’s physician.

How to Avoid:

Young children occasionally pull the tube out themselves. Keep the tube covered with clothing to prevent this. Onesies work well for infants and toddlers. It’s also important to secure the tube during activities so that it doesn’t get pulled out. You can use various methods to secure the tube. Some companies make special wraps and clothing for protecting and accessing the feeding tube:

Do you have any troubleshooting tips to share with other tube-feeding families? What problems have you encountered and what tricks have you learned?

- Mallory

Feeding Tube Awareness Week 2015

Posted 2.3.15 | Rob McCandlish, RDN

It’s almost here – February 8-14, 2015 is Feeding Tube Awareness Week! This year’s theme is ‘The truth about tube feeding.’ FT Awareness Week was founded by the Feeding Tube Awareness Foundation (FTAF) and is also supported by a partnership with The Oley Foundation. Neocate and our Food Allergy Living blog help support Awareness Week, because a lot of Neocate families depend on a feeding tube to deliver formula. New this year, Feeding Tube Awareness Week has its own website! See below for more information and ways that you and other Neocate families can help celebrate and spread the word!

Feeding Tube Awareness Foundation

The FTAF is dedicated to providing information and support to families who have tube-fed children. FTAF launched Feeding Tube Awareness Week in 2011, and it’s been growing ever since! The FT Awareness week website includes some great materials to guide you in asking your local media to help. This is an ideal time to raise awareness of feeding tubes in your community to promote greater acceptance and understanding. If you’re new to FTAF, please visit their inspiring stories page and FTAF’s facebook page, which gets loads of visitors during FT Awareness Week!

The Oley Foundation

The Oley Foundation is dedicated to sharing information and supporting families who deal with tube feeding. They partnered with the FTAF on Awareness Week in 2012, and have a page full of great suggestions for activities to promote Awareness Week. They are asking for photos and video clips for this year’s Feeding Tube Awareness video – you can see the 2014 video they produced here. If you’re new to the Oley Foundation, please visit their support community to connect with other tubie families. You can also visit the Oley Foundation’s facebook page.

Let’s all give thanks to these great organizations for helping educate people in the community about feeding tubes. Please inform others about how many precious little ones’ lives have been improved and saved with the help of feeding tubes.

What will you do this year to help promote Awareness Week?

- Rob


Enteral Tube-Feeding: Understanding the Basics

Posted 1.29.15 | Mallory West

Although most Neocate users drink their formula, many patients receive Neocate through a feeding tube. This is referred to as “enteral nutrition”. Those of you with tube-fed family members are already experts on the subject, however, I hope this post will be useful for those of you who are new to tube feeding or for those of you who are just interested in learning how it works.

Tube feeding provides nutrition to someone with a medical condition that impairs his/her ability to eat or drink (or impairs their ability to consume enough to sustain his/her nutritional needs). Nutrition is provided by a special liquid food that is given through the feeding tube.

The liquid food contains all components of nutrition (protein, fat, carbs, vitamins and minerals) so it provides everything a person needs to live and be healthy. Some people are exclusively tube-fed while others continue to eat food while supplementing with tube-feeds. Fluids and medications (most of them) can also be given through the tube (which is a nice perk for kids who require some bad-tasting meds!).

Types of Feeding Tubes

There are various types of feeding tubes. A nasogastric or nasoenteral tube is inserted through the nose into the stomach or small intestine[1]. Alternatively, a tube may be surgically inserted through the skin and directly into the stomach or the small intestine in a procedure called a gastrostomy or jejunostomy, respectively. You may hear these refered to as a “g-tube” (short for gastrostomy tube) or a “j-tube” (short for jejunostomy tube). Patients with g-tubes may get a feeding port (commonly known as a MIC-KEY button or a mickey tube), so that the outside feeding tube only needs to be attached during feedings.

Methods of Tube-feeding

There are 3 ways that tube-feeds are administered:

  • Gravity: With gravity feeds, a bag of formula hangs above the patient so that the formula flows down the tube.
  • Syringe: With syringe feeds, formula is administered by hand using a syringe to push the formula through the tube.
  • Feeding pump: An electronic pump moves formula through the feeding tube at a controlled rate. Common brands of feeding pumps include the Kangaroo pump and the Infinity pump.

Feeding Rates

  • Bolus feedings: Bolus feedings are relatively large in volume and given over a relatively short period of time. Feedings are given several times a day and the schedule more closely resembles “mealtimes” in comparison to a continuous feed.
  • Continuous/drip feedings: Feedings that are given at a slow rate, over a relatively long period of time. Continuous feeds may be indicated for patients who are unable to tolerate large volumes.
  • Combination: Some people may do a combination of both types. For example, they may receive bolus feeds during the day and a continuous feed overnight.

Enteral nutrition is such an amazing example of the impact that medical technology has on our lives. Before there was enteral nutrition, the inability to eat was a life-threatening situation. Although nobody wants to rely on a feeding tube unnecessarily, it is such a blessing for those who could not live without it.

My younger sister Caroline got her G-tube about 6 years ago (she was 11). We tried to avoid it for so many years but once she got it, it turned out to be such a blessing in disguise! She has never looked healthier; she gained some much-needed weight, her hair and skin look so much healthier, and she’s so much stronger. Our family is so thankful for it! If you have come across this post because your little one is getting a feeding tube, I hope this gives you a new and optimistic perspective!

Do any of you have experience with a feeding tube? What impact did it have on your child’s life? What are the biggest obstacles you experience with a feeding tube?


[1] American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.).


Understanding Expiration Dates

Posted 1.27.15 | Nutrition Specialist

Is the expiration date really that important? Can we use Neocate after the expiration date? What will happen if my child consumes Neocate after it’s expired? These are questions we hear often here at Nutricia North America. In today’s post, we’re hoping to clear up any confusion regarding expiration dates.

An expiration date on any product, not just Neocate products, is based on several factors. One being the durability of the packaging materials. We want to ensure the packaging will keep the contents safe until the expiration date.

Another is the stability of the ingredients. For example, some ingredients break down over time which can affect the smell or taste of the product. We want to ensure that the product is at the highest possible quality during the duration of the shelf life.

A final factor which is probably the most important is to ensure that the nutrients in the product are present at the levels on the label. Nutrients, particularly vitamins, have a tendency to naturally break down over time, some faster than others. Especially since many individuals use our products to meet a large portion of their nutritional needs, it’s very important that the right amount of each nutrient is in the product. We conduct extensive testing under a number of conditions to ensure that the nutrients hold up through the expiration date.

Federal regulations require a "use-by" date on the product label of infant formula under FDA inspection(1), and rightfully so.  The ultimate intent of an expiration date is to keep our customers safe and ensure they receive the nutrients that they expect. With that being said, we cannot recommend using any of our products past the expiration date. If you still have questions, the best thing to do is to share this information with your healthcare team for their guidance.

-Kendra Valle, RDN, LDN

Your Hands and Your Baby’s Formula

Posted 1.22.15 | Nutrition Specialist

by Kathleen Smith, RDN, LDN

In your daily rush to take care of your baby along with all your other responsibilities, sometimes we take shortcuts to accomplish everything or just forget about certain safety steps that will decrease your baby's risk of foodborne illness and exposure to allergens.

Germs and allergenic proteins can easily be transferred from hands to formula and food. One of the best ways to help decrease the risk of foodborne illness and allergic reactions is for mothers and caregivers to wash their hands with soap and water before preparing baby formula and food. 

Healthcare providers are concerned about hand washing because of a study by the Food and Drug Administration and Center for Disease Control about the infant formula feeding practices of 1,533 mothers. The study found that over half of the mothers, of even young infants, did not always wash their hands with soap before preparing formula for their babies (1). 

How should you wash your hands?(2)

·         Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.

·         Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.

·         Scrub your hands for at least 20 seconds. Need a timer? Hum the "Happy Birthday" song from beginning to end twice.

·         Rinse your hands well under clean, running water.

·         Dry your hands using a clean towel or air dry them.

Hand-sanitizers will not get rid of food protein residues and do not eliminate all types of germs. Washing hands with soap and water is the best.

When should you wash your hands? (2)

·         Before, during, and after preparing food

·         Before eating food

·         Before and after caring for someone who is sick

·         Before and after treating a cut or wound

·         After using the toilet

·         After changing diapers or cleaning up a child who has used the toilet

·         After blowing your nose, coughing, or sneezing

·         After touching an animal, animal feed, or animal waste

·         After handling pet food or pet treats

·         After touching garbage

We hope you find this helpful!


(1) Labiner-Wolfe L, Fein SB, Shealy KR. Infant Formula-Handling Education and Safety. Infant Formula – Handling Education and Safety. Pediatrics 2008; 122; S85

(2) Center for Disease Control and Prevention. Hand Washing: Clean Hands Saves Lives.  Available at: Accessed on July 25, 2014

Image 1

Image 2

Families Value Dietitians

Posted 1.21.15 | Rob McCandlish, RDN

In our previous post, we heard from a Registered Dietitian Nutritionist (RDN or RD) who helps families to manage food allergies. She explained the role of an RD in her post. This week, we wanted to share some research out of the United Kingdom that reveals the value families find in working with an RD to manage a child's food allergies. You can read an abstract of the research here

Background: We know that there are ways that an RD can help families with food allergies to manage their diet, both in planning to avoid foods as well as ensuring adequate nutrition. We can see how this might improve quality of life, but is there any proof? The research team set out to explore the benefits families get from meeting with an RD regarding the child's food allergies.

How: The research team met with 17 mothers, all of whom attended the same allergy center for dietary advice. They conducted focused discussions on various aspects of dietary advice to manage food allergies.

Outcome: The moms revealed that two of their main goals were to protect their child from the food allergy and to keep life as normal as possible. The RDs that they met with helped them to become experts in their child's food allergy so that they could ensure a safe and nutritionally sound diet. Dietitians also provided these moms education as well as advocacy and emotional support.

So there you have it - dietitian's provide real value to families who are managing food allergies! Have you or your family gotten to work with an RD in managing food allergies? If so, what value did it bring to you?



Page 1 of 72 pages  1 2 3 >  Last ›

About Us

Food Allergy Living is a resource for parents of children with food allergies, brought to you by Nutricia, the makers of Neocate. For more in-depth information about our purpose & authors, see our About Food Allergy Living page.