Food Allergy Living Blog

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Experts Say When in Doubt, Emergency Teams Should Use Epinephrine

Posted 10.1.15 | Nutrition Specialist

In a recent article published by the American College of Allergy, Asthma and Immunology (ACAAI), a panel of allergy experts and emergency physicians advise that emergency medicine teams should administer epinephrine to any patient they suspect is experiencing an allergic reaction.  This challenges previous recommendations that the decision to use epinephrine should be weighed more carefully.

Epinephrine is considered by doctors to be the first line of defense in an episode of anaphylaxis, or a life-threatening allergic reaction. In the past, medical teams might have hesitated to administer epinephrine to patients unless the patient’s reaction met multiple criteria. Now, experts are looking at it a different way.

“The consequences for not using epinephrine when it’s needed are much more severe than using it when it might not be necessary,” said Stanley Fineman, MD, ACAAI.

Fineman and fellow panel members also say epinephrine should be given to patients at risk of an anaphylactic reaction.  At-risk patients are those who have had a previous severe reaction, or those who have ingested a food known to trigger an allergic reaction. Emergency medicine teams should administer epinephrine regardless of whether symptoms are apparent.

Additional key recommendations to emergency medical teams include:

  • When in doubt, administer epinephrine.
  • Epinephrine, in appropriate doses, is safe, and there are no absolute contradictions for its use in treating anaphylaxis.
  • It is not necessary for the established medical criteria to be met to administer epinephrine.
  • Patients treated in the emergency setting for anaphylaxis or for severe allergic reactions, or those who are at risk of a future event should be provided with a prescription for epinephrine autoinjectors and an action plan for their use before discharge from the hospital.
  • Patients should be referred to an allergist to assist with diagnosis confirmation, trigger identification, and continued outpatient management.
  • Use epinephrine as the first-line therapy for anaphylaxis, for severe allergic reactions, and for mild symptoms following a suspected exposure to a trigger that has previously caused a serious allergic reaction.

As a caregiver, what should you do?

Watching someone close to you have a severe allergic reaction is scary, and preparing in advance is the best thing you can do. Put an action plan in place today, and start by talking to your healthcare team to get their guidance on how to handle suspected allergic reactions. Make sure anyone involved in caring for your loved one also knows the plan. If you believe that your loved one may be experiencing an episode of anaphylaxis, don’t hesitate to use epinephrine and call 9-1-1. For more information, you can read the full publication here.

Who Says Mealtime Can’t Be Fun?

Posted 9.29.15 | Nutrition Specialist

Getting kids involved in preparing meals and doing fun activities together before and during mealtimes can help to build healthy habits. Children with food allergies may especially benefit from positive activities centered around mealtime to remind them that food can be fun. Even though a special diet might require a little more thought and planning, it’s important to create these positive experiences.

Description: C:\Users\valleke\AppData\Local\Temp\notesE8B3C6\Capture Blog PIC.PNGInvolving children in preparing meals is a great way to build autonomy and confidence. What better way is there to teach children about food than to actually involve them in the process with their own hands?  Bring them along to the grocery store with you and have them help you choose ingredients. Involve them in the preparation and cooking process based on their abilities for their age. Try turning the TV off and store electronics away during meals, as mealtime can be a great opportunity for families to bond and catch up on each other’s days.

Here are some fun ideas for activities that families can do during mealtimes to have fun, learn about food, and enjoy mealtime together!

Play Restaurant

Children love to play “restaurant” at home. At a family meal, let your child pretend to be a waiter or waitress. First tell your child what is on the menu for dinner. Then give your child a small pad of paper and a pen to take orders from the customers. Let him or her serve the food and then he or she can leave the check. To extend the play, ask your child to create their own “real” menus for the next meal.

Thankful for ABC

What are you thankful for? Even on our worst days, we can still find things for which we are grateful. Go around the table and have each family member share something for which he or she is grateful in alphabetical order. For example, you’re thankful for apples, your son is grateful for bananas, and so on until everyone is feeling thankful from A to Z!

Family Recipe Cards

Your child can create a recipe card for any simple meal, for example “How to make a turkey sandwich.” Give your child paper or index cards and writing utensils and ask him or her to draw each step as you make the sandwich. If your child likes this activity, he or she can make a whole set of recipes.

Taboo Story

Each family member takes turns talking about his or her day, but first picks a letter. Words beginning with that letter may not be used in the description of one's day. The “taboo words” can make these stories a comical vocabulary exercise. Make sure each family member gets a chance to participate.

Theme night

To change up your routine, offer a theme meal night or host a dinner dress up night! Some ideas you can include: International Night, Halloween, Luau, Pajama Night, Breakfast for Dinner, Backwards Day.

Ingredient Race

Pick one of the ingredients from a meal and put it on the counter or in the center of the table. Give everyone 2 minutes to write down as many meals that use that ingredient as possible. Whoever comes up with the most meals wins!

What are some fun mealtime activities you and your family engage in? We’d love to hear your ideas!

-Hilary Smith, RD


Image source: Stephanie Sicore

Food Allergy-friendly Family Night Activities

Posted 9.25.15 | Nutrition Specialist

Busy, busy, busy! Our lives seem to be non-stop with everyone in the family going in different directions with work, school and activity schedules. Having some designated time for the family is important for bonding and reconnecting. For those with food allergies, making this time a non-food event is also important. Make it a priority, plan it out, turn it OFF (TV, computer and video games) and make it fun. Following are some ideas and resources to help you get started.

Game Night

If there’s one thing that everyone in the family can do at the table that doesn’t involve food, it’s games! Designate a weekly family game night and make it a priority to get everyone involved. Rotate which family member gets to choose which game to play each week. You’ll be amazed how much family bonding can be achieved over a spirited board or card game!

Indoor Gardening

This can be an exciting and rewarding activity, independent of the weather. What a great sense of fulfillment when kids can see seeds sprout or a flower bloom. This can be as simple as a few potted plants, a rock garden, a mini-themed garden or a terrarium. Below are some sites to check for further inspiration:

Family Fitness Night

What a great way to get kids moving and put a positive spin on physical activity. These can be held at home, around the neighborhood or at a local community center.

  • Home Fitness: When watching TV, turn commercial breaks into fitness breaks with simple moves like jumping jacks, marching, running in place or crunches. Create fun names to correspond to these and take turns with family members being the fitness break coach. Consider buying some small pieces of equipment to keep around the house (resistance bands, stability balls, yoga mats). Plan places to put these around the house and use them for a few minutes every day. Incorporating yoga or daily stretches is a good way to relieve stress and can protect from injury later in life.
  • Make chores fun: Turn on some tunes and dance and sing along. Consider making a SPECIAL playlist of chore songs with everyone contributing their favorite. Perhaps a chore + exercise combo. Clean the bathroom and do a set of squats every few minutes.
  • Sports Night: Weather is no issue for this! Inside, try aerobic DVDs or fitness video games that are age- and space-appropriate. Outside, consider the backyard or nearby park for Frisbee, basketball, jumping rope, or other outdoor games. Check out a close-by playground with the whole family. Consider recreation centers for swimming, rollerblading, or ice skating.

Need some more ideas? These sites have ideas for various activity types, durations and intensities.


Volunteering as a family enhances values such as kindness, compassion and tolerance. Family members can learn new skills and feel appreciated for their contributions. Opportunities abound and need not be limited to holiday times or associated with food. Consider your time commitment ability: one time or ongoing? Consider your interests, the ages of your children and perhaps whether you want to do this as a single family unit or joining with another family or even an organization. A helping hand might be needed in your own neighborhood, your community, or for distant places too. It’s important to explain to your children your volunteer activity purpose and what to expect.

These sites offer more guidance in volunteering and opportunities for families.

Family time is important and rewarding. What kind of food allergy-friendly family night activities does your family engage in?

-Jody L. Benitz, MS, RDN

Image from familytravelck

How to Explain Food Allergies to Relatives AND Make Them Understand Why They’re Important

Posted 9.17.15 | Nutrition Specialist

Food allergies are difficult to understand, let alone to explain to someone else. But when you have company over for dinner parties, or send your child to spend the night at a relative’s house, it becomes essential that you explain your child’s food allergies. Your relatives need to know what to do to manage food allergies, and how to handle the situation if your child experiences an allergic reaction in their presence.  

This conversation can be a difficult one to have. Often, your relatives might not fully understand the severity of food allergies, especially when they have never experienced a reaction first hand. So, how do you go about having this conversation the right way?

Here are some tips that will make explaining food allergies to relatives easier.

  • Be direct. Don’t leave anything open to interpretation. Be as clear as possible when explaining your child’s food allergies.
  • Be as detailed as possible. Assume that they don't know anything. Give them the most basic details you can think of, even if you think those details are common sense.
  • Let them know that certain foods have different names on labels. Write those names down for them so they know what foods to avoid buying. For example, if your child has a peanut allergy, your family should know all the names on a label that indicate peanuts, peanut oil, or peanut protein.
  • Give examples. Tell a story of a time your child had a terrible reaction to a certain food in front of you. This will make them realize how severe the allergy is, how scary it is to witness and the possibility of dangerous consequences.
  • Tell them what to do if they are caring for your child when an allergic reaction happens. It’s not just about explaining that your child has food allergies; you also need to tell your relatives how to handle an allergic reaction. They need to know what your child’s allergic reaction looks like, and when and how they should react.

You can’t control your child having food allergies, but you can control the amount of information the people in your child’s life have about food allergies. Talking about food allergies with your relatives isn’t necessarily an easy conversation to have, but it is absolutely necessary. Hopefully, these tips will help make that conversation easier for both parties.

Do you have any tips on talking about food allergies with relatives? We would love to hear them!

How Neocate Helps Educate Clinicians

Posted 9.16.15 | Nutrition Specialist

Many parents ask us why some of the clinicians they've seen haven't been able to answer their questions about symptoms or conditions. Indeed, many clinicians in general practice just aren't very familiar with the medical conditions in which Neocate is used as part of dietary management. Sometimes even specialists aren't familiar with everything. In medicine, there's never enough time to learn everything, science is constantly changing, and we don't have all of the answers!

The Neocate team at Nutricia knows that healthcare professionals want to be able to help their patients, and sometimes can use help in learning about conditions that they don't see as often, such as eosinophilic esophagitis (EoE) or FPIES (food protein-induced enterocolitis syndrome). We are using today's post to give you a brief look at the efforts we take to support ongoing education for healthcare professionals.

Nutricia Learning Center
This website is specifically designed for healthcare professionals. It's their one-stop shop for clinical information about our products, tools and resources that can help them use our products, and educational resources about the conditions in which Neocate is used.

Educational Webinars
Healthcare professionals like to learn from experts. Webinars - "web seminars" - are a great way for a lot of people in different locations to learn from one expert online. The Neocate team supports webinars to connect widespread clinicians to experts in the field. Clinicians can listen to the webinar live or, if they can't listen live due to their busy schedule, they can view a recording later on their own time.

In-person Lectures
While online education is convenient, in-person education is often more effective because it's more interactive. Nutricia supports in-person lectures across the continent, so that experts can reach clinicians in one area to help inform them about medical conditions.

Educational Courses
Sometimes, healthcare professionals want to learn a lot, from a lot of experts, on a lot of topics, in a short period of time, and in person! In-person educational courses are a great way to accomplish this. The Neocate team supports several educational courses for clinicians so that they canlearn about multiple medical conditions from several experts. We do this because a lot of the less common medical conditions in which Neocate products are useful don't receive a lot of attention at major healthcare professional conferences. The courses we support are even targeted to different healthcare specialists, such as dietitians and gastroenterolotgists.

We look forward to doing more to help support ongoing education for healthcare professionals. It's our hope that this will help clinicians to answer your questions, and get more families answers sooner.


Image source

Tiny Tastes App

Posted 9.1.15 | Nutrition Specialist

We like to share great ideas and new tools when we hear about them. We thought this new tool could help a lot of parents and families that manage picky eating. Picky eating is something almost every child goes through, and it can be really tough to know how to manage!

We recently heard about a new app for mobile devices - the Tiny Tastes app. Tiny Tastes is a new mealtime companion app, available in the iTunes App Store for iPad & iPhone and in Google Play for Android tablets & phones. It's available in both English and Spanish!

Tiny Tastes was created to make the mealtime more entertaining and less stressful for the whole family! Tiny Tastes can help by providing some extra encouragement to try new healthy foods or drink certain things by modeling adventuresome eating. For families working with a feeding specialist, Tiny Tastes can be a part of feeding therapy or help your child to reach specific nutrition goals between visits.
How helpful could an app like this be for your family?
Image source ammichaels

About Neocate

Posted 8.27.15 | Nutrition Specialist

Have you ever wondered what makes Neocate different than standard nutritional formulas? This is a very good question and definitely worth sharing.

All of our Neocate products are “elemental” formulas, or to be more specific “amino acid-based” formulas. The term ‘amino acids’ may bring back some memories from high school biology or chemistry class. Amino acids are essentially the building blocks of protein. The reason free amino acids are so important in some medical conditions is due to the fact that intact protein, in most cases, is what is responsible for triggering a food allergic response. Neocate is considered to be a hypoallergenic formula, as it does not contain any intact protein. In addition to the hypoallergenic nature of an elemental formula, the free amino acids make digestion and absorption easier as the protein is already in its most broken down form. It’s also important to mention that our bodies are able to use the amino acids in the same way that they use intact protein for healthy growth and development.

There are a number of reasons why an individual might need an elemental formula such as Neocate, such as:

  • Cow milk allergy (CMA) and/or soy milk allergy
  • Multiple food protein allergy
  • Short bowel syndrome (SBS)
  • Eosinophilic esophagitis (EoE)

This isn’t a complete list. Neocate products are sources of essential nutrients, and are often used as a sole source of nutrition (meaning they are used to meet all of an individual’s nutritional needs with no other source of nutrition). Of course, the amount of a Neocate product needed should be prescribed by a healthcare professional to ensure a patient consumes an amount needed to meet specific nutritional goals.

What makes Neocate products unique? Many reasons, but one that stands out to me the most is that Neocate powdered products are made in our own, dedicated facility that is 100% dairy-protein free. We also know that none of the ingredients in the Neocate products are derived from wheat, barley, rye, fish, shellfish, tree nuts, peanuts, or eggs; removing the risk of cross contamination with those allergens.

If you would like to read a little more about what makes Neocate products different, check out a page on our Neocate web site that I think you’ll find to be pretty helpful:

The various types of formulas available can be overwhelming and definitely cause some confusion. Please don’t hesitate to let us know if you have any questions by leaving a comment below!

- Kendra Valle, RDN

Neocate Mixing Videos Round-Up

Posted 8.25.15 | Nutrition Specialist

A few weeks ago, we posted a simple ‘How to Guide’ for mixing Neocate ( This blog included basic steps for preparation as well as various recipes. Being a visual learner, I thought it may be beneficial to highlight our mixing Neocate videos developed by my colleagues. All of these videos are available on our NeocateUS YouTube page; however to save you a step I have included the direct links to these videos below. Happy viewing!

Neocate Infant DHA/ARA:

Neocate Infant DHA/ARA in Spanish:

Neocate Nutra:

Neocate Junior with Prebiotics, Strawberry:

Neocate Junior with Prebiotics, Vanilla:

Do you have any helpful preparation tips that you want to share with other Neocate parents and caregivers? If so, we’d love to hear them!

-Kendra Valle, RDN

5 Questions with Rob McCandlish, Medical Affairs Associate

Posted 8.19.15 | Nutrition Specialist

Say hello to Rob McCandlish, a veteran blogger for the Food Allergy Living team! He has worked for Nutricia for more than 5 years. Rob is a Registered Dietitian Nutritionist and, at Nutricia, is a Medical Affairs Associate. He serves as a resource to parents/caregivers, dietitians, physicians, nurses and other individuals who have questions about Neocate products and medical conditions for which Neocate is used. 

We sat down with Rob to find out what his day to day looks like working at Nutricia, and learned about what drew him to medical nutrition. 

Why did you choose to work in this field? What do you find most interesting about medical nutrition?

I think what drew me to this field, and what I find most interesting about it, is the fact that our products are specific to uncommon disorders and that they touch a different aspect of health, because they fall somewhere in between food and pharmaceuticals. I enjoy having a positive influence on families who manage unusual disorders and who need specialized nutrition.

How have severe food allergies impacted your family?  

My nephew (who is going to turn two next month) developed symptoms of a cow milk allergy at around 3 months of age. After he was diagnosed he was on Neocate Infant for close to a year, and luckily he grew out of his milk allergy. It really brought home for me the difficulties parents face when their infant has a cow milk allergy, and the difference Neocate can make.

What is your favorite part of working at Nutricia?

I'd have to say I really love going to conferences and connecting with patients who use Neocate products in person. Getting to meet them and hear about how much of a difference our products have made in their lives helps add meaning to my work. It is very rewarding to personally hear about their transformation and success stories on Neocate.

What was your favorite nutrition course in college and why?

My favorite course in college was ”Experimental Foods.” I got to spend a whole semester manipulating a recipe – I think it was green curry chicken - to develop a healthier version. The challenge at the end of the semester was a blind tasting panel, and results were measured on whether or not tasters could tell the difference between the original recipe and the healthier recipe. I’d say that course is where I found my love for food science, and the experience in manipulating recipes has helped me in developing recipes that use Neocate products.

For some of Rob’s favorite Neocate recipes, download our Neocate Recipe booklet.

If you had one piece of advice for parents with children who have a cow milk allergy, what would it be?

Time and time again I hear frustration from parents who have gone through multiple doctor visits with few answers. Some doctors rarely see patients with conditions like EoE, FPIES or even a cow milk allergy, which can make it difficult to recognize what’s contributing to the child’s symptoms. Therefore, I suggest that parents go to their medical appointments armed with a logbook or diary of what they’ve been experiencing. That can help the medical team to link the symptoms to the condition. And never be afraid to ask questions! Asking your doctor the right questions can make a big difference in finding answers.

The ABCs of Back to School with Food Allergies

Posted 8.13.15 | Nutrition Specialist

‘Tis the season for back to school. While this can be exciting for many students and parents, there can be added anxiety for those dealing with food allergies. Besides the typical hustle and bustle associated with getting school supplies ready, food allergies require some extra preparation to assure a smooth and safe school transition. Assembling a variety of care plan documents, Bringing allergy-related supplies and Communicating with school administration, teachers and other students is essential for making this process as easy as A-B-C .

A is for Assembling of care plan documents.

It is a good idea to notify the school prior to school starting and ask to meet with school administrative staff and the school nurse to discuss and develop care plans to ensure food allergies and health are well managed while at school. These should identify the types of responsibilities, training and services required for keeping school safe and addressing emergencies should one occur. The three most common plans used for food allergic children are known as Emergency Care Plans (ECP), Individualized Healthcare Plans (IHCP) and 504 Plans. The following are good sources for becoming educated on these and offering sample templates as well.

Kids With Food Allergies (KFA) offers both video and print resources related to care plan topics.

  • This resource addresses four sample plans: protocol and procedure for allergy management in the classroom; ensuring trained individuals for epinephrine administration; defining the allergy disabilities; and food policies for classroom and cafeterias.
  • This two part video series includes both a Parents Need to Know video
  • …and a Question and Answer video
  • … along with additional tips, resources and links for parents on the website

The National Association of School Nurses (NASN) worked with the Center for Disease Control and Prevention (CDC) in creating comprehensive guides and resources for both the school communities and parents.

B is for bringing allergy awareness supplies to school.

Besides hand sanitizers and sanitizing wipes to reduce the risk of surface allergen contamination, other items might be worth consideration too. Here are some suggestions for allergy-related gear and allergy-safe foods.

Safety tattoos may be a good idea, especially at the beginning of the school year and for younger students until the school staff becomes familiar with your child’s food allergies.

Medical alert bracelets are a good idea for those with severe food allergies as they are helpful for EMT personnel if there is an emergency.

Re-usable wraps that hold a sandwich and then unfold to become a place mat while eating are offer by Wrap N Mat

Lunch boxes with food allergy information printed on them as well as tags and stickers can be found at Allergy Apparel

Snack ideas that are food allergy-friendly.

C is for communicating food allergy information to everyone.

Parents need to know as much as they can about their child’s food allergies in order to share this with school staff. It’s also good to work with your child so she knows her food allergies and can self-manage them when you feel she’s ready. Having information to share with your child’s classmates can help friends understand and be supportive. Here are some resources to help in these areas.

The following books are good for teaching younger students about allergies.

The Food Allergy Resource and Education (FARE) website has age-specific materials for kids of all ages with food allergies.

University of Utah Medical School offers an online program called A Shot to Live geared to teachers; this is also good for others too and includes videos on use of epinephrine auto-injectors.

The extra time, effort and energy of preparing for child with food allergy to return and/or start of school can make a world of difference in avoiding food allergy mishaps. It’s a matter of your ABCs.


Finally, here are two more resources related to heading back to school with food allergies worth considering:

FARE is a great go-to organization for multiple helpful resources. Need an allergist? Newly diagnosed with food allergies? Need materials in Spanish? The information here is downloadable and can be distributed as well. Check here for assistance on what to do on field trips, extracurricular activities and transportation issues too

KFA offers a guide containing a list of food allergens that can be found in unexpected places such as food used in science or math lesson plans, crafts, and cooking classes. Alternatives and precautions are suggested. Take note that ingredients may change so it is best to contact and verify these with the manufacturers.

What tips do you have for other families managing food allergies as they prepare to head back to school?

-Jody L. Benitz, MS, RDN

Image from Shardayyy

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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.