Food Allergy Living Blog

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6 things I wish I knew before starting a milk elimination diet

Posted 10.21.16 | Nutrition Specialist

1. Prepare yourself—take time to get ready! Starting an elimination diet half-way will not benefit your child.  It is an all or nothing effort.

As a parent, caregiver, or someone who loves a child that requires a special diet, learning that milk and dairy products could potentially cause your child great harm is very stressful. This stress can be multiplied ten-fold if this is the first family member that needs an elimination diet. There is so much to learn about cross contamination, alternative products, and providing a diet that meets the nutrition demands of a growing child.

Make sure you take time to mentally prepare yourself for some of the challenges such as preparing your family (see next point) and knowing what to do in the event of an accidental exposure. If your child is still on an infant formula, the first few months may be easy since your baby only drinks formula and is just beginning to eat single ingredient fruits, vegetables, grains, and proteins. As your baby gets older and is able to start self-feeding, be prepared to spend extra time at the grocery store as label reading becomes more critical (see point number 3).

As a parent, be sure to engage in regular self-care by talking to a counselor, pastor, friend, or family member when the stress becomes overwhelming. Find a support group so you can remind yourself that you and your family are not alone.

2. Prepare your family

A well-prepared family is often less likely to challenge the news that another family member needs to start avoiding milk and all dairy products. Members of older generations often question the need for such diets because they often were not exposed to this as children or young adults and the frequency of having a food allergy was much lower—even a decade ago.  While their questions can be downright frustrating, try to remember their perspective; this is just as new to them as it is to you. And, chances are you are ahead of their thinking because you are the one that has seen the negative reactions related to food allergies and you have been to all your child’s doctor appointments that led to the food allergy diagnosis. 

Regardless if your baby needs to drink an amino acid based infant formula or if you are trying your toddler (with your doctor’s or dietitian’s advice) on a milk elimination diet, your family needs to be prepared. If you have other children that are allowed all of the milk and dairy products they want, they need to understand that their sibling has to eat and drink different “special” foods. They need to be a “big boy” or a “big girl” and help keep their sibling safe by not offering to share and keeping their cups and food out of their sibling’s reach.

Placing all children in the home on a milk elimination diet regardless if they need it to accommodate one child’s special diet is not a good idea. Children that must avoid cow’s milk very often require supplements or a specialty formula to ensure their diet is nutritionally complete. In addition to the very high cost of supplementing all children, it places an unnecessary burden on the child/children without any food allergies.

Grandparents, aunts, uncles, cousins, siblings and close friends all mean well but it is critical that they understand that there are no cheat days and yes, just one cookie could in fact hurt. Help these extended family members find safe treats to provide as alternative since so many of us like to show our love through food.

3. Read every label every time.

I saw a family not too long ago in the allergist’s office because they were concerned that their child had developed additional food allergies beyond milk. The child was on a milk elimination diet for many months and the family was managing it quite well without too many issues or worries. The child was growing well and tolerating the amino acid based formula nicely.

During my nutrition assessment and diet review, we discovered that a normal “go-to” food was most likely the culprit. The manufacturer changed the ingredients and the family was unaware that this “go-to”food now contained whey protein (a component of milk). The best way to identify product ingredients is by reading the actual packaging label that corresponds to product contained within that packaging or call the product manufacturer.  Product websites do often have ingredient information; however these sites are not always kept up to date and may misguide your label reading judgement.

Please remember that product manufacturers view their ingredients as commodity items. They know what ingredients can be changed or substituted and will do so when prices increase or supply is interrupted. Food manufacturers do what they can to continue to produce their products while making a consistent level of profit without changing the price on the grocery store shelf. As commodity prices change, their manufacturing process may change and they do not have to warn consumers about any changes in how they manufacture or in the ingredients they use.

Read every food label every time.

Fortunately, there are apps for smart phones that help track ingredients in products with a quick scan of a bar code or QR code. Technology can seem quite invasive in our lives today but in this case, it can be a huge benefit to someone who is buying groceries to accommodate multiple diets types within a family.

4. Avoid cross contact at home

Cross contact or cross contamination for example occurs when one food without milk touches a food with milk. Some children are so sensitive to milk proteins that this type of accidental exposure can result in anaphylaxis.

One way to help avoid cross contamination is by designating one shelf in the refrigerator as the “milk-free shelf.”

Here are things parents wished they knew before starting a milk elimination diet:

  • (See point number 2: Creating a milk-free home with other children in the house that can drink milk is not a good idea)
  •  Designate a specific shelf in the pantry or perhaps an entire cabinet for milk-free dry ingredients. The benefit of making an entire cabinet a milk-free zone is that it also provides a space to include pots, pans, toaster, cups, cutting boards, knives, etc. if you have duplicates and have designated these as “milk-free equipment.”
  • It is not necessary to purchase a second set of cooking tools and eating utensils to prepare and serve a milk-free diet if the tools and utensils have been washed in the dishwasher or washed thoroughly in warm, soapy water. 
  • Once a milk-free food has been prepared, cover that food and place it aside while preparing other food that contains milk.
  • After the meal is over, remember to wipe down all kitchen surfaces including the kitchen table. It is better to do this when one meal concludes rather than trying to remember if that was done prior to preparing the next meal or snack.

5. Teach your child to be her own advocate

Knowledge is power and children are always learning. As soon as your child is old enough to walk and start feeding themselves, teach her to ask if it is okay for her to eat certain foods. Teach your child how to ask an adult if a food contains milk and never to take food offered to them by other children (even siblings) without an adult’s approval.

Teach children to be their own advocates and to respectfully ask questions as this will help keep them safe when you are not with them. I hope this will also help you, as a parent, feel more comfortable about giving them the freedom to be out in the world without you constantly by their side monitoring what is placed in their mouth.

Children have an amazing ability to adapt and view their allergy as just part of life. The adults in their lives more often have a much harder time with the diet.

6. Use supplements

I am a food first kind of mom and dietitian. I firmly believe that a diet can be nutritionally balanced and meet the needs of just about anyone.  However, in certain situations, supplements are necessary to avoid placing children at risk for nutritional deficiencies. Children that have to avoid cow’s milk are at risk for poor growth, bone health and/or short stature if they do not consume adequate amounts of protein, calcium, and vitamin D among other nutrients that they would normally get by drinking milk and eating other dairy products.

Alternative milks such as rice, soy, oat, hemp, and coconut are an acceptable way to include variety in the diet, however, they are not nutritionally balanced enough for a baby or toddler to drink as a sole source or main source of nutrition.  Please do not rely on these milks the same way you may have relied on cow’s milk and dairy products for your other family members.

Work with a registered dietitian to help you determine your baby’s nutrition needs and how food and supplements can work together to meet those demands. Remember to see a dietitian regularly since the needs of young children can change quite quickly as they grow.


What’s For Lunch? Allergy-Friendly School Lunch Ideas

Posted 10.6.16 | Nutrition Specialist

Do you find yourself in the morning frenzy mode as you get your kids AND their lunches ready for school?  You are not alone!  Rushing in the morning can be stressful and potentially can put you into a lunch idea rut. To help you saygoodbye to boring and dull lunches and to help lessen some of that morning frenzy stress, here’s some inspirational ideas that you might find useful.

We started this round-up of ideas by first asking our Facebook and Instagram followers their favorite go-to lunch ideas. Here are some of the ideas that you shared with us for lunch box treats:

  • GoGo squeeZ pouches
  • Plain applesauce pouches
  • Lay’s® chips
  • Jet-Puffed Marshmallows

Other fun ideas from around the Web:

  • Once a Month Meals - This service is based on the premise that advanced preparation can take the panic out of day to day lunch prep.  Through this service you can receive recipes and resources to help you stocking your freezer with allergy-friendly ingredients.
  • Cook it Allergy Free - Stuck in a lunch packing ruts? This website has a 50+ allergy friendly lunch box idealist.
  • Keeley McGuire - Tired of sandwiches?  Check out Keeley McGuire’s blog post that includes 20 non-sandwich lunch ideas!  
  • Kitchen Stewardship -How about cheeseburger soup and a muffin?  YUM!!  Mary Voogt offers 9 different leftover soup ideas paired with several kinds of muffins.
  • Kids with Food Allergies (KFA) - hosted a webinar last September about Allergy-Friendly School Lunch box Ideas that includes blogger Keeley McGuire and Registered Dietitian, Debra Indorato addressing ways to make lunches creative and nutritious.  

Need Neocate in your lunchbox?  We have you covered! Our Neocate Cookbooks are a great resource. For example you can find delicious recipes such as Cream of Broccoli Soup, Hamburger Harvest Soup, Vegetable/Cracker Dip, Neocate Shakes, Dairy-free Mac and Cheese.

Last but not least, lunch-box planning doesn’t have to be something that you take on by yourself. Get your kids involved. Give them opportunity to learn how to prepare their meals and pack their own lunches. Additionally, this will also provide them with a sense of empowerment by making recommendations. Empower your kids- let them have a say about their lunch box content

Do you have any other nifty ideas for allergy kids school lunch boxes?  Please share.

~Jody Long

P.S. If you missed our blog post on the importance of lunch-box printables and labels, take time and look over it today. 

What is the 4 Food Elimination Diet?

Posted 10.4.16 | Nutrition Specialist

The 6-food elimination diet has been used for a number of years to help EoE patients of all ages figure out their trigger foods. Now, there is some interesting and promising research that suggests the 4-food elimination diet may be an effective way to control and manage EoE symptoms.

On the 6-food elimination diet, a person must avoid milk, wheat, soy, egg, peanut, tree nut, fish, and shellfish. If you count all of those foods, it is actually 8 and not 6 but I digress. On the 4-food elimination diet, a person is allowed to continue to eat peanuts, tree nuts, fish, and shellfish (as long as there are no other types food allergies such as anaphylaxis) but still must avoid milk, wheat, soy, and egg.  Anyone that has ever tried to avoid multiple major foods groups will agree that this is huge news.  Beware of the potential nutritional pitfalls so this diet can still be balanced and healthy.

While avoiding milk and dairy products, the nutrients at greatest risk for deficiency are calcium, vitamin D, phosphorus, vitamin B12, riboflavin, and niacin. Some alternative sources of these nutrients include spinach, collard greens, kale (think dark, leafy green vegetables), oatmeal (as long as it has not had cross contact with wheat), asparagus, pork, chicken, beef, salmon (and other fatty fish), sardines, peanuts, fortified beverages, and fortified wheat free breakfast cereals.

Wheat is an important source of thiamin, niacin, vitamin E, zinc, and selenium in the typical American diet. Alternative sources of these nutrients are pork, beef, oysters, salmon (and other fatty fish), fish such as tuna and cod, raisins, sunflower seeds, mushrooms, asparagus, collard greens, tree nuts, and fortified wheat free breakfast cereals.

Soy provides vitamin E, choline, iron, and potassium in the diet. Alternative sources of these nutrients include sunflower seeds, plant oils, raisins, oranges, bananas, melons, tomato, potato, squash, broccoli, cauliflower, beef, oysters, clams, salmon, grape juice, peanuts, tree nuts, and fortified wheat free breakfast cereals.

Eggs are an important source of vitamin D, vitamin B12, vitamin A, riboflavin, niacin, choline, and iron. Alternative sources of these nutrients include beef, pork, chicken, fish and fatty fish such as salmon, fortified beverages, green and dark green leafy vegetables, carrots, squash, broccoli, cauliflower, cabbage, cantaloupe, apricot, mango, grape juice, raisins, peanuts, and fortified wheat free breakfast cereal.

Before you get overwhelmed thinking about all of these different foods, take a step back and notice that these foods are colorful and come from the protein, fruits, and vegetables food groups. Specifically, what are these allowable foods that require removal in the 6 food elimination diet? These are fish, shellfish, plant oils, peanuts, tree nuts, and seeds. These are the hallmark foods of a Mediterranean style eating pattern. The same basic principles of a healthy and balanced diet apply to an elimination diet as with any other diet. People should not eat meals on a regular basis that are all one color or are bland colors; beige is boring. Even while avoiding 4 major types of food, it is possible to keep variety in the diet. You may even find that the elimination diet may be a healthier eating pattern than the one you were previously following.

Since peanut (a legume) is allowed in a 4 food elimination diet, it is best to talk to your doctor to find out if you can include other legumes in your diet such as navy beans, kidney beans, garbanzo beans, lentils, or peas.

Because the Mediterranean eating pattern has been well studied for many years and has been found to reduce the risk of heart disease, there is a tremendous amount of information available on the internet and in cookbooks.  You may find this eating pattern listed as the DASH diet, Mediterranean diet, Heart Healthy Diet…among others. Just remember that as you find recipes and tips that you will need to tweak suggestions and recipes to fit your specific elimination diet. Remember, you will still need to avoid milk and all dairy, wheat, soy, and egg.

Adjusting to a new diet can take time. If a Mediterranean style eating pattern is completely new and different to you and your family, allow yourself more time to adjust and find alternative foods. It may also be necessary to include a hypoallergenic amino acid-based supplement to avoid unintentional weight loss and nutritional deficiencies. Be honest with yourself and your doctor about what you are and are not willing to do while on any elimination diet.  These diets are intended to control EoE symptoms and improve quality of life…even though it may feel like they do just the opposite.

Members of your EoE healthcare team can help you determine if the 4-food elimination diet is the right fit for you. Do not be afraid to ask questions when you go about identifying what foods trigger your inflammation and EoE symptoms. 


Our guest blog today comes from Alexia Beauregard. Alexia Beauregard is a Registered Dietitian. The inspiration for this blog is based on her extensive experience working with the families of patients diagnosed with EoE. Please be sure to talk to members of your child’s healthcare team to determine if this information is appropriate for your child.

Neocate Blueberry Scones

Posted 9.29.16 | Nutrition Specialist

Looking for an allergy-friendly brunch recipe? Our Blueberry Scones are perfect for the whole family. Made with our Neocate® EO28 Splash, Tropical Fruit, these scones are delicious and easy to make.

This recipe, developed by a professional chef who also happens to be a Registered Dietitian, is one of our favorites!

As always, please check all ingredients to ensure suitability, and consult your doctor or dietitian with questions or for advice before you bake with Neocate, as cooking can affect some nutrient levels.

What is EO28 Splash?

E028 Splash is a hypoallergenic amino acid-based liquid formula for individuals one year of age and older. It is available in a convenient, ready-to-drink form for individuals on the go. It provides all essential nutrients to promote balanced nutrition and can be used to supplement individuals on elimination diets. E028 Splash is available in three great-tasting flavors: grape, tropical fruit and orange-pineapple.

E028 Splash is for the dietary management of cow and soy milk allergy, multiple food protein intolerance (MFPI), eosinophilic esophagitis (EoE), short bowel syndrome (SBS), and other conditions of gastrointestinal tract impairment and malabsorption requiring an elemental diet. E028 Splash is gluten- and casein-free.

What You Need:

  • 1 ¾ cups gluten-free all-purpose flour substitute
  • ½ cup of sugar
  • 2 teaspoons baking powder
  • ½ teaspoon xanthan gum (optional)
  • ½ teaspoon salt
  • ¼ teaspoon nutmeg (optional)
  • ¾ cup non-dairy margarine (or allowable fat substitute), cold and cut into pieces
  • ¾ cup blueberries, fresh
  • 1 Tablespoon of egg replacer
  • ½ cup E028 Splash Tropical Fruit
  • 2 teaspoons imitation vanilla extract


  • Preheat the oven to 400°F.
  • Line baking sheet with parchment.
  • Whisk together the flour substitute, sugar, baking powder, xanthan gum, salt, and nutmeg.
  • Work in the cold margarine till the mixture is crumbly with a pastry cutter or fork.
  • Stir in the blueberries.
  • Whisk together the E028 Splash Tropical Fruit, egg substitute, and vanilla till frothy.
  • Add to the dry ingredients, stirring till well blended. The dough should be cohesive and very sticky.
  • Drop dough by using rounded tablespoons onto the baking sheet. Let the scones rest for 15 minutes.
  • Bake for 15 to 20 minutes, until golden brown.
  • Remove from the oven and let rest for 5 minutes or so before serving.

Quick Tip:

If you prefer drier scones, use less of the E028 Splash mixture. Looking to add a little pazzaz to your scones? Sprinkle the scones with sparkling sugar or cinnamon sugar, if desired.

Nutrition Information:

  • Serving Size: 1 Scone
  • Servings Per Recipe: 24
  • Amount Per Serving
  • Energy 136 kcal
  • Protein 1.2 g
  • Fat 7.3 g
  • Carbohydrates 16.1 g
  • Fiber 0.9 g
  • Vitamin D 1.5 IU
  • Calcium 45.2 mg
  • Iron 2.2 mg
  • Zinc 0.2 mg

Allergy-Friendly Fall Snacks For Your Little Pumpkin

Posted 9.27.16 | Neocate Admin

The fall harvest yields all sorts of nutritious fruits and vegetables. Particularly popular are root vegetables and varieties of squash, making for some hearty after-school snack options. For growing toddlers, tweens and teens alike, snacking is a great way to meet daily nutritional needs. With the cold weather setting in, why not try some warming soups to feed your little one?

Here are three delicious recipes that are perfect for an after-school snack.

Neocate Butternut Squash Soup Recipe

Butternut squash is delicious, in season, and can be found at your local farmer’s market or grocery store!

Tomato Basil Soup

Tomatoes harvested from the summer are ripe for making a healthy and flavorful soup. Warm up with our tasty recipe.

Nutra Mashed Potatoes

Potatoes of all different shapes, sizes and colors can also be found at your local farmer’s market or grocery store. Mashed potatoes make for a perfect meal for babies who are still transitioning to solid foods.

For additional snack ideas or to print your own recipe cards, download our Neocate Footsteps Recipes. Share your favorite snacks with us in the comments below or on our Facebook page!

5 DIY Allergy-Friendly Play-Doh Recipes for National Play-Doh Day

Posted 9.16.16 | Nutrition Specialist

September 16th is National Play-Doh* Day! Did you know that Play-Doh was originally a wallpaper paste that became popular due to its ability to be molded into a variety of shapes? It originally came in 3 colors – red, yellow and blue – from which many other colors could be formed. Now Play-Doh is available in over 50 different colors!

National Play-Doh Day was started in 2006 and has been celebrated every year since! But, for children with food allergies (including wheat), Play-Doh may not be a suitable option for a modeling compound. Don’t despair; our team took on a challenge of compiling allergy-friendly recipes you can make at home with your family.

Gluten-Free Baking Soda Play Dough

This recipe is an adaption of the Arm & Hammer Play Clay recipe


  • 2 cups baking soda
  • 1 cup cornstarch
  • 1 ½ cups water
  • 1 tablespoon oil


  1. Mix ingredients together in a sauce pan and heat over medium heat, stirring constantly. If you have older kids, they may get a kick out of doing this part.  During the heating process, baking soda makes the mixture fizz for quite a while before it starts to thicken. When it starts to thicken, beware! It goes really fast.
  2. Take the mixture off the heat as soon as it’s thick enough to start wanting to stick together. Let cool, partially covered until it can be handled.
  3. Next comes the fun mixing part. If you want your mixture to come in different colors, separate into balls and start adding your favorite food grade colors. I used Wilton®** icing gel colors left over from my cake decorating days and really loved the results. Beware – the icing colors may stain your hands but can be easily removed with a baby wipe.

2-Ingredient Silky-Smooth Play Dough By Our Best Bites

This silky-smooth 2-ingredient play dough can be made in just a few minutes with stuff you already have in your house--hair conditioner (or lotion) and cornstarch!


  • 2 cups cornstarch
  • 1 cup hair conditioner or lotion (don't use the expensive stuff, but I recommend something that is either scent-free or a scent that you/your kids like)


  1. Place the cornstarch in a large bowl.
  2. Mix in the beauty product of your choice with your hands--it will just start coming together and it will be pliable and very, very smooth.
  3. You may need to add more conditioner/shaving cream/lotion as you go. Use food coloring to color as desired. Keep covered when not in use.

Some tips from our mixing experiments:

For this recipe, don't use the expensive hair condition or lotion. Additionally, we recommend something that is either scent-free or a scent that you/your kids like. Bonus, if you decide to use a lotion for this mixture, you might notice very soft hands!

Gluten & Corn Free Play Dough Recipe


  • 1 firmly packed cup brown rice flour
  • 1 cup water
  • 1/2 cup salt
  • 1 Tablespoons oil
  • 1 Tablespoons cream of tartar
  • Food coloring as desired


  1. Place all ingredients into a medium sized saucepan.
  2. Stir continuously over a medium heat until the mixture congeals and forms a ball, approximately 3-5 minutes. Continue to turn the ball over on the heat for another 1-2 minutes.
  3. Remove from the heat and turn dough out onto a board or bench top.
  4. Allow to cool completely and then knead until the dough is smooth. Sprinkle with a little rice flour as you knead if the dough feels at all sticky but be sure to only add a little at a time to prevent your dough drying out.

Hints & tips:

Although it can be difficult to wait, I find so often when cooking with alternative flours it’s best to let the mixture cool before handling. Waiting allows the ingredients to bind fully.  One way you can speed up the cooling process is by breaking the mixture into smaller pieces.

Liquid food coloring can be added to the pot or kneaded into the cooled dough. It’s best to add your coloring one drop at a time. Doing so will help you achieve the desired color and may help to keep the dough from getting too sticky. If you find yourself in the situation where your dough did become sticker than anticipated, adding a bit more rice flour may help.

Store play dough in an air tight container or wrapped tightly in a plastic bag.

No Allergy Edible Play Dough

This recipe might be a better alternative for younger children who may want to eat the play dough! Added bonus, it’s super easy to make.


  • 1 cup sunflower seed butter (Sun Butter Spread)
  • 1/3 cup maple syrup
  •  2/3 cup arrowroot powder ( or organic corn starch)


Mix all ingredients together and play!

Rice Flour Play Dough


  • 1 1/4 cups rice flour
  • 1/2 cup salt
  • 2 tsp cream of tartar
  • 1 cup water
  • 1 Tbsp oil
  • 1/4 tsp vanilla extract
  • food coloring or sparkles (optional)


  1. Mix flour, salt, and cream of tartar in a large pot. Add water and oil.
  2. Cook over medium heat until the mixture pulls away from the sides of the pan (about 5 minutes), stirring constantly.
  3. Add vanilla extract (for smell, not taste). Mix thoroughly. Put play dough on a clean surface. When cool enough to handle, knead lightly.
  4. Store in airtight container.
  5. Add food coloring to the water to make colored play dough. Add sparkles during the hand-mixing time for sparkly play dough.

- Ellen

*Play-Doh is a registered trademark of Hasbro™ and not affiliated with Nutricia North America

**Wilton is a registered trademark of Wilton Products Inc. and is not affiliated with Nutricia North America.



6 Things I wish I knew Before Starting an Elimination Diet for Eosinophilic Esophagitis (EoE)

Posted 9.13.16 | Neocate Admin

Our guest blog today comes from Alexia Beauregard. Alexia is a food allergy specialist dietitian who also specializes in eating and feeding disturbances and is based in Greenville, South Carolina. She loves working with food allergy families to help make food fun again. Alexia believes that eating should be one of the basic joys in life and wants everyone to be able to enjoy whatever foods they can. She works with families in an outpatient setting and also teaches college courses. Her professional organization memberships include the American Academy of Allergy, Asthma and Immunology (AAAAI), American College of Allergy, Asthma and Immunology (ACAAI), the Council for Pediatric Nutrition Professionals (CPNP), and the International Network for Diet and Nutrition in Allergy (INDANA). She speaks regularly at conferences for medical professionals and for families.  You can find her on her Facebook page or in her private practice--Seagrass Nutrition & Therapy ( Her three children and husband keep her pretty busy at home. The Beauregards love sailing, biking, hiking, and just being outside in general. As a family, they are very active in sea turtle conservation and believe in conservation through education on the importance of preserving marine life habitat. You can often find them enjoying the beaches of South Carolina.

1. You can start getting ready to implement the full elimination diet gradually

You do not have to run to the grocery immediately following the appointment in which you are told to avoid milk, wheat, and soy (for example) to try to find alternative products. You have time to process that information and figure out how to make it work. It is important to determine what foods your child relies on the most for calories, protein, vitamins and minerals and what substitutes are available.  As with any diet change, slow and steady wins the race. Pick one or two foods at a time that you are going to change and experiment with alternative allowable foods. Try new cooking techniques. Also, take this time to inform school, daycare and anyone that may be involved in feeding your child about these dietary changes. The important thing to remember is that you or your child needs to be on your full elimination diet for at least 8 weeks before getting another endoscopy to determine if diet therapy is helping. The faster you begin to implement the full elimination diet, the faster you can start the countdown to your next endoscopy, and the faster you may be able to expand your diet again.

2. It will take more time

Be prepared to spend more time finding and preparing foods. The good news is that once you find your set “go to” foods at your usual grocery store or a grocery store new to you, the amount of time required will decrease.  Commit the time to finding as many alternative allowable foods as you can at the beginning of your elimination diet period. It will take more time to plan for travel or even going out to dinner on a Friday night. Remember, that this time is an investment in your or your child’s safety and can help prevent accidental exposure. It is heartbreaking to hear stories of a family that is 6 weeks into their 8 week elimination diet only to learn that they included a food that had milk in it because they did not take the time to fully read a food label. When this happens, the elimination diet clock has to start over.  Time spent finding and preparing allowable food is time well spent.

3. You can select the start date

You and your doctor agree that your child should start an elimination diet to determine if that will help reduce their EoE symptoms.  It’s September and all you can think about is Halloween, Thanksgiving, and Christmas and how to manage this diet around the holidays.  I tell the families I work with to pick an 8-week time frame when they know they will have the highest likelihood for success. Some families may choose to use medication until they start their diet while others want to jump in and think of a milk free and wheat free Thanksgiving as a good challenge. However you feel about the diet, pick a time to implement the diet when you know you can be successful.

4. It does not have to cost more

Yes, alternative products such as wheat free bread are more expensive.  That is an undeniable fact. But, the diet does not have to include bread made from specialty flours. Think outside the sandwich when it comes to lunch. Single ingredient whole foods (think whole chicken) actually costs less per pound then chicken already cut up and sold in marinade. Grocery stores will charge more for items in which they do most of the prep work. Single ingredient foods are going to be a safer choice by decreasing the risk of accidental exposure to foods/ingredients that need to be avoided. Utilize websites like or for some alternative products. Some families have found that purchasing other staple household items online is cheaper and provides more money in their budget for food items that may be more expensive. Get creative with how you shop and meal plan. Remember point #2…it will take more time at first.

5. You are not alone

Any medical diagnosis can feel very isolating for the person with the illness or for the entire family. The good news is that in our highly connected and wired world it has never been easier to find people to connect with that are living with a similar situation. Organizations such as APFED have a tremendous amount of valuable information on their website to not only manage an elimination diet but can also help find a local support group. Other websites like Inspire can help connect you with other EoE families in an online community. Families that have done an elimination diet in some form or fashion are a great source of information about products, restaurants, hotels, and finding food free activities. This is a hard diet but it can be done. Find support to help make this challenging time a little bit easier for your family. EoE is not something that a family has to endure alone.

6. You or your child may not feel any differently

The truth is that you or your child may not feel any differently on this diet. Some EoE patients have very pronounced symptoms and feel much better when they avoid their trigger foods. Some people have much more subtle symptoms and may not feel any differently on this diet. Even in the absence of symptoms, it is important to follow the elimination diet. Remember, the goal of this diet is to prevent damaging inflammation in your esophagus and find the foods that cause the body to react in this way. The goal is to avoid those EoE symptoms that may occur both inside and outside the esophagus, and avoiding trigger foods is one way to do that.


Alexia Beauregard is a Registered Dietitian. The inspiration for this blog is based on her extensive experience working with the families of patients diagnosed with EoE. Please be sure to talk to members of your child’s healthcare team to determine if this information is appropriate for your child.

Food Fight! Tips for Feeding a Child on a Restricted Diet That Just Does Not Want to Eat

Posted 9.7.16 | Nutrition Specialist

Feeding children can be a complicated and stressful proposition for any family but couple that with a restricted diet due to food allergy and that could be enough to make even the most laid back parent turn into a drill sergeant that would make highly trained soldiers cry.

Why do kids sometimes refuse to eat?  Why do they stop eating foods they claim to love?  Why do they eat one thing one day and then the very next day decide that they hate that food?

If you ate a few bites of food and then experienced a pain so severe it took your breath away, would you be willing to eat that food again? How adventurous would you be in trying new foods?

And, what if these bad experiences with food are happening to you when you are only three years old with a limited vocabulary? How would you protect yourself?  You would probably only eat a certain number of foods or foods that always looked the same. 

So how do you feed a child on a restricted diet that just does not want to eat? Seek to understand the child’s perspective.

First, it is important to understand that food is a major control issue for all children starting at a very young age.  Most children have many decisions made for them and the one decision that is theirs and theirs alone is what and how much to eat.  Some children will let their parents or caregivers coerce them to eat while them others will push back and may push back hard.

Second, it is critical to understand that as a parent or caregiver, you cannot force feed a child.  It WILL NOT work. Children have absolute and total control over what they put in their mouth and that is the way it should be. Even if you are not physically placing a spoon in a child’s mouth, using pressure language such as “take one more bite” or “no dessert until you finish your broccoli” is an attempt to force a child into eating against their will.

Regardless if your child has to avoid one food or ten foods, eating needs to be a relaxing experience for everyone. Sharing a meal with other people needs to be a time where children learn table manners, how to engage in conversation, how to sit still, and how to use a fork, among other life skills. Eating and learning to eat are life skills. It should not be a time that they are badgered, begged, or belittled into eating the food in front of them. If you find that mealtime in your home is incredibly stressful then it is time for a change.

The good news is that there is help--and change for the better is possible.

As an Associate in training with the Ellyn Satter Institute, I am a huge fan of Ellyn Satter’s work. Her techniques and recommendations for feeding children (and adults) can encourage food seeking instead of food avoidance behavior in children with food allergies.

The Ellyn Satter Institute (ESI) website is filled with an amazing amount of information to help you on your journey of adjusting how you approach food and feeding at your house. Until you have time to read one of Ellyn’s books and information on the ESI website, here are a few tips to get you started:

  • Division of Responsibility. As the parent or caregiver, you decide what food, when to eat, and where the eating will take place. It is up to the child to decide if and how much they will eat. Drop the drill sergeant act, take deep breaths, and let your child decide on their own what and how much they want to eat. For most children, skipping a meal will not cause immediate harm.  You have provided the opportunity for the child to eat. It is up to the child to decide if they will utilize that opportunity; but take comfort knowing that as a parent or caregiver, your job is done.
  • Eat at a table without distractions. Turn off the screens (large and small) and make eating the main activity. Eating at a table is especially important in situations when cross contamination is a concern or if young children may try to take food off of someone else’s plate that may not be safe for them.
  • Serve the food family style. Let the child choose what foods they want on their plate.  It is important that the child sees other family members eating the same food as them…even any hypoallergenic supplements that may be included in your child’s diet. If the child feels that their food is just like everyone else’s food, they may be more inclined to eat it.
  • Trust your child. If they say they do not want to eat a food do not pressure them. They may not be able to fully explain the feelings of worsening acid reflux, difficulty swallowing, or anxious feelings over trying something new.

How do you know if a child is just “going through a phase” or if they are truly becoming fearful of eating? 

This is a more difficult question to answer. If you find that your child starts to self-restrict and refuses to eat foods that are safe and this lasts longer than a week, it may be time to have them evaluated by a professional that is specially trained in eating and feeding disturbances. This can be a speech therapist, an occupational therapist, or a registered dietitian. A family counselor or therapist may also be able to help identify how much anxiety your child is experiencing around food.

Continue to follow low-pressure techniques such as those recommended by the Ellyn Satter Institute.  Provide emotional support by backing off, backing down, and letting your child have some control over their food and food choices. All children want control, but for those with health issues control is something that is harder for them to gain. They spend more time at the doctor’s office, less time at a friend’s house playing, and may feel like they have fewer privileges then a sibling without food allergies. Find ways to allow your child to have some control over their world. Control over other parts of their world will translate into better experiences at the dinner table.

A diet needs to have as much variety as possible in order for it to be a healthy, well balanced diet. If you find yourself in a situation where your child only wants to eat five foods (for example), consider adding a hypoallergenic supplement to fill the holes while variety is worked back into the diet. This is important to ensure that your child is getting all of the vitamins and minerals, protein, and calories they need to maintain a healthy immune system and grow.

All children, regardless of any medical conditions, go through different phases with their eating habits. As a parent or caregiver, listen to your instincts. Do not hesitate to have your child evaluated by a professional if you are concerned that they are developing a fear of food. It is a very real fear and do not assume that your child is simply trying to manipulate you into only getting the food he or she wants. Do not feel embarrassed if you find you need professional help to help your child through it. With the right help, your child will get past their fear or anxiety and everyone will be happier on the other side.

- Alexia Beauregard, MS, RD, CSP, LD

Our guest blog today comes from Alexia Beauregard. Alexia is a food allergy specialist dietitian who also specializes in eating and feeding disturbances and is based in Greenville, South Carolina. She loves working with food allergy families to help make food fun again. Alexia believes that eating should be one of the basic joys in life and wants everyone to be able to enjoy whatever foods they can. She works with families in an outpatient setting and also teaches college courses. Her professional organization memberships include the American Academy of Allergy, Asthma and Immunology (AAAAI), American College of Allergy, Asthma and Immunology (ACAAI), the Council for Pediatric Nutrition Professionals (CPNP), and the International Network for Diet and Nutrition in Allergy (INDANA). She speaks regularly at conferences for medical professionals and for families.  You can find her on her Facebook page or in her private practice--Seagrass Nutrition & Therapy ( Her three children and husband keep her pretty busy at home. The Beauregards love sailing, biking, hiking, and just being outside in general. As a family, they are very active in sea turtle conservation and believe in conservation through education on the importance of preserving marine life habitat. You can often find them enjoying the beaches of South Carolina.

6 Tips for Staying Safe at BBQs with Food Allergies

Posted 8.30.16 | Nutrition Specialist

With summertime coming to a close, there will be many “end of the summer barbecues” to attend. Don’t let food allergies be the reason not to spend time with family and friends! To ensure you or your child is safe at these BBQ’s, we put together a list of helpful tips for attending cookouts with food allergies:

Talk With the Host Before Attending

Regardless of who is hosting the family (family member, friend or a co-worker), they may or may not know about any potential food allergen your family is avoiding. Prior to the party, it’s always a good idea to give them a heads up by taking a few minutes to talk to them. If you had such conversations with the host in the past, don’t assume they remember.

It’s best to begin such conversations with education about food allergies, instead of jumping right into expectations/your needs. Remember not everyone is as knowledgeable about food allergies as you are. You don’t have to go into the nitty gritty details, but more about what you (or your child) is allergic to, what potential reactions can happen and how the host can offer a safer opportunity to be included in the event.

This is a great time to ask what foods they plan to serve and any ingredients in those foods that may contain an allergen. Sometimes the host may take extra precaution to use ingredients that don’t contain the allergen or they will make sure you know so extra precaution can be taken. During such conversations it’s always a good idea to bring up other ways you can assist.

Offer to Clean the Grill

While cleaning the grill may be labor intensive and time consuming if you aren’t grilling at home, it may add to your peace of mind. If you can’t or don’t want to clean someone else’s grill (lid included), consider wrapping your child’s food in aluminum foil (either heavy-duty or double wrapped to help prevent tears in the aluminum foil) prior to cooking. You can also consider bringing food that can be microwaved or cooked in a skillet to avoid the grill altogether.

Bring “Green Light" or "Safe” Food

Offer to bring a side dish or dessert that is allergen free for your child to consume. This way you know there will be a few things there that are okay to eat. You can also choose to bring your own condiments in individual-sized packets to help prevent any potential cross contamination with allergens when people eat family style and share large containers.

If you are looking for fun ways to incorporate Neocate into dishes you bring for your family, make sure to review our Neocate Footsteps Recipes. This guide contains delicious allergy-friendly recipes you can make to enjoy with the whole family. Recipes including Neocate Infant, Neocate Nutra, Neocate Junior and Splash products.

Go First in Line

Some sauces and condiments may contain foods that your child is allergic to. When at a BBQ, consider asking if food for your allergic little one could be prepared first (potentially separately) on the grill before adding those sauces to other food on the grill. This can help ease the concern of cross contamination with allergens.

Going first also pertains to going first in the buffet line. Some people are unaware of how easily cross contamination with allergens can happen and don’t realize that you shouldn’t switch the spoons for the coleslaw and the potato salad. By going first in the buffet line, you know the “safe” foods haven’t been contaminated with a potentially allergenic food.

Eat Before You Go and Bring Snacks

Sometimes it is easiest to feed your child before attending an event. With a full belly, there is less of a desire to eat foods that may contain potential allergens. If the event lasts more than a few hours, consider snacks you know your child will be able to eat.

Always Be Prepared

It’s always best to prepare for emergencies than to be caught by surprise. Prior to your event, take steps to make sure everyone knows what to do in an emergency situation. Better yet, write down and carry with you an emergency plan of action.  If your child carries an epinephrine auto-injector in case of anaphylaxis, make sure you have it with you at all times!


6 Allergy-Friendly Breakfast Recipe Ideas

Posted 8.25.16 | Nutrition Specialist

Neocate Fruity Tutti Pancakes

Doesn't this name just makes you want to try some! This is a great recipe if you are looking for a nice, hot breakfast option. Pefect if the rest of your family is eating pancakes and your are looking to make allergy-friendly option.  Pancakes also make a good finger-food option for weaning toddlers.

Want to print or save this recipe? Click the image below for your own recipe card:

Baked Oatmeal

(Submitted by: Kristy Harbaugh)
  • 1 cup oil (can sub. applesauce)
  • 1 1/2 cups sugar (can reduce)
  • 4 eggs
  • 6 cups oats (not the quick-cook kind)
  • 4 tsp baking powder
  • 1 tsp salt
  • 1 tsp cinnamon
  • 2 cups water

Combine all ingredients in order listed.  Pour into a greased 9 x13” pan.  Bake at 375°F for 30-40 minutes until lightly browned.  Serve with fresh fruit (bananas, strawberries, blueberries).

Notes: Do not use cooking sprays as all of them contain soy.  I used olive oil.

Serving Size: 8

Per Serving:

  • Calories: 650
  • Protein: 11g
  • Carbohydrates: 79g
  • Fat: 6g

French Toast

(Submitted by: Katherine Kennedy)
  • 2 Pieces of spelt bread
  • 1/4 cup of soy milk
  • Dash of cinnamon

Combine milk and cinnamon. Dip and coat the bread lightly in the soy milk mixture. Place on preheated skillet on low-med heat. You will have to cook it longer to ensure the soy milk dries and the toast isn’t mushy.

Serving Size: 2 pieces

Per Serving:

  • Calories: 250
  • Protein: 10g
  • Carbohydrates: 44g
  • Fat: 5g

Cinnamon Breakfast Bread

(Submitted by: Mary Blackorby)

With fall just around the corner, this is a fun option to warm up on a cool morning.

  • 2 cups Bob’s Red Mill All Purpose Baking Flour
  • 3 tsp gluten-free baking powder
  • 2 tsp sugar
  • 1/2 tsp salt
  • 1/2 cup Spectrum Organic All Vegetable Shortening
  • 5 fl oz rice milk (or Neocate formula)

Stir together flour, baking powder, sugar & salt. Cut in shortening with a fork until fine and mealy. Add rice milk (or Neocate formula) all at once. Pour into a greased 8” pan, sprinkle with cinnamon sugar mixture and bake at 400°F for 10 to 12 minutes. Serve warm for breakfast.

Serving Size: About 12 servings

Per Serving:

  • Calories: 150
  • Protein: 2g
  • Carbohydrates: 17g
  • Fat: 9g

Nutrition information for cinnamon bread recipe above calculated using rice milk.

Banana Bead Muffins

(Submitted by: Laura LaMotte)
  • 4 ripe bananas
  • 3/4 cup sugar
  • 1/2 cup of dairy-free margarine
  • 1 tsp vanilla
  • 1/4 tsp salt
  • 1 tsp baking soda
  • 1/4 tsp cinnamon
  • 2 cups of brown rice or oat flour

Preheat oven to 350°F. In a food processor, blend bananas, sugar, margarine and vanilla. Add remaining ingredients and process until smooth.

Pour into muffin tins and bake for 15-20 minutes, or if using a bread loaf tin, for 60 minutes. Let cool and enjoy!

Serving Size: 15 muffins

Per Muffin:

  • Calories: 230
  • Protein: 2g
  • Carbohydrates: 43g
  • Fat: 7g

Wheat-Free Pumpkin Muffins

(Submitted by:Karen Mischler)
  • 3 cups wheat-free flour
  • 2 cups sugar
  • 1/2 tsp cinnamon
  • 2 tsp baking soda
  • 1 cup canola oil
  • 2 cups canned pumpkin

In a large mixing bowl, sift together dry ingredients. Add oil and pumpkin, mixing well. Transfer into lined muffin tin and bake at 350°F until fork inserted in center comes out clean (about one hour).

Serving Size: 10 muffins

Per Muffin:

  • Calories: 330
  • Protein: 3g
  • Carbohydrates: 31g
  • Fat: 23g

For additional Neocate recipe ideas, make sure to download Neocate Footsteps Recipes Guide.

Do you have a favorite recipe that you would like to share with the Neocate community? Post below, we would love to hear about your favorites.

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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.