Cross contamination is a big concern among food allergy sufferers.  According to Kids with Food Allergies, cross contamination can be defined as “a food being inadvertently contaminated with food proteins other than those listed on the food label during the course of its being prepared, stored or served”.

During Manufacturing and Production:

One way that cross contamination may occur is during the manufacturing of a food. For example, when a safe food is manufactured on the same equipment as an unsafe food, there is a chance for trace amounts of the unsafe food to end up in the safe food. For those with food allergies, even trace amounts of an allergen can lead to serious allergic reactions.

Although the Food Allergen Labeling and consumer Protection Act of 2004 (FALCPA) requires manufacturers to clearly list the top 8 allergens on the food label, this rule does not account for cross contamination. Sometimes you will see “may contain (allergen)” or “made in a facility that also produces (allergen)” on a label but the manufacturers are not required to list this information. If you have any doubts, call the manufacturers and ask about the possibility of cross contamination. If your child’s allergies are severe and the manufacturer can’t guarantee it is safe, its probably not worth the risk.

By the way, this is why we are proud to say that Neocate is the only amino acid-based infant formula prepared in a 100% milk-free manufacturing site, eliminating the risk for cross contamination!

At Home:

Cross contamination can also happen in your home. Kids with Food Allergies provides some helpful tips on minimizing this risk: http://www.kidswithfoodallergies.org/resourcespre.php?id=65.

Eating Out:

Eating out can be intimidating for those with food allergies because you have less control over how foods are handled and efforts to minimize cross contamination. For helpful tips, check out this article from Food Allergy Gourmet.

Food Safety for Everyone:

The risk of cross contamination is not limited to allergy sufferers. Cross contamination of bacteria from foods (such as raw meat, seafood and eggs) is a concern for everyone. To keep you and your loved ones safe, follow these tips from the USDA Food Safety and Inspection Service.

Have any of your children experienced an allergic reaction as a result of cross contamination?  Any advice to offer other parents?
 

-Mallory

As we enter the new year, which just so happens to be a leap year, it’s a great time to take a “leap” (pun intended) and resolve to add new foods to your little one’s diet.

When your child has multiple food allergies, you have to work within the range of safe foods so as always, if you are unsure if a certain food is safe or not, always consult with your child’s healthcare professional first.

Be persistent!

One important thing to remember is that if you don’t succeed with a certain food, don’t give up on it or assume that your child doesn’t like it. A certain degree of “neophobia”, or fear of new foods, is normal for toddlers and young children. According to Angela Haas, a speech language pathologist and feeding therapist with over 18 years of experience, children may need up to 20 exposures to a new food before they will accept it. So, if the first try fails, continue to present the food occasionally in a non-forceful manner and eventually, you might be surprised to find that your child accepts and even enjoys it.

Give choices!

Another tip for introducing new foods is to always provide choices so your child feels in control of what they are eating. Instead of saying “You are going to try sweet potatoes today!” ask “Would you like to try sweet potatoes or squash today?”

You may choose to present a small amount of several different foods (only those which are allergy-safe of course). Include a few familiar, preferred foods and a few new ones that they can choose from. Again, this makes them feel in control of what they are eating and less resistant to try new things. You may think that children would be overwhelmed by multiple foods at one time but a recent article reports that on average, children prefer a plate with 7 different items and six different colors (while adults prefer a plate with 3 different items and 3 different colors)[1].

Baby steps!

With toddlers and young children, its important not to pressure them to eat a certain food. Give them the option to say “no, thank you” (but not, “eww gross”) if they aren’t ready to try it. Depending on how resistant the child is to new foods, there are different levels for gradually getting them to accept them. You can start by presenting a new food, along with other familiar foods. They don’t have to eat it but they have to allow it to remain on the plate throughout the meal. Continue to present a new food along with familiar foods and allow your child to get acquainted with it. This might mean smelling it, touching it, playing with it and once they are ready, tasting it. We’ve always heard “don’t play with your food!” but for very young children at this stage, the goal is get them comfortable and familiar with a new food, however that may be.

For more tips on expanding your child’s diet, here are some resources which might be helpful:

• Child of Mine: Feeding with Love and Good Sense
• How to Get Your Kid to Eat…But Not Too Much
• Secrets of Feeding a Healthy Family: How to Eat, How to Raise Good Eaters, How to Cook
• Just Take a Bite
• http://www.ellynsatter.com/

Please remember that these are general guidelines for expanding your child’s diet. Always ensure that you only introduce foods that are safe for your child’s specific food allergies and when unsure, consult with a healthcare professional.
 

What challenges do you have with expanding your child’s diet? Any tips for other parents?

-Mallory

Q:I’ve found a few cans of Neocate at the back of my pantry that I’d forgotten about. The expiration date was last week, but they’re still okay to use, right?

A:We get questions about using Neocate past the expiration date often. Here’s what you need to know:

The expiration date

For our powdered Neocate products you can find the expiration date on the bottom of the can. If you’re looking at a drink box of E028 Splash, you can find the expiration date on the top of the drink box. The expiration dates on the Neocate family of products follow the standard North American format, which is Month/Day/Year. Technically, the product is good to use through midnight on that date.

How are your expiration dates determined?

The expiration date on any product, not just Nutricia products, is based on several factors. One is the integrity of the packaging materials. We want to ensure they will keep the contents safe until the expiration date. Another is the stability of the ingredients. For instance, some fats go rancid faster than others – think fresh walnuts versus vegetable oil for cooking. We want to ensure that the product is fresh for the full shelf-life.

A related factor is to ensure that the nutrients in the product are going to be 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 children use Neocate to meet their full 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 until the expiration date.

What we recommend

The ultimate intent of an expiration date is to keep our customers safe and ensure they receive the nutrients that they need. We cannot recommend using any of our products past the expiration date. Period!

If you have further questions about this, we’d recommend discussing this with your health care team. It may help to provide them with the above information to get their informed opinion. 

Q: My son has severe allergies and his pediatrician recommended Neocate. I see that it’s expensive and isn’t available at the store. I’ve also been online and see that similar products exist. Can you tell me what makes Neocate so special?

A: We get this question often. Not only have most parents never heard of Neocate, there are still some health care professionals who aren’t familiar with Neocate either.

Setting the Bar

Neocate was the first of its kind, and we set the bar high. The Neocate products are amino acid-based formulas, which by nature makes them special. The fact that Neocate is made with amino acids instead of protein is what sets it apart and allows it to help so many children to feel better. With Neocate, Nutricia is committed to producing the best amino acid-based formulas possible.

First, we ensure that our customers get a product that will not cause a typical allergic reaction. To start, none of the Neocate ingredients are derived from milk, and we mix the Neocate powders in a facility that is 100% dairy protein-free: no cows allowed! We also test every batch of Neocate for dairy, just to be sure. And with E028 Splash, we also test for gluten to ensure it’s gluten-free.

Specialized Products for Special Kids

Because many children need Neocate for more than just a few weeks, we want their Neocate experience to be as easy as possible. We do this by offering more options. For instance, Neocate Nutra is the only amino acid-based semi-solid food available. We also make Splash, the only ready-to-feed (no mixing needed) amino acid-based formula. On top of this, we offer lots of flavors in Neocate Junior, E028 Splash, as well as Flavor Packets. To top it off, Neocate Junior with Prebiotics is the only amino acid-based formula available with prebiotic fiber, which can help improve regularity. We think all of these make Neocate great and help children to stick with an elemental diet.

Extensive Research

Lots of work has gone into making Neocate the best product possible. Since the 1980s, we’ve supported over 50 publications involving Neocate, spanning over 240 pages in scientific journals. In fact over 1,000 people, mostly children, have participated in research that involved Neocate: that’s a lot of research! And while Neocate has been extensively studied in cow milk allergy, we’ve also supported research with Neocate in other conditions such as eosinophilic esophagitis(EoE), short bowel syndrome(SBS), multiple food protein intolerance(MFPI), food protein induced enterocolitis syndrome(FPIES), and others.

We’ve gotten to work with lots of researchers, many of whom are leaders in their field. And not just in the US – plenty of our research has taken place internationally on five continents! This research has helped to improve the way medicine is practiced, including diagnosis and treatment. We’re pretty proud of that! We even have a team of researchers based here in the US working on current Neocate studies. This is just one example of our dedication to advancing medical research.

Customer Support

Neocate wouldn’t be Neocate if it didn’t come with a lot of great “add-ons” for our families. For instance, we have great resources for parents on our website, blog, twitter, YouTube channel, and Facebook page. We (the Nutrition Specialists) also are available to answer questions for parents, caregivers, and health care professionals by phone, by email, and online. We even get to help develop new recipes to keep things interesting.

Finally, families new to Neocate often feel like they’re in unfamiliar territory. This is why we offer lots of reimbursement support, which is incredibly helpful for many of our customers.

The most important factor that makes Neocate special? Neocate kids! We love getting to talk to parents about their little ones every day, especially when they tell us how helpful Neocate has been and share good news. Hearing how special they are just makes our work that much more important.

My Top 5 Lunch Picks from our Neocate Food Allergy Cookbook:

• Cream of Broccoli Soup (Page 8)
  As a cream of broccoli soup enthusiast, I love this allergy-friendly (and far healthier) variation of the original. This is a very well balanced meal and a great way to sneak some vegetables into your child’s menu. 
   
• Hamburger Harvest Soup (Page 9)
  Naming a soup after a hamburger is a great way to entice your kids to eat it! This recipe is full of flavor and nutrients. It’s especially high in protein; Each serving provides 12 grams!
   
• Vegetable/Cracker Dip (Page 10)
  Serve with raw veggies and/or crackers (see cracker recipe on page 18!) and this is a healthy lunch. This would be a great option to send to school or have with you on-the-go. 
   
• High Calorie Neocate Shake (Page 22)
  This may not be an appealing lunch for everyone but since we so commonly hear from parents who have trouble getting their child to eat and gain weight, I thought this would be a great idea for some of you. A parent sent this recipe idea to us and said she uses it for sick days or when her child needs to gain weight. One shake provides a large amount of nutrients, healthy fats and of course, calories. You could easily use this as a meal replacement.
   
• Macaroni and Cheese (Almost) (Page 20)
  Mac & cheese is one of the most popular foods among kids. Thanks to this dairy-free recipe, children with milk allergies can have their mac & cheese too! You can also add some pureed butternut squash to this recipe for some added flavor, nutrition and to make the color more similar to standard mac & cheese.

Remember that you should always check the ingredients of these recipes to make sure they are appropriate for your little one’s food allergies.

What are your favorite allergy-friendly lunch recipes?  They can be from the cookbook or some of your own!

-Mallory

[Picture from Flickr.com]

In a recent study done in the UK, researchers surveyed restaurants about food allergies and found that most were misinformed.

To give some background, according to the study, deaths caused by food-induced anaphylactic reactions are increasing with most deaths being caused by food purchased outside of the home.

Allergen avoidance is always the most desirable form of prevention. and this is often easily accomplished in the comfort of your home. However, a late soccer practice, or meeting, or simply just wanting to enjoy the cuisine of a favorite local restaurant can make avoidance difficult.  This is because when choosing to eat out the responsibility of allergen avoidance is shared by the diner and the restaurant staff.

The researchers surveyed various restaurants and found that:

·        1 out of 3 kitchens, common food allergens like wheat, nuts, dairy, fish were not separated from other foods.

·        About 20% thought it was safe for an allergic customer to consume only a little of the allergen – and to pick the offending food out of the dish.

Probably the most concerning finding to come out of the research is that 81% of the restaurants reported they could provide a safe meal for allergic customers!

Keep in mind this study was conducted in the UK so similar findings in the US may not be as drastic. But in the world of food allergies, you can never be too careful! So when you eat out always remember it is your responsibility to be proactive and speak up about your allergies.

Also, If you’re looking for more information on dining out with food allergies, you can view our other posts on the topic here: Dining out with Food Allergies. These posts will help you and your family prepare for an allergy friendly dining experience.

- Christine

Study Reference:  Bailey et al. Restaurant staff's knowledge of anaphylaxis and dietary care of people with allergies. Clinical & Experimental Allergy.2010.41(5):713-717

Q: My child has multiple food allergies including milk, eggs, and soy.  With such a restricted diet, I am worried about his nutrition.  Is he getting enough nutrients in his diet?

A: As we know, there is no cure for food allergies.  The only way to manage them is by eliminating the specific allergen from the diet.  Most food-allergic children are at an increased risk of nutritional deficiencies especially when they have allergies to commonly used allergens such as milk, soy, eggs, and wheat.  Below is a table that highlights the important nutrients often found in these top allergens.  These nutrients may be lacking in a child’s diet if they are avoiding these foods due to allergies.  

Multiple studies have also found that children allergic to milk also have higher risk of poor bone growth and tend to be shorter in height versus children without food allergies.^1,2  Children eliminating just milk from their diets have been shown to be lacking in vitamin D, calcium, and protein.^1,3-4  The nutritional deficiency risk increases as the number of food allergies increase. These kiddos are at risk for malnutrition unless supplementation replaces the nutrients found in the offending allergen.¹

Age-appropriate nutritional supplementation is vital for these children.  A hypoallergenic supplement is highly recommended if the child is under two years old.⁵  Extensively hydrolyzed and amino acid-based formulas are often used to supplement a child’s diet when food allergies are evident.  Keep in mind, while extensively hydrolyzed formulas (eHFs) are considered hypoallergenic, they still use cow milk protein as seen in the ingredients (casein and whey are milk proteins). Amino acid-based products, such as Neocate, are more hypoallergenic than eHFs and are 100% free from allergens. Amino acid-based products are often used if the child does not tolerate an eHF, which can occur in 10-30% of food allergic children.^6-8Registered dietitians are important in evaluating your child’s diet. They can determine what percentage of the DRIs (Daily Recommended Intakes) of each vitamin and mineral your child is receiving and if changes need to be made in order to ensure your little one is getting 100% of their DRIs. With the help of your doctor and/or registered dietitian, you can find the right hypoallergenic product that will fit your child’s nutritional and developmental needs. 

1. Henriksen C et al. Nutrient intake among two-year-old children on cows’ milk-restricted diets. Acta Paediatr. 2000;89:272-278.

2. Agostoni C et al. Growth of infants with IgE-mediated cow’s milk allergy fed different formulas in the complementary feeding period. Pediatr Allergy Immunol. 2007;18:599-606.

3. Levy Y et al. Nutritional rickets in children with cows’ milk allergy: calcium deficiency or vitamin D deficiency? Pediatr Allergy Immunol. 2005;16:553.

4. Fox AT et al. Food allergy as a risk factor for nutritional rickets. Pediatr Allergy Immunol. 2004;15:566-569.

5. Fiocchi A et al. Diagnosis and Rationale for Action Against Cow’s Milk Allergy (DRACMA): a summary report. J Allergy Clin Immunol. 2010;126(6):1119-28.

6. de Boissieu D et al. Allergy to extensively hydrolyzed cow’s milk proteins in infants; safety and duration of amino acid based formula. J Pediatr. 2002;141(2):271-273.

7. Latcham F et al. A consistent pattern of minor immunodeficiency and subtle enteropathy in children with multiple food allergies. J Pediatr. 2003;143:39-47.

8. Isolauri E et al. Efficacy and safety of hydrolyzed cow milk and amino acid-derived formulas in infants with cow milk allergy. J Pediatr.1995;127 :550-557. 

With the Fourth of July around the corner, we wanted to share some food allergy-friendly ideas and recipes for you to enjoy during the holiday weekend. We wrote a blog in the past that may help to find general food allergy tips if you and your family are planning a day out of the house.

In honor of the Independence Day, I compiled a couple food allergy-friendly recipes with a red, white and blue theme. As always, check the ingredients to ensure they are allowed in your little ones diet. Also, recipes can always be tweaked to meet your needs, so if you have other ideas on how to make it better for your family, feel free to experiment.

Being the Nutritionist, I tend to stay away from high fat and nutritionally void treats. Fruit recipes are always a great way to add beneficial fiber as well as important vitamins and minerals to a healthy diet.

These recipes are all diary free and egg free.

RED Strawberry Shortcakes

This recipe is definitely a family favorite, with that same classic taste without the dairy. I prefer to use my own dairy-free vanilla ice cream if I have the time, but for weeknight desserts or quicker treats, a dairy-free store-bought variety works just as well. Feel free to use whatever fruits you like along with the strawberries; peaches, mangoes and other berries are always a nice variation.

Prep Time: 10 minutes

Cook Time: 25 minutes

Total Time: 35 minutes

Ingredients:

About 3 cups fresh strawberries, hulled and cut into halves

¼ cup and 2 Tbsp. white sugar, plus more for sprinkling

1 ½ cup all-purpose flour

¼ cup and 2 Tbsp. white sugar

2 ½ tsp. baking powder

¼ tsp. salt

6 Tbsp. dairy-free soy margarine, cut into pieces

½ cup unsweetened plain almond milk, soymilk or rice milk

Dairy-Free Vanilla Ice Cream, either store-bought or homemade

Directions:

1. Preheat the oven to 400 degrees. Line a large baking sheet with parchment and set aside. In a medium mixing bowl, toss the strawberries with the 2 T. sugar until well coated. Cover and place in the refrigerator for about 20-30 minutes.

2. Meanwhile, make the biscuits. In a food processor, mix together the remaining ¼ cup sugar, flour, baking powder and salt until well-mixed. Add the dairy-free soy margarine, pulsing until the mixture resembles fine crumbs. With the machine still running, add the non-dairy milk alternative gradually, until the dough just begins to hold together and pull away from the sides of the bowl.

3. On a lightly floured surface, turn out the dough and pat into 8 small round biscuits. Transfer the biscuits to the prepared baking sheet, sprinkle lightly with sugar, and bake about 18-22 minutes, or until golden. Allow the biscuits to cool on the baking sheet. To serve, place two biscuits on each plate with a scoop of dairy-free vanilla ice cream and a helping of the sugared strawberries.

WHITE Bean and Garlic Dip 

Ingredients:

2 cups cooked (1 c dry) white beans, ie. Great Northern, Cannellini, Navy, or Butter Beans (canned beans may be used)
2-3 garlic cloves
1/4 c olive oil
1/4-1/2 c bean cooking liquid, broth, or water
1 Tbsp fresh thyme or 1/2 Tbsp dry
Juice of 1/2 lemon
1/2 tsp sea salt
Fresh cracked pepper

Optional: olive oil, salt, pepper, and thyme for garnish

Directions:

If starting with dry beans, soak overnight, then cook beans per desired method, saving any leftover bean cooking liquid. If using canned beans, drain beans, and rinse well. 

Place cooked beans in blender or food processor, along with garlic, olive oil, 1/4 cup liquid, thyme, and Vitamin C crystals. Pulse a few times, then blend until well smooth. If mixture is too thick, add additional liquid as necessary while blending. Add salt and pepper salt and pepper to taste, and blend again to mix. 
To serve, scoop into serving bowls, and drizzle with additional olive oil, salt, pepper, and thyme leaves. Store leftover dip in the fridge for up to 5 days, or freeze in an ice cube tray and store in a freezer bag for up to 3 months.

Pineapple-Strawberry (or BLUEberry) Granita

Ingredients

1 cup strawberries or Blueberries, hulled
1 1/2 cups pineapple juice
1/2 cup sugar
1/4 cup water

Directions

Purée strawberries (or blueberries) in blender or food processor; pour in pineapple juice, blend and set aside. In small saucepan over medium heat, bring sugar and water to a boil, stirring occasionally to dissolve sugar. Remove from heat and let syrup cool, about 20 minutes. Whisk pineapple-strawberry mixture into sugar syrup and pour into to a shallow metal pan. Place pan in freezer, mixing with a fork every 30 minutes until frozen, about 2-3 hours.

If you have any other recipes to share, please let us know, we would love to hear them.

Enjoy the 4^th of July weekend!!

-Christine

While we usually write about common food allergy symptoms, such as diarrhea or eczema, more severe reactions like anaphylaxis are possible for many children and adults with allergies. Allergens that cause anaphylaxis include food, insect stings, drugs, latex, and even exercise.  When anaphylaxis happens as a result of contact with an allergen, a rapid immune reaction occurs that can quickly make breathing very difficult.  For those patients an immediate injection of epinephrine can prevent very serious complications.  Sometimes even the few minutes it takes emergency medical care to arrive is too long, and a personal device with automated injectable epinephrine, an auto-injector, such as the EpiPen® Auto-Injector, is essential.

The EpiPen, made by Dey Pharma, works by delivering a quick shot of epinephrine to the thigh.  There are also similar devices available, such as the Adrenaclick® and TwinJect®, both made by Shionogi Inc. Twinject is unique in that it has a built-in backup dose of epinephrine, which can take the place of two auto-injectors in an emergency.

Epinephrine helps the body to keep the airway open so that breathing does not become as difficult, allowing time for emergency medical care to arrive. But many parents worry that one auto-injector might not be enough or that something might go wrong that could require additional auto-injectors. For instance, someone nearby might experience a severe allergic reaction and need to use your child’s auto-injector. Or what if your child’s only auto-injector was unknowingly broken? What if the auto-injector were accidentally put in the fridge or left in the sun? What if the contents were cloudy? Or if it had expired? So many scary possibilities!

So, what is the right number of auto-injectors? The answer to that question depends on a number of factors. Bear in mind that the Twinject has two doses of epinephrine, but according to the company the second dose should only be used as a backup to the first dose and should not be saved for future allergy emergencies.

How Many to Carry?

On their websites, Dey Pharma and Shionogi recommend that patients at risk for allergic emergencies carry two doses of epinephrine. This is because up to 20% of patients who have an allergic emergency requiring epinephrine will require a second dose. At all times the injector should be kept close to room temperature, out of sunlight, and replaced by the expiration date. You can even sign up for an expiration date reminder on either of the websites. It’s a good idea to occasionally check the solution in the auto-injector to make sure it hasn’t discolored, which can be a sign of a possible loss of effectiveness.

If a long trip is planned, especially one overseas where similar products may not be readily available in pharmacies; two auto-injectors (or one that contains two doses) may not be enough.

Should you or your child carry more than two auto-injectors? Not necessarily. Additional backups would likely be for peace of mind. A second dose of epinephrine may be needed in an emergency, but more than two doses during an emergency should only be given with medical supervision. Some caregivers choose to carry two auto-injectors from different lots for added precaution.

Multiple Locations

Some patients who use auto-injectors prefer to carry the standard two with them and also keep backup injectors in one or more strategic locations. These might include an extra one or two at work, school, daycare, and/or a relative’s house. These are great because they can serve as backup in case someone forgets their daily go-everywhere auto-injectors. Just make sure you follow the recommended storage instructions everywhere you keep an auto-injector and check your backups for discoloration and expiration dates. Knowing that you have extra auto-injectors in places like this, in addition to the daily carry-with auto-injectors you have, may bring you more comfort.

How about you? How many auto-injectors does your family keep on hand, and where? Please share your thoughts in the comment section of this blog post.

- Rob

[Image Source]

Q: Our family keeps kosher, and we just found out that my son needs to be on Neocate due to his severe milk allergy. I know some formulas aren’t kosher, can you tell me if Neocate is?

A: Neocate does not have an official kosher certification. However, the London Beth Din Kashrut Division (LBDKD), an independent, leading authority on kosher food and Jewish Law, recognizes the Neocate family of products as Kosher. Please note that we are not affiliated with this organization. Below are some of their websites which may be helpful for you.

• To view an “Approved Product List” which lists Neocate, visit http://www.kosher.org.uk/documents/ApprovedProducts2010_003.pdf.
• To view an “Approved Product List” which lists Duocal, Monogen, E028 Splash, metabolic products, and Ketocal, visit http://www.kosher.org.uk/documents/Medicines2010.pdf.
• You can look up the kosher status of any product using the search feature on the LBDKD website: http://www.theus.org.uk/jewish_living/keeping_kosher/keeping_kosher/kosher_product_search/.

If you are interested in using one of our products and are concerned about the kosher status, you can share the information above with your Rabbi. To contact the London Beth Din Kashrut Division, visit http://www.kosher.org.uk/contact.htm. 

Kosher and Food Allergies

You can look for the kosher symbol on a product, which is usually some variation on the letter U or K (click here to view the commonly used kosher symbols in the US). This indicates that the food has been inspected by a kosher certifying agency. If it has a “D” or the word “dairy” next to it, this means that it contains dairy. If the kosher symbol has an “m” or the word “meat” next to it, this product contains meat and if it has “pareve” written next to it, it contains neither milk nor meat. Fish is commonly classified as “neutral” or “pareve” so keep this in mind if your little one has fish/shellfish allergies.

Don’t forget that kosher labels may not always take cross-contamination into account so it’s possible that there are traces of milk proteins in a product even though it is not labeled as “dairy". So if something has a kosher symbol listing “meat” or “pareve”, you should still read the ingredients closely or call the manufacturer and not assume it is 100% dairy-free.