We know your child relies on Neocate, and we want to make sure he or she receives the best possible nutritional support according to the very latest medical and scientific knowlegdge.  This means from time to time we improve our products to better serve your family.

There has been speculation in recent weeks about whether there have been changes to Neocate Junior, unflavored over the past year.  Up until now, we have made no changes (you can read about this here).  Whenever we plan changes or improvements to our products, we announce them to you in advance and also provide information and resources to help you and your family prepare.

We would like to share with you that we are making upgrades in 2013 to many products within our Neocate family, specifically Neocate® Infant, Neocate® Junior and Neocate's E028 Splash.  Improvements will be made first to Neocate Junior, starting in mid-February.

You can find details on what we have changed, when you can expect to see them and helpful resources here.  We will also update you well in advance with information and tips on the coming changes to Neocate Infant and Neocate's E028 Splash.

Here's briefly what you can expect to see from the improved Neocate Junior:

• The levels of eleven vitamins and minerals in Neocate Junior have been upgraded to provide better nutritional support for your child.  The changes are in line with the latest dietary reference intake (DRI) recommendations by the Institute of Medicine.
• The levels of protein, fat and carbohydrate (i.e., macronutrients) will remain the same.
• No new ingredients will be added to the product.
• There will be no change in can size, price, codes or graphics.
• Beginning in January we will announce that an improved product is coming through the use of stickers on the lids of current Neocate Junior products.
• The improved Neocate Junior will be available beginning in mid-February, clearly marked with stickers informing parents that the product has "improved levels of vitamins and minerals."  Specific availablity in each area and by flavor may differ.

We understand the sensitivity of the chidlren who rely on our products.  For most children, moving from one formula to an improved version of the same forumla does not require a "transition period."  However, some parents and clinicans prefer to transition over the course of a few days.  We recommend that you contact your child's pediatrician or other healthcare provider with any specific questions or concerns about making this transition.

Additional details including transition tips can be found here or by calling our Nutrition Specialist at 1-800-Neocate (636-2283) 

- Team Neocate

Hosting or attending a holiday dinner can be stressful for parents of children with food allergies. We’ve compiled a list of helpful resources to help you ensure a safe and enjoyable holiday celebration for your family.

Guides

• Kids With Food Allergies Guide to Holiday Dinner  
• Holiday Tips for Those with Food Allergies from American College of Allergy, Asthma and Immunology
• Allergies, Asthma and Winter Holidays from American Academy of Allergy Asthma and Immunology

Remember to check for hidden allergens that may be added during the processing or preparation of your holiday feast. Gravies and sauces may contain hidden allergens, so be sure to check the ingredients first.

Food and Recipes

Below is a list of some allergy-friendly variations to the traditional holiday dishes. Please be sure to consult your healthcare professional to determine if these recipes, there ingredients and consistencies are appropriate for your child.

• Neocate Nutra Allergy-friendly mashed potatoes from Nutricia
• Allergy-friendly herb biscuits from FAAN
• Allergy-friendly Desserts:
  • Allergy-friendly Old-fashioned Apple Pie from FAAN
  • Dairy-Free, Soy-Free Pumpkin Piefrom GoDairyFree
• General tips and recipes:
  • Basic Recipe substitutions for food allergies from Kids With Food Allergies
  • Neocate Food Allergy Cookbook from Nutricia

Helpful Articles for Celebrating the Holidays with Food Allergies

• Allergy-Free Holiday Recipes from AAAAI
• Turkey, Mistle Toe, and Food Allergies? From Food Allergy Living
• Thanksgiving and Other Holidays with Food Allergies from Food Allergy Living

For those of you who will be traveling over the holidays, here are some articles that may be helpful to you:

• Food Allergy Travel Tips: You Can Take it with You from Food Allergy Living
• Kids With Food Allergies guide to Traveling With Food Allergies

Do you have any fun allergy-friendly recipes or holiday tips? Please share them!

- Mallory

Do you find yourself wondering if your little one has a food allergy?  As we’ve mentioned in previous blogs, skin rash, diarrhea, colic, reflux, vomiting, restless sleep and excessive crying are all possible symptoms of a cow/soy milk allergy. 

A good way to help you find out if there might be food allergens affecting your baby is to keep a daily diary of their diet and any symptoms that occur.  This will help your child’s doctor or dietitian detect which foods could be triggers for allergic reactions.

To make life easier for you, we have developed a baby allergy tracker app which will help you to keep accurate track of everything your baby eats, their activities and any symptoms that occur on a daily basis:

• Keep track of your baby’s diet
• Record your baby’s symptoms and upload photos directly from your phone and attach them to diary entries
• Log daily care activities
• Use the reminder function to let your phone automatically remind you to update your diary
• Personalize your diary with your baby’s name, image and date of birth
• Export your diary as a PDF file via email

The app is available for download here: http://itunes.apple.com/us/app/neocate/id433627727?mt=8&ls=1 and it is compatible with iPhone, iPod touch, and iPad iOS 3.2 or later.

Have you downloaded the app?  What do you think of it?  Leave us a comment below!

We get a lot of questions from food allergy families about how to get insurance to cover elemental formula like Neocate.  While some insurance companies do reimburse families for these formulas, many do not.

At Nutricia, we feel strongly that reimbursement for formulas that are medically necessary is something insurance companies should do.  Getting help with the costs of feeding a child with cow milk, soy or protein allergies, or severe GI issues, can go a long way to helping the whole family feel better.  

On the Neocate website we have lots of resources and information that can help you find reimbursement for the medical foods and exempt infant formulas your child needs to thrive. You may be eligible for private insurance coverage, government support and even assistance from us.

We are especially proud of our Nutricia Product Coverage Navigator program! The program assists patients living in Arizona, Connecticut, Illinois, Massachusetts, New Jersey, New York or Texas obtain insurance coverage for Nutricia products, including Neocate.

So, if you are a resident of Arizona, Connecticut, Illinois, Massachusetts, New Jersey, New York or Texas please call 1-800-365-7354 for help with:

• Obtaining prior authorization for any and all Nutricia products, including Neocate Infant, Neocate Junior and E028 Splash;
• Answering questions regarding claims submissions;
• Drafting letters of medical necessity;
• Providing instructions on how to correct billing errors;
• Interceding with the insurance company on complex reimbursement matters; and
• Appealing a denied claim.

But, if you don’t live in one of these states, please visit the Neocate website where you will find tips for obtaining coverage and details about reimbursement legislation.

As most of you know, we redesigned our Neocate.com website in May of 2011.  In case you haven’t paid us a visit, come on by.  We added a few new online tools to help provide support and guidance to you and your family.  Our new Parent’s Toolbox and Reference Library includes a symptoms guide, glossary and a symptom checker which have all gotten great reviews – thank you for the feedback! 

Our website is always a work in progress and we will continue to work on providing new tools and resources.  Our newest online tool that we are excited to share with you is the online diary!

The online diary is a perfect tool to use when you are trying to determine the right formula for your child, starting on solids or reintroducing foods into your little ones diet.

It is tough to remember or keep track of all the small (or big) symptoms or behaviors that may occur throughout the day and even more difficult trying to relate those symptoms back to a food if you’re not recording it somewhere.  Keeping a daily diary of what your child eats and drinks – and any symptoms you see afterward – gives your child’s doctors vital information. It can help them identify what might be triggering any symptoms. This online diary makes keeping track of everything a snap.

Over the past few weeks, under the guidance of my little ones physician, I have started adding solids into my 6 month olds diet.  Since starting, I've noticed a little rash around his mouth and chin.  With the dry winter weather just starting and the drool from new teeth coming in I couldn't figure out if the new foods I was introducing was causing the rash or not.

So I started using the online diary to record everything that we did.  When he took a bottle, when he ate solids, what he ate, when he was out in the cold, when the rash appeared, the severity of the rash, etc.  With the help of the online diary I was then able to begin to see a pattern of when the rash was appearing - right after we fed him, every night.  Could he really be allergic to peas?  I still had my doubts but relieved to have a record of what was occurring to share with my doctor.  Now we both had a clear understanding of what was going on and therefore were able to best determine the root of the problem.

I hope all of you find the online diary to be as resourceful as I do.  Do you have any other ideas of useful tools you'd like to see on Neocate.com?

-Sarah

Three million children are affected by food allergies in the US. Studies have also suggested that food allergies persist longer in life than was once previously assumed.¹Food allergies can have a wide ranging negative effect on children and their families, affecting life at home as well as the social lives of the family.

Sending a food allergic child to school, camp or any child care can be a scary task for a parent. Doctors are helping families prepare for these situations by ensuring that:

• Each child has an epinephrine device
• The family and child (if age appropriate) know how and when to use the device
• The family can train others on how to use device
• The student has an emergency plan (such as a 504 plan) for the facility in case of a reaction

Reactions in schools

Reactions in schools are actually rare. However, it is important to know that reactions do occur in schools and can be severe in some circumstances.

There has been a growing trend of parents who home school their food allergic child due to fear of a reaction. It is important to know that the vast majority of food allergic children can and do attend school safely.^2-4

The highest risk of a reaction is from direct ingestion of the food. Studies have shown that reactions to environmental or airborne exposure to allergens are extremely low.  In summary, the greatest risk of a reaction is from direct ingestion of the allergen.

Management of reactions at school

Reaction to a food allergen should be treated in a universal fashion. Isolated skin or mild GI symptoms without signs of shock (ie. hypotension, respiratory symptoms) can be generally managed with short acting oral histamines such as Benadryl® or Vistaril®.

Epinephrine should be given as soon as possible for more severe reactions involving laryngeal, pharyngeal or respiratory symptoms, severe vomiting or shock, followed by antihistamines with additional epinephrine as necessary. These protocols should be clearly communicated to parents by the healthcare professional.

Food reaction scenarios are where an Emergency Plan or 504 plan for your child must be available and easy to follow for all appropriate personnel at the school. Full time nursing availability in schools is becoming uncommon, which has placed the burden on the teachers and administrations. Studies have shown that emergency plans are not always followed as written, especially in schools without full time nurses.  This is why the healthcare community and parents must seize the opportunity to better educate all involved.

Do you have any tips for managing your child’s food allergies at school?

*This article was adapted from a Medscape Special Report, Oct 2011, written by Dr. Matthew J. Greenhawt, MD, MBA

1. Boyce JAS, Assa'ad A, Burks AW, et al. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010; 126(6 Suppl):S1-S58
2. Young MC, Munoz-Furlong A, Sicherer SH. Management of food allergies in schools: a perspective for allergists. J Allergy Clin Immunol. 2009;124:175-182.
3. Greenhawt MJ, McMorris MS, Furlong TJ. Self-reported allergic reactions to peanuts and tree nuts occurring in schools and child care facilities (Abstract). J Allergy Clin Immunol. 2008;121(S1):S95.
4. Sicherer SH, Furlong TJ, DeSimone J, Sampson HA. The US peanut and tree nut allergy registry: characteristics of reactions in schools and day care. J Pediatr. 2001;138:560-565.

On behalf of all of us here at Nutricia North America the makers of Neocate, we want to wish you and your families a very happy, healthy holiday season!  We hope these festive allergy-friendly recipes brighten your holiday!

Milk-Free Hot Chocolate

• 4 scoops Neocate Junior Chocolate
• 4 ounces water
• 2 tsp sugar (optional)

Heat water on the stove or in the microwave. Remove from heat, allow to cool and add Neocate powder and sugar. Stir well. Top with marshmallows (check the label to be sure the brand is appropriate for your child’s dietary restrictions).

Calories: 170
Protein: 5.2g Fat: 7g
Carbohydrate: 22.5g
Calcium: 183mg
Vitamin D: 1.8mcg

 Gingerbread Cookies:

• 3 3/4 cups flour
• 1 cup brown sugar
• 3/4 cup molasses
• 2/3 cup canola oil
• 1 egg beaten
• 2 tsp cinnamon
• 1/2 tsp baking powder
• 1 tsp baking powder
• 1/2 tsp nutmeg
• 2 tsp ground ginger

Directions:

Over medium heat combine molasses, oil and sugar in a saucepan and bring to a boil while stirring constantly. Set aside. Combine flour and other dry ingredients in a mixing bowl and add molasses, sugar and oil and pour into mixing bowl and then add egg and blend together to form a thick dough ball. Wrap dough in plastic and chill for 1 hour (if dough is too dry, add drops of canola oil, if too sticky to roll out, add flour). Preheat oven to 350°F. Divide dough in half and roll out on floured surface. Use cookie cutters and place cookies on a greased cookie sheet. Bake 10-14 minutes and let cool.

• Calories190
• Protein 2g
• Carbohydrates 31g
• Fat 7g

Makes 2 dozen cookies

Submitted by: Marie Bedard

Milk-free Peppermint Shake:

• 6 scoops Neocate Junior unflavored
• 6.5 ounces water
• 1 cup Organic Rice Dream® Vanilla Frozen Dessert if tolerated, or alternatively, add 1 cup crushed ice
• 1/8^thtsp peppermint flavor (be careful, a little goes a long way!)
• 2 tsp sugar (optional)

Add all ingredients except Neocate powder into the blender and mix until smooth. Next, add Neocate powder and mix on low setting until blended. Pour and serve. Makes 1-2 servings. If your child drinks smaller servings, pour half and store the remaining shake in the refrigerator for up to 24 hours.

Tip:Remember using the Old-fashioned peppermint sticks as a straw? Try using it with this shake! Check ingredients because brands will vary. Alternatively, you could use candy-striped straws, which you can find at most party stores!

Calories: 409
Protein: 8g
Fat: 18g
Carbohydrate: 54g
Calcium: 295mg
Vitamin D: 206mcg

 Halloween is right around the corner and your little ones are probably getting excited about their costumes, class parties and trick-or-treating.  And while these  can be fun experiences for children, we know that for parents of children with food allergies these events can be more frightening than ghosts and ghouls.

 Fortunately, with a little advance planning, you and your little ones can have a safe and spooky Halloween, without the risk of an allergic reaction.  Check out some of these blog posts for tips to help you prepare:

1. Celebrating Halloween without a Food Allergy Scare
2. Halloween with Food Allergies
3. Food Allergy Friendly Sweet Treats
4. Safe and Spooky Halloween Tips
5. Halloween: Focus on the Fun, Not the Food

What are you planning for Halloween?  Be sure to share your tips for having a fun and safe Halloween in the comments! 

We’re excited to introduce you to our newest product — Neocate® Junior with Prebiotics, Vanilla!  This is the first and only flavored amino acid-based medical food with soluble prebiotic fiber for children with GI conditions.  Neocate® Junior with Prebiotics, Vanilla will help fight flavor fatigue and provide digestive support for a balanced gut for manychildren who suffer from milk or soy allergies, multiple food allergies or allergy-induced gastrointestinal disorders.

Just like Neocate® Junior, Chocolate and Neocate® Junior, Tropical, Neocate Junior with Prebiotics, Vanilla is an aspartame-free, hypoallergenic and nutritionally complete medical food for children over the age of one.

Children who use Neocate Junior should be under the care of a healthcare professional. Families with questions about Neocate Junior with Prebiotics, Vanilla or the whole Neocate family of nutritionally complete amino acid-based medical foods, please visit www.Neocate.com or call the toll-free number at 1-800-365-7354, Monday through Friday, 8:30 am – 7:00 pm EST.  

It’s time for back to school and whether it’s your child’s first day of school or they’re returning to school for another year, introducing a child with food allergies into a new environment can be nerve-racking.  This is why it is important to educate and remind your children’s teachers and caregivers about food allergy precautions and safety before school starts.

Here are some simple steps you can follow to make sure that the transition is a safe one for your child:

1. Schedule a back-to-school checkup with your pediatrician or allergist to make sure that your current treatment plan is still effective.
2. Document your child’s allergies and treatment plan in school or daycare paperwork.
3. Provide teachers and caregivers with brochures and information on your child’s allergy to prevent accidents.
4. Create a one page “Cheat Sheet” with information about your child’s allergies for substitutes or new employees.
5. Discuss what to do in case of an emergency.  Ask your pediatrician about keeping an EpiPen on-site.  Be sure to train the caregiver on when and how to use one.
6. Make sure that your child fully understands what can trigger their allergy.
7. Look at upcoming lunch or snack menus and identify safe options, also provide the school with a list of safe foods that your child can enjoy at any time.
8. If no safe options are available, pack food from home and warn your child not to trade food with his/her classmates.
9. Offer to bring in allergy-safe treats for holidays and special events.  This way you know that your child is safe, and they won’t feel excluded from the fun!

Communication and education is the most important part of going back to school with food allergies.  Hopefully these tips will provide you with some ideas on how to best educate your child’s new classroom on living with food allergies.

If you have any creative strategies to help prepare for a safe school year, we’d love to hear about them in the comments!