Food Allergy Living Blog

Nutrition Specialist Column

Food Allergies and Dining Out

Posted 7.19.17 | Guest Blogger

When it’s time to dine out, every parent with a child who suffers from food allergies has a hard time letting go of kitchen control.  This is because allergen avoidance is always the most necessary form of prevention and this is often easily accomplished in the comfort of your home. However, a late soccer practice, meeting, or simply just wanting to enjoy the cuisine of a favorite local restaurant can make allergen avoidance difficult. Eating out puts the responsibility of allergen on both the diner and the restaurant staff.

 

Research shows that there is ample opportunity for restaurants to improve their food allergy safety practices. According to the Food and Drug Administration Food Code, the person in charge at an establishment (i.e., the manager) should be knowledgeable about food allergies. We cannot guarantee that all staff will be knowledgeable, but that shouldn't discourage families from eating out. We want our children to be able to enjoy the typical and “normal” parts of everyday life, and there are a number of steps that we can take to be safe.

 

Fortunately, many large restaurant chains have picked up on how important it is to make sure they offer options and service to families managing food allergies. Many have standardized menus, which often include ingredient information, which can provide you and your family with safe, allergy-friendly food options.

 

Do Your Research

A great place to start is to research the restaurants you are interested in! Most major chain establishments have websites where you can view their menus before you visit. This gives you a chance to identify safe options for your little ones with food allergies before you go.

 

Keep in mind that websites may not be updated frequently and ingredients may change, so it’s always a good idea to speak to a manager at the location where you're interested in dining before you go. This will help you ensure that the restaurant really is food allergy-friendly and cross-contamination won’t be a problem.

Another great resource when doing research is AllergyEats, which describes itself as "the leading guide to allergy-friendly restaurants in the United States."

 

AllergyEats is a free, peer-based website and app (for both Apple and Android devices) where people find and rate restaurants based solely on their ability to accommodate food allergies. The site, app and related social media forums allow families with food allergies to help each other reduce guesswork and limit some of the anxiety surrounding dining out with food allergies. We're all about free, and you can't beat social support systems where you can get input from families like your own!

 

As always, it's still important for you to ask questions of restaurant staff and make requests to make sure you're comfortable. Another family managing a less-severe food allergy or an allergy to a different food might report that the restaurant met their needs, but their needs may not be the same as yours.

Always Double Check

As parents, we always want to make sure our kids are safe, so I recommend always checking to make sure the restaurant is still food allergy-friendly even if it’s a restaurant you dine at frequently. Always be sure to tell your server about all food allergies to ensure that you have a happy and healthy dining experience. Many times, they'll be happy to send the chef out to speak with you personally about your dietary restrictions!

 

Once you’ve identified a restaurant with potential, call them during non-peak dining hours (Fridays and Saturday afternoons are generally super-busy, so try a weeknight, which is typically slower). Ask to speak with the manager or a chef and find out if they can prepare a safe meal for your child. If they say "yes" don't be afraid to ask them what steps they'll take so that you can feel confident. Some parents prefer to “try out” the restaurant without the children to get a feel for their ability to accommodate. If you get the feeling that they are unwilling, unable or just don’t “get it,” move on.

 

In the meantime, you may want to prepare an allergy card for the chef that specifically lists your child’s allergies. Having a list of foods that aren’t safe for your child, and possibly a list of suitable substitutes for common ingredients, can make it easier for the chef to keep track of. This adds an additional reminder, particularly if you are dealing with multiple food allergies.

Go Prepared to Eat

Before you leave for the restaurant, bring a few staples in case the restaurant does not have everything you need. For some parents, bringing a safe food in a thermos or a safe sandwich is an excellent alternative. It's easy to bring a little dairy-free margarine and some vinegar and oil for salads, too! (Dressings often contain dairy, soy, wheat, nuts and/or seeds). Lastly, if your child has been prescribed an epinephrine auto-injector, make sure you have it with you before you leave for the restaurant.

 

Do you have any additional tips for eating out? Comment below!


Will My Child Outgrow Their Cow Milk Allergy?

Posted 5.24.17 | Christine Graham-Garo


When children are diagnosed with milk allergies, parents might wonder, “Will my baby grow out of it?” As much as your new hypoallergenic formula and allergen-friendly diet is helping, you can’t help but wonder when you can feed your child without anxiety. Keep in mind, it’s normal to wonder!

Good news – Many children do outgrow their allergies; however, it may depend on what the child is allergic to and the type of allergy they have. Most importantly, keep in mind that all children are different!

Children with cow milk allergy (CMA) may be more likely to outgrow their allergies than their peanut or tree nut allergy buddies. One research study showed that 80% of kids diagnosed with a CMA will outgrow their allergy by 16 years of age[1]. More specifically, other research studies have found that about 45-50% of children outgrow CMA at one year, 60-75% at two years and 85-90% at three years.[2],[3]

Fortunately, the general consensus is that around 80% of children with cow milk allergy will outgrow it by 3-5 years of age[5]. Regular follow up by your medical specialist is important to re-test tolerance of cow milk protein.[6]

Now, compare that to the studies which show that about 20% and 10%, respectively, of young patients may outgrow peanut and tree nut allergies and approximately 8% of patients who outgrow a peanut allergy will later relapse, meaning the allergy comes back. Additionally, nut-related allergies are typically more severe and more likely to be fatal, which is quite scary![3]

For example, if your little one has multiple food allergies, such as both CMA and tree nut allergies, he or she may outgrow the CMA while the tree nut allergy could still persist. Still, outgrowing an allergy to cow milk will expand their diet and improve the quality of life and available foods for your little one.

Now this may be “good news/bad news” for some families. The good news is that the chance of the cow milk allergy being outgrown is very good, even if the child has the allergy into their teenage years, they are still likely to outgrow it. The bad news is that some infants with CMA may have it into their early teenage years, and a handful may never outgrow it.

The other factor that may influence your little one’s chances of outgrowing a food allergy is the levels of allergen-specific IgE detected in their blood. This means, the lower the allergen-specific IgE detected, the greater the chance of outgrowing the allergy. Your doctor can monitor this - make sure to ask them to explain the results, show you have the level has changed over time, and explain what the possible implications are.

As mentioned before, all children are different. Your little one may have all the right “ingredients” to overcome their cow milk allergy, but there is no way to know exactly when he or she will outgrow it. Your doctor may decide to attempt a food trial by introducing some foods that your child is allergic to, in order to see if the allergy still persists. Be patient, sometimes food trials can be taxing.

Our advice to allergy parents is not to worry, there is usually a light at the end of the tunnel! It’s wonderful if a child can outgrow their cow milk allergy, but if not, they can still thrive and lead happy, healthy lives.

To the more experienced food allergy parents, can you shed any advice on food trials and outgrowing allergies? Comment below or share your thoughts with us on our Facebook page!


[1] Skripack et al, J Allergy Clin Immunol. 2007

[2] de Boissieu D, Dupont C. Time course of allergy to extensively hydrolyzed cow's milk proteins in infants. J Pediatr 2000;136:119-20.

[3] de Boissieu D, Dupont C. Allergy to extensively hydrolyzed cow's milk proteins in infants: safety and duration of amino acid-based formula. : J Pediatr. 2002;141:271-3.

[4] The natural history of peanut and tree nut allergy. Fleischer DM. Curr Allergy Asthma Rep. 2007 Jun;7(3):175-81. Review.

[5] March 2016.  Cow’s milk (dairy) allergy, Australasian Society of Clinical Immunology and Allergy, [http://www.allergy.org.au/patients/food-allergy/cows-milk-dairy-allergy] Viewed 6 May 2016

[6] Motala & Fiocchi, 2012, Cow’s milk allergy in children, World Allergy Organisation, [http://www.worldallergy.org/professional/allergic_diseases_center/cows_milk_allergy_in_children/] Viewed 15 May 2016


Baby Rashes from A to Z (Acne to Eczema!) and When Is It a Milk Allergy?

Posted 4.18.17 | Nutrition Specialist

What new parent hasn’t asked questions like this: “Where did THAT come from?” Or maybe “Why is she suddenly so ITCHY?” Or even “What ARE all of those little bumps on her head?”

Babies drink what we give them (unless they don’t like it!), wear what we put on them (until they take it off!), and tend to stay where we put them (until they go mobile!). If adults are in control and a baby never leaves our sight, we should have answers to these questions. But almost every new parent comes up against a skin condition that they can’t explain.

As newborn babies grow and develop they can experience lots of different skin conditions. Some are typical, whereas others can be hard to explain. In today’s post, we’re going to walk through some of the most common questions and answers related to baby rashes. Food allergies can play a role in some of these conditions, so we’ll point out where that’s the case. 

Acne

Acne is something we associate with teenagers, but it can happen anytime in life. Acne is usually related to hormones, and babies sure do have hormones! Where do babies get hormones, maternal hormones are passed through the womb. Baby acne is harmless and usually goes away within a few weeks.

According to MayoClinic, “Baby acne can occur anywhere on the face, but usually appears on the cheeks, nose and forehead. Baby acne is common — and temporary. There's little you can do to prevent baby acne. Baby acne usually clears up on its own, without scarring.” Read more to learn when to see a doctor about baby acne

Atopic Dermatitis

Atopic dermatitis – which may also be called atopic eczema, involves scaly and itchy rashes that can be over a small or large part of the body. It can be triggered by allergens in the air (pollen, mold, dust mites, or animals), dry skin, or any number of factors. Severity of symptoms varies from one person to another. There’s an association between atopic dermatitis and food allergies, especially in cases of severe atopic dermatitis. At this time, it’s not clear if one causes the other. For infants, atopic dermatitis and cow milk allergy often are linked.

Contact Dermatitis

Contact dermatitis describes a situation where some substance makes contact with the skin and causes it to become red or inflamed. This could be anything from food to laundry detergent or lotions. Your little one’s healthcare team can help you narrow down the possibilities and make changes to remove whatever’s causing this type of dermatitis. If food is a cause, you’ll need to keep your little one from coming into contact with the food and cosmetics with ingredients from that food. Symptoms and treatments of contact dermatitis.

Diaper Rash

Diaper rash happens when a rash occurs on parts of the skin in contact with diapers. Some causes include having wet diapers on for too long, when the infant has diarrhea, or diapers are too tight. Rash can also be caused by introduction of new products to clean, for example if you are using cloth diapers. Symptoms and treatments of diaper rash.

Eczema

Eczema is a generic term for any dermatitis or skin swelling or itching. It’s often used to describe atopic dermatitis – see above! Read over a story of Morgan and his food allergy related eczema.

Hives

Hives, also called urticarial, are red, itchy bumps on the skin, often caused by an allergic reaction to a food or a drug. Hives can vary in size and can at times connect with one another to create a larger swelling. They often go away within 24 hours, but are still no fun. It’s important to avoid whatever substance or food triggers hives. Symptoms and treatments of hives.

Rash

A rash is a generic term that describes some sort of itchiness or irritation of the skin. Your doctor would be the best resource to look and narrow down what a rash represents and what might be causing it. For little onces, their pediatrician may decide to refer you to an allergist and/or a dermatologist.

When is a Rash a Milk Allergy?

Baby Rash

You should always refer to your pediatrician to help you understand what is causing your little one’s rash, but it’s also important to look at the big picture. Sometimes a baby with a cow milk allergy will also display other symptoms in addition to the rash. For instance, you may also see symptoms of diarrhea, vomiting, gassiness, wheezing, runny nose, and/or colic.

If you do see a rash accompanied by any of these other symptoms, make sure to keep detailed notes and share all symptoms with your little one's doctor so that the healthcare team has all of the information to get to the bottom of what might be happening.

Also, make sure to work with your pediatrician to come up with a plan for taking care of your baby’s skin – no matter what is triggering the rash, it is important to take possible steps to alleviate the rash and any discomfort. Some possible steps your little one's doctor might suggest include:

  • Bathing your baby in soothing lukewarm water
  • Avoiding scented soaps, bath oils, and perfumed powders
  • Applying an over-the-counter moisturizer to your baby’s skin
  • Keeping your baby’s fingernails filed short and smooth to minimize damage from scratching
     
  • Using cotton mittens to help prevent scratching
  • Dressing your baby in soft cotton fabrics to prevent possible fabric irritation
  • Keeping your baby cool and avoiding hot, humid environments
  • Trying to keep your baby distracted from the itchiness with fun activities

We’ve told you what we know about various common skin conditions that you might see on your little one. Keep in mind, there are other conditions that can cause skin rashes, including various infections. Even with this info, you probably still have questions and want answers! The next step is to discuss them further with you little one’s healthcare team. Make sure you plan ahead, take notes and ask the right questions when you see your doctor.

-Rob

Rob McCandlish is a registered dietitian nutritionist (RDN) who joined the Nutricia team in 2010. Rob has years of experience at Nutricia following food allergy research, working with Neocate products, talking with Neocate families and learning about the science behind Neocate and food allergies. Rob has two nephews who both used Neocate for their cow milk allergies!


Carbohydrates in Neocate

Posted 2.21.17 | Nutrition Specialist


The Neocate Nutrition Services team of dietitians gets lots of questions every day from parents who want to know more about Neocate, what it is, and how it can help their little ones. But as many of us do with a lot of our food, some parents have questions about the unique ingredients that make Neocate so special. The ingredients in Neocate - especially the amino acids - make us unique among formulas! In this post, we are going to answer some of the frequent questions we receive about the carbohydrates used in Neocate products.

Why do you use carbohydrates in Neocate?

Carbohydrates are one of the main nutrients our bodies need to grow and thrive. Carbohydrates include most fibers, starches, and sugars, and most of the carbohydrates in our diets come from plants. (Did you know? Glucose - a type of sugar - is the main energy source for the human brain!) In short, we include carbohydrates because they're necessary.

Some Neocate products contain prebiotics, which are carbohydrates that we (humans) can't digest, but that some of our good gut bacteria can digest. Prebiotics can help to support digestive health. Learn more about prebiotics.

See the table below for the various sources of carbohydrates in Neocate products. Here are the main reasons for including them:

  • Corn syrup solids - as a source of carbohydrate
  • Maltodextrin (from corn) - as a source of carbohydrate
  • Fructooligosaccharides - as a source of prebiotic
  • Inulin - as a source of prebiotic
  • Rice starch - as a natural thickener
  • Sugar - for sweetness

If you have questions around the use of corn syrup solids in nutritional formulas like Neocate, please read over our Corn Allergy 101 blog post, which explains that these are highly refined in a multi-step process designed to remove protein.

What is the sugar content of Neocate products?

To answer this question, let's first dive into a quick review of what sugars are. "Sugars" describe carbohydrate molecules that are one unit (monosaccharide) or two units (disaccharide) long. These are also called simple sugars, and include glucose and sucrose. Simple sugars are digested and absorbed easily and fairly quickly. Starches, which are longer carbohydrate molecules, are digested and absorbed more slowly.

There are two ways to classify sugars when looking at sugar content of a food, beverage, or nutritional formula. "Total sugars" describes all of the sugars in a product, including sugars that come from main sources of carbohydrates. For example, corn syrup solids are mostly starch, with a small amount of naturally present mono- and disaccharides. Total sugars also includes added sugars. "Added sugars" are sugars that are added to the food, usually to provide some sweetness.

This table shows you, per 100 calories, how many grams of total sugars and how many grams of added sugars each Neocate product contains. (For infant formula, 100 calories is 5 fluid ounces; for Neocate Junior and Splash formulas, 100 calories is 3.3 fluid ounces)

Neocate Product

Carbohydrate 
source(s)

Total Sugars
(per 100 calories)
Added Sugars
(per 100 calories)
Neocate Syneo Infant
  • Corn Syrup Solids
  • Fructooligosaccharides (prebiotic)
  • Inulin (prebiotic)
0.95 g None
Neocate Infant
DHA/ARA
  • Corn Syrup Solids
0.97 g None
Neocate Nutra
  • Corn Syrup Solids
  • Rice Starch
  • Sugar
2.6 g 1.9 g
Neocate Junior,
Unflavored
  • Corn Syrup Solids
0.94 g None
Neocate Junior
with Prebiotics,
Unflavored
  • Corn Syrup Solids
  • Fructooligosaccharides (prebiotic)
  • Inulin (prebiotic)
0.91 g None
Neocate Splash,
Unflavored
  • Maltodextrin (from corn)
  • Sugar
5.2 g 5.0 g
Neocate Junior,
Tropical
  • Corn Syrup Solids
0.93 g None
Neocate Junior,
Chocolate
  • Corn Syrup Solids
  • Sugar
1.9 g 1.1 g
Neocate Junior
with Prebiotics,
Vanilla
  • Corn Syrup Solids
  • Sugar
  • Fructooligosaccharides (prebiotic)
  • Inulin (prebiotic)
2.4 g 1.6 g

Neocate Junior
with Prebiotics,
Strawberry

  • Corn Syrup Solids
  • Sugar
  • Fructooligosaccharides (prebiotic)
  • Inulin (prebiotic)
2.4 g 1.6 g
Neocate E028 Splash,
Grape
  • Maltodextrin (from corn)
  • Sugar
4.9 g 4.3 g
Neocate E028 Splash,
Orange-Pineapple
  • Maltodextrin (from corn)
  • Sugar
  • Corn Syrup Solids
5.2 g 4.7 g
Neocate E028 Splash,
Tropical Fruit
  • Maltodextrin (from corn)
  • Sugar
5.2 g 4.7 g

Why do you add sugars to some Neocate products?

Unlike other formulas, amino acid-based formulas that are plain, or unflavored, can seem bitter or sour. (Infants don't seem to notice this as much.) This is due to the use of amino acids - which are 100% non-allergenic, as the protein source. To help make the formulas taste great, our product team works with artificial flavors to improve the taste. For the products that have flavors added, sugar and/or artificial sweeteners can help to balance out the flavor to taste its best.

Some parents wonder if we really need to use sugars or artificial sweeteners at all. For now we have to say 'yes, we do.' Why? Without them, the flavors simply wouldn't work. Without an artificial sweetener, the amount of sugar needed to reach a balanced flavor profile would be extremely high, and exceed recommendations. The artificial sweeteners we use are safe and approved, and we only use one for each product (one that works well with the flavor). For children whose parents seek a product without any artificial sweeteners there are several options, and we have one flavored Neocate product with no added sugars, Tropical Neocate Junior.

This table shows you which Neocate products contain an artificial sweetener and, if so, which sweetener:

Neocate Product Artificial Sweetener
Neocate Syneo Infant None
Neocate Infant DHA/ARA None
Neocate Nutra None
Neocate Junior, Unflavored None
Neocate Junior with Prebiotics, Unflavored None
Neocate Splash, Unflavored None
Neocate Junior, Tropical Acesulfame Potassium
Neocate Junior, Chocolate Sucralose
Neocate Junior with Prebiotics, Vanilla Sucralose
Neocate Junior with Prebiotics, Strawberry Sucralose
Neocate E028 Splash, Grape Acesulfame Potassium
Neocate E028 Splash, Orange-Pineapple Acesulfame Potassium
Neocate E028 Splash, Tropical Fruit Acesulfame Potassium

 

We hope this information is helpful!

-Rob McCandlish, RDN


Prebiotics vs Probiotics – Part 2

Posted 12.29.16 | Nutrition Specialist


As we shared in the first post in this two-part series, many people are confused about the differences between prebiotics and probiotics. A lot of us think they mean the same thing. That can make it hard to know what benefits they offer, which one is in the foods or supplements you're taking, or what questions to ask your healthcare team! The first post in this series reviewed prebiotics - with an "E" - what they are, when they may be beneficial, and why they're included in some nutritional products. Today - you guessed it - we'll review the same information for probiotics - with an "O"!

So, what are probiotics?

Probiotics, sometimes referred to informally as “good bugs,” are living microbes that are in some way good for us, or good for a specific condition. We naturally have lots and lots of microbes living in and on our bodies. In fact, if you count all of them, the number of human cells in our body is far outnumbered by the number of microbes! 

When you look at the microbes in our guts, you can classify them as ones that are neutral, ones that are beneficial, or ones that may be harmful. Probiotics are ones that are beneficial in some way. 

Consuming a probiotic puts some of a good microbe directly into your digestive tract. This can have general benefits, like crowding out potentially harmful microbes. Or it can have specific benefits. For example, some probiotics may be helpful for people with diarrhea related to antibiotics, and others can help people with specific digestive disorders.

Probiotics are available as supplements, such as in sachets, tablets or capsule form. Probiotics can also be present in certain foods, such as yogurts or other beverages. Probiotics are also added to some nutritional formulas. Of note, probiotics can be sensitive to heat, so don't cook foods that contain probiotics or add them to anything warmer than body temperature.

While everyday foods – in particular yogurt and fermented foods  – contain microbes, probiotics are specific microbes that are added to foods or formula. More on that below!

How do you define probiotics?

Here is a list of characteristics that have been used to define what makes a microbe a probiotic:

  1. a live microorganism (meaning that it's a bacteria, yeast, fungus, or alga that is still alive or dormant)
  2. that, when administered in adequate amounts (meaning you have to take enough of it)
  3. confers a health benefit on the host (that's us!)

So, in essence a probiotic is a living microbe that we take as a supplement or add to food or nutritional formula for the benefits it offers. The benefits come from the fact that every microbe is unique. I like to compare them to plants and animals: some live on land, in the air, or in water; some plants make energy from the sun, some animals eat plants, and some animals eat animals. Taken together, plants and animals form a giant community with lots of different roles. The microbes in our gut have a similar community with different roles.

That introduces another concept that's crucial to probiotics. First, it's important to know that most probiotics are bacteria, though probiotic yeasts are also common. But bacteria come in a HUGE variety of shapes, sizes, and they're able to do many different things. Because of that, a probiotic is a specific strain of a bacterium. 

So what are some examples, and how do you know what strain you have? Well all strains start with a genus name, which is broad. Examples include Lactobacillus, and Bifidobacterium. Next is the species name which comes after the genus name. Examples are L. rhamnosusL. reuteriB. breve, and B. lactis. (Since we already named the genus, we can abbreviate it to the capital letter!)

But those names only tell you the species. With bacteria, the strain is even more specific than the species, and different strains within the same species can be very different. Unless you know the strain, you don't really know what probiotic you're taking. Names that include strains are L. rhamnosus GG, L. reuteri DSM 17938, B. breve M-16V, and B. lactis Bb-12. (Notice how the genus and species are in italics, but the strain is not. Funny science!) These are just a handful of examples.

Of note, while all yogurt is made using bacteria, not all yogurt contains probiotics. Even buying yogurt that says "live active cultures" doesn't necessarily mean it contains probiotics. The bacteria used to make yogurt can be considered "beneficial bacteria," but they haven't been shown to have any specific benefits, so are not probiotics. Some yogurts, though, do have an added probiotic strain that has demonstrated benefits.

Why should I consider taking probiotics? How will it benefit me?

While all probiotics have some benefit, they are not all the same. Various probiotics have been shown to have a variety of health benefits. Probiotics may help to bring the community of microbes in the gut back into balance. They can also influence digestion or other aspects of health. Here are some conditions in which research has found strong or moderate evidence that specific probiotics may be helpful:

  • Managing infectious diarrhea
  • Lessening risk of antibiotic-associated diarrhea
  • Lessening risk of daycare-associated diarrhea
  • Lessening risk of nosocomial diarrhea (related to infections picked up in a hospital)
  • Managing Inflammatory bowel disease (Crohn's disease, Ulcerative colitis)
  • Managing atopic dermatitis associated with food allergy
  • Necrotizing enterocolitis
  • Irritable bowel syndrome

Again, there are specific strains that have been studied for these conditions, and a healthcare provider can provide more information about which specific strains and how strong the evidence is.

People who take probiotics might have been prescribed them by a physician, or might be looking for specific benefits. The best thing to do if you have questions about the possible benefits of probiotics is to talk to your healthcare team. They can help you to understand the possible benefits of adding probiotics to your diet, and may be able to help you choose the best source or type.

Why are probiotics in some nutritional formulas?

For breast-fed infants, breast milk naturally contains beneficial bacteria. These bacteria come from the mom and can help to provide a community of microbes for the infant. Sometimes this community can get out of balance - more of some and less of others than is typical - and the addition of probiotics to an infant formula can help to correct that imbalance. The probiotics added to various infant formulas include:

  • B. breve M-16V
  • B. lactis Bb-12
  • B. longum BB536
  • L. reuteri DSM 17938
  • L. rhamnosus GG
  • L. rhamnosus HN0001

In the Neocate family of products, Neocate Syneo Infant (for infants) is supplemented with the probiotic B. breve M-16V. It also contains the prebiotics scFOS and lcFOS. The combination of probiotics and prebiotics is known as a synbiotic.

We hope that these two posts helped clear up any confusion! What questions do you have about probiotics?

-Rob

Rob McCandlish is a registered dietitian nutritionist (RDN) who joined the Nutricia team in 2010. Rob has years of experience at Nutricia following food allergy research, working with Neocate products, talking with Neocate families and learning about the science behind Neocate and food allergies. Rob has two nephews who both used Neocate for their cow milk allergies!


Navigating Holidays with Food Allergies

Posted 12.22.16 | Nutrition Specialist


It’s the hustle bustle time of year - the HOLIDAY SEASON! Sprinkle this with food allergies and it’s like a manic Monday every day. Are you feeling this? I know I am and I look for any go-to guidance I can get. Would you like some Holiday Help? I thought so. Below I’ve got 15 resources to assist you in navigating all things holiday. Check it out!

TRAVELING

  1. Tips to make traveling with food allergies just a bit easier
     
  2. Tips for traveling by train, plane, or automobile with Neocate
     
  3. Stay up-to-date with all things Neocate using the Neocate Footstep App!
     
  4. Learn more about TSA special procedures for traveling here
     
  5. Calling the TSA Cares hotline to answer questions about what you can bring on an airplane at 1-855-787-2227
     
  6. Kids with Food Allergies offers eight great travel tips to help avoid allergic reactions and enjoy the holidays

FOOD

  1. Check out 3 great tips for hosting parties and get togethers where some guests have food allergies
     
  2. Browse 3 delicious recipes for a festive holiday
     
  3.  FAACT offers this list of fabulous tips to make sure you maintain allergy safety with food during the holiday season
     
  4. The pretty bee shares how to stock your pantry for holiday baking
     
  5. Kids With Food Allergies has several great guides for recipe substitution

OTHER HELPFUL RESOURCES

  1. Family outdoor activities for the Holidays to help everyone stay sane!
     
  2.  Check out this video - Ms. Miller, the founder and president of Allergic Girl Resources, Inc., discusses talking to relatives and friends when planning holiday events, reframing holiday meaning and connecting with the joy of the season.
     
  3. Will grandparents be helping care for the grandkids this holiday season? FAACT just developed a comprehensive guide to help grandparents caring for kids with allergies right here.
     
  4. How great is this? A customizeable letter from Santa to help an allergic child feel like part of the Christmas cookie fun. Santa wants your little one's help in ensuring the elves with food allergies can enjoy a cookie too!
     
  5. Always be prepared. Keep in mind these 6 things that save lives in case of a severe food allergy emergency from Allergic Living.

The Neocate team at Nutricia wishes you the best of the Holiday Season and a happy and healthy New Year!


We’re having a baby - should we get a dog and move to a farm?

Posted 11.10.16 | Nutrition Specialist


Science is crazy. Sometimes we hear in the news about researchers looking at things that seem completely off-the-wall. On the other hand, a lot of scientists and researchers look at things that can have meaningful impacts on our lives. Sometimes, the research can even be practical for everyday folks like us.

Today, I’ll share some interesting research related to pets, the environment and allergic conditions. I find it interesting not just because I love science, but also because it can be helpful. Sure, I geek out over research sometimes, but when it’s practical research, everybody wins. The questions at hand: can owning pets or living on a farm actually provide a BENEFIT when it comes to allergic conditions?

The state of affairs

  1. Lots of people are allergic to pets. I have some friends who have allergies to cats, which range from mild (sneezing) to pretty bad (difficulty breathing). I have other friends who have allergies to dogs. I even know people who seem to be allergic to just about any animal with fur.
     
  2. Many children who have one allergic condition also have one or several other allergic conditions. For example, it’s not uncommon for an infant with a cow milk allergy to develop allergies to other foods. There are also children who have atopic dermatitis as well as asthma. Any number of combinations is possible, and allergies to animals are in the mix too.
     
  3. We used to think that avoiding things that we have the potential to become allergic to is the best way to prevent actually BECOMING allergic to that thing. For years parents were cautioned to avoid introducing peanut into their babies’ diets until they were several years old. (That advice has changed – but that’s a subject for another post!)

With all this in mind, it seemed logical that for a child with one allergic condition, it might be best to avoid things that might become a future allergen. Why not? If my child already has food allergies, then maybe they’re likely to also become allergic to animals, so why take the chance with a new pet?

But in science, a theory is just a theory. The scientists and researchers among us don’t assume these are facts. We should be grateful that, just because an idea is logical, our scientific friends are willing to test those theories to see if they hold up! When they test a theory they come up with a hypothesis – something they think will be true related to the theory, but that they want to test.

In fact, one theory that you may have heard of is the ‘Hygiene hypothesis.’ This is the idea that in western societies, like North America, our environments (home, school, work, the kitchen counter) are so clean – or hygienic – that our immune system doesn’t develop normally, and that may be contributing to the increases we’re seeing in allergic conditions. We’re beginning to realize that some exposure may be good, especially at key “windows” of time when exposure to something may help LESSEN the risk of later allergy.

The latest science on pets, farms, and allergies

With all that in mind, scientists have tested several hypotheses related to the environment an infant is raised in, such as growing up in a household with pets, and the effect it has on the likelihood of developing certain allergic conditions. We wrote on this topic last in 2013. As an update, here’s some of the latest research that’s been shared in the past few years:

  1. A recently published study found that infants who live in a house with a dog for their first year of life may be less likely to develop eczema and other allergies, depending on a few factors. Read a summary of the research here.
     
  2. Researchers in Sweden looked at data from their entire nation. They found that having a dog in the first year of an infant’s life was associated with a lower likelihood of asthma in children beyond 3-6 years old (but not younger). Growing up on a farm with animals was also associated with a lower likelihood of asthma through age 6. Read a summary of this research here.
     
  3. Maybe farms help? Researchers in Europe looked at a large group of children, comparing them based on how rural their environment was. The children who grew up closer to more forest and agricultural land were less likely to develop environmental allergies. They think the microbes in the environment can be key – read more here.

So what’s the catch?

Well, not everyone is able to pick up and move to a farm! Second, pet ownership is also a big decision. Those are obvious considerations.

Also, research is messy and often leads to more questions than answers. First, not all research that’s been conducted in this topic has come to the same conclusions – some of the results are contradictory. And sometimes you find something you don’t expect. For example, researchers in Finland found that growing up in a household with a dog or cat may be slightly more likely to lead to an allergy to that animal than growing up in a house without one.

With that in mind, the best thing to do may be to talk to your little one’s pediatrician and/or allergist to see what their take is on pets and allergic conditions. They often have a good understanding of the science, including how best to interpret the research, and can offer some guidance or at least help you make an informed decision.

One final note: keep in mind that there really is no such thing as a hypoallergenic dog breed! You can certainly ask your allergist for more information, but don’t believe the hype if you see a breeder selling “hypoallergenic” dogs.

-Rob

How do I come across such interesting topics? In my role as a Medical Advisor and Nutrition Specialist at Nutricia I get to attend major conferences, such as the annual meeting for the American Academy of Allergy, Asthma and Immunology (AAAAI). I always discover some really interesting research there!


What to do with Unused Neocate Products? You Can Donate!

Posted 7.19.16 | Nutrition Specialist


Clutter. It is something I don’t like to have around my work or living area. If you are like me, and you have extra Neocate formula around your house (that you no longer need), you may view that extra formula as “clutter” and something that you need to get rid of. But what do you do with that formula that was prescribed to you by a healthcare professional?

Consider donating your unused Neocate to someone who may be able to benefit from it! When donating, it’s very important to ensure that the formula is not expired. 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 Neocate Splash, you can find the expiration date on the top of the drink box. The expiration dates on most of the Neocate family of products follow the standard North American format, which is Month/Day/Year, but some may be Day/Month/Year - either way, it will be obvious!

Oley Foundation

One option is to consider donating to an organization that assists those in need who can’t afford formula. One such example is the Oley Foundation. The Oley Foundation was started in 1983 and it “strives to enrich the lives of those living with home intravenous nutrition and tube feeding through education, advocacy, and networking”.

The Oley Foundation has an Equipment/Supply Exchange Program to connect families who have items to donate with families in need of enteral formula, pumps, tubing and other supplies. Note that items are for donation only and there may be costs associated with shipping the formula. In general, it is the responsibility of the individual receiving the formula to pay for the shipping costs. Read more about procedures for donating to Oley Foundation.

 

The Parker Lee Project

This is another organization, based in Texas, that you might want to consider when donating unused formula. The Parker Lee Project was started by Megan & Phillip Smith after they had first-hand experience of struggling, arguing and pleading with offices, insurance companies, and DME companies for various supplies for their daughter.

The Parker Lee Project accepts all unused, unopened supplies (except Suction Supplies) and all gently used equipment (as long as it hasn't been molded to fit your child specifically). View their website on various ways to connect.

The Hovannesian Feeding Foundation

This foundation was started by Hovannesian family after welcoming into their family a daughter born with Kabuki Syndrome. The organization collects items to redistribute to families that have to pay out of pocket despite having insurance.

Additional Resources

You can always call your local healthcare team, such as the pediatrician, gastroenterologist, allergist, or dietitian. They may know of other families in need of formula, or their office may accept donations for people whose insurance won't cover Neocate. You can also check with your local children's hospital to ask if they accept donations or know of a local organization that does. Additionally, you can find other family support groups via the following pages:

If you know of a resource that accepts donations of Neocate products that you would like to share with our community, please don’t hesitate to comment below! You can also consult with your healthcare professional for other options on donating your unused formula to other families that may need it.

Note, organizations listed above or in the comments section below are not endorsed by Nutricia North America, and Nutricia cannot be responsible for the information or products they provide.

- Ellen

Ellen Sviland Avery joined the Nutricia team during the summer of 2014. She has extensive experience in pediatrics, metabolics and tube feeding. Prior to coming to Nutricia, she worked in home infusion. She has been a registered dietitian for more than 12 years. Her passion in pediatric nutrition started when she was in Birmingham working with children with neurodevelopmental disabilities and has continued throughout her career.


Meet Some Awesome Neocate Families!

Posted 7.12.16 | Nutrition Specialist

In March of this year we at Nutricia had the great privilege to meet with three wonderful families that are using various Neocate products to manage their cow milk and multiple food allergies. We were delighted to hear about their unique stories, about the ups and downs in their allergy journeys, both the tears and the laughter and ultimately about how all their experiences have made them stronger!

One topic we talked about with the families was the areas of support that they felt were the most important to them. They also told us how more information and more unique support could be made available for everyone that is dealing with a food allergy. But hear for yourself what they shared with us!

We would like to thank the families involved for their time, their energy and their wonderful stories. We will be posting more updates in the future. In the meantime, if you have a story that you would like to share about food allergy, cow milk allergy, Neocate or anything related you can get in touch with us by commenting below!

  


Cow Milk Allergy – It’s More Than Just Blood in Stool

Posted 6.14.16 | Nutrition Specialist

According to Food Allergy Research & Education, Inc (FARE), approximately 2.5% of children younger than 3 years of age are allergic to cow milk. Most of these infants and children will outgrow their cow milk allergy, while some may not.

How Do I Know if My Child is Allergic to Cow Milk?

Blood in a child’s stool can be a sign of an allergy to cow milk, and it's one that you may have heard about, or that your healthcare team may have shared with you. But what are some other signs that your child might be allergic to cow milk?

The following infographic highlights eight common signs and symptoms of a cow milk allergy (CMA), while also providing tips on what parents should look for and next steps if children are exhibiting signs of CMA.

Difference Between Lactose Intolerance and Milk Allergy

Now that we've reviewed common CMA signs and symptoms, you might be wondering, What is the difference between CMA and lactose intolerance? The following video from Dr. Adam Fox helps to explain the difference:

Dr. Adam Fox

Common Signs and symptoms of a Cow Milk Allergy

These signs or symptoms may take anywhere from minutes to hours to days until they appear.

  • Skin Rash/Itchy Skin/Hives
  • Vomiting
  • Extreme fussiness
  • Diarrhea
  • Excessive Gas
  • Wheezing, coughing or other respiratory symptoms

Now, let’s talk about each of these signs in further detail.

Skin Rash/Itchy Skin/Hives

There are many causes of rashes in infants and children. Some are viral, others are due to something in the environment, but some may be due to the food that your child is consuming if he or she has an allergy. If hives develop right after your child has consumed food, it may warrant further investigation into food allergies. The skin around the mouth may be especially itchy if your child has certain food allergies. Note where the rash is and if it seems to bother your child. Remember that old saying, “A picture is worth 1,000 words”. If a rash appears on your child, don’t forget to take a picture and show it to your doctor. If you would like to keep a diary of all the symptoms your child is exhibiting and what she consumed, make sure to check-out the Neocate Footsteps App.

Vomiting

Some babies spit-up after eating if they eat too much, too quickly or a combination of both. They may also vomit due to an illness. By keeping track of your child’s vomiting, it may help to determine if cow milk is the cause of her vomiting.

Extreme Fussiness

The definition of colic applies to healthy, well-fed infants who cry more than 3 hours a day, more than 3 days a week, for more than 3 weeks. Even though these criteria exist, colic is not well defined. The crying and fussiness that we call colic could mean that they are experiencing extreme abdominal pain, and cow milk may be the cause. Investigate extreme fussiness with your pediatrician to determine if there is a change in your child’s diet that may help.

Diarrhea

Diarrhea (and other gastrointestinal symptoms) may be due to the foods your child eats or to an illness. It is important to note when the diarrhea starts and how long it lasts. If diarrhea continues more than 2-4 times per day for more than 5-7 days, it may be a sign of a cow milk allergy. It is also important to note if there is mucus and/or blood in the stool, as these can also indicate a cow milk allergy.

Excessive Gas

Babies can be gassy as their gastrointestinal tracts get used to foods they are consuming. If your child seems excessively gassy and it has a foul odor, it may be a sign of a cow milk allergy, especially when it is in combination with some of these other symptoms.

Wheezing, coughing or other respiratory symptoms

Respiratory symptoms may be a more serious sign of a cow milk allergy and should be taken seriously if you suspect your child has more than a cold. These include wheezing and coughing. If your child starts wheezing or has other respiratory problems after consuming cow milk-containing foods, seek medical attention. More severe than other respiratory symptoms is anaphylaxis, a serious allergic reaction that requires immediate medical attention.

It is best to talk with your healthcare provider if you suspect a food allergy, and keep track of the symptoms with a food diary to help determine what the food allergen may be. The Neocate® Footsteps App can help you keep track of some of these symptoms and allows you to take pictures, if need be, of any skin rashes or other reactions.

Management of a Cow Milk Allergy

If your child is allergic to cow milk, your doctor may recommend a hypoallergenic formula like Neocate to help meet your child’s nutritional needs. Neocate products are available for children of all ages for the dietary management of a cow milk allergy. Just like you'd expect, Neocate is dairy-free! Learn more about available Neocate products.

Can You Outgrow a Milk Allergy?

Most infants and children eventually outgrow a cow milk allergy. However there is no specific age by which this will happen. Each child is unique. Over the years, research has shown that most children will outgrow a cow milk allergy within a few years. For more severe cow milk allergies, research has shown it can take longer. For example, some researchers found that 80% of chidlren they followed with CMA outgrew their allergy by 16 years of age. Read more.

These are just some of the signs and symptoms of a cow milk allergy with a couple frequently asked questions we encounter. When it comes to cow milk allergy, what other questions do you have that we can address in our future posts?

-Ellen



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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.