Food Allergy Living Blog

Nutrition Specialist Column

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
     
  6. Snack Safely has a GREAT holiday snack list good through 1/3/2017. Visit this page to download a copy. And remember, they continually update the information, so be sure to visit regularly to download the latest version!

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.


3 Tips to Prepare for Summer Camp with Food Allergies

Posted 7.14.16 | Nutrition Specialist

School is out and summer is here!  For a lot of families that means vacations and summer camps. Do you need help making sure your child’s allergies stay in check over the summer?  We can help! Preparation is important when sending kids with food allergies away to camp, on vacations, or to stay with relatives.  But how can you prepare?

Research

First, find out if the summer camp your child will be attending has a policy on food allergies. Additional questions to help with your research:

  • Does the camp allow other children to pack lunches/snacks which contain possible food allergens like peanuts, nuts and/or milk products?  If so, is there a designated area for allergic children to eat their snacks and lunches? 
  • What kind of staff will your child have access to? Is there a healthcare professional on site? What are their credentials and responsibilities?
  • What are the procedures for emergencies? How far away is the camp from a hospital or a medical treatment center?
  • What activities will the camp provide during your child’s stay?  Is there elevated potential for exposure to known allergens?
  • Is there a dedicated place where allergen-free snacks are stored?
  • For some information on allergy-friendly camps, or camps that are aware of how to manage allergies:
  • FARE: List of Food Allergy-Friendly Camps
  • GoDairyFree.com: Summer Camp Options for Food Allergic, Gluten-Free and Vegan Kids

Additionally, check-out the following recording of a webinar featuring Dr. Pistiner and Ms. Polmear-Swendris answering questions about how to choose a camp, what questions to ask of summer camp staff, how to store epinephrine at camp, and a review of basic food allergy management.

Advocate

Once you have decided upon your camp of choice, the next step is to advocate for your child. Notify everybody about your child’s allergies: the camp director, counselors, subs (if you have access to them), even insist the camp lifeguard is aware.  If the camp you chose to attend does not have an allergy policy in place, help educate organizers on how to keep your child safe.  First, help camp counselors and administrators understand your child’s allergy.  Don’t assume they have all the facts. Second, tell them how to handle any possible exposure and give them your emergency care plan (this is a perfect time to share an allergy card you can create using the Neocate Footsteps App).  Here’s another helpful link that you can use to help staff members prepare: PDF Example of FARE Food Allergy & Anaphylaxis Emergency Care Plan

Educate

Finally, one of the best ways to prepare is to talk to your child about their food allergies.  If your child is old enough to understand their allergy, they can be the first line of defense against an accidental exposure.  Help them recognize their symptoms and how to alert staff members for help.  Have your child label their lunch and snack; reiterating the importance of not sharing foods and/or drinks with other campers. 

Educate your child on how to properly manage food allergies at camp and ensure that they are aware of:

  • Green light and red light (or safe and unsafe) foods
  • Strategies for avoiding exposure to allergens (i.e. NEVER trade food with other campers)
  • Symptoms of allergic reactions (i.e. NOT to go off alone if symptoms are beginning);
  • How and when to tell an adult about a possible allergic response
  • How to read a food label (if your child is younger, plan with the camp how to handle this)
  • How to use epinephrine 

If you are sending your little toddler to their first camp, use the following link to read 3 Easy Steps for Success when Explaining Food Allergies to your Toddler.

And finally, have them wear a medical alert bracelet.   There are many options available for bracelets, including waterproof ones, perfect for summer!

Keep in mind, getting ready for camp can be similar to how you get ready for a new school year or traveling.   If you need additional tips on how to specifically travel this summer with Neocate, make sure to check-out Helpful Tips and Resources when Traveling with Food Allergies.

We hope these tips will help make this summer a fun and exciting experience for your children; a summer they will never forget while staying healthy and safe!  Do you have any other tips or suggestions to share?  We would love to hear from you!


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


National FPIES Day 2016

Posted 5.3.16 | Nutrition Specialist


The one day of the year a pie to the face is a GOOD thing! 

Got your attention? Good! Because May 4th is National FPIES Day! We wanted to share a few facts about FPIES and tell you about National FPIES Day, ways that you can get involved, and some organizations that help to raise awareness and support for FPIES.

FPIES

FPIES stands for Food Protein-Induced Enterocolitis Syndrome. This is a rare form of food allergy that is gaining awareness. FPIES affects infants and young children primarily, can take a long time to be recognized and diagnosed, and can mean very significant dietary restrictions. Want more details?

National FPIES Day

What better way to raise awareness for a condition than with a dedicated day? We can’t think of one! In 2015, the United States Senate designated May 4th as National FPIES Awareness Day! This resulted from efforts from the International FPIES Association (I-FPIES, more on them below) and over 1,000 supporters.

Raising awareness of FPIES can help highlight the disorder on behalf of affected children and adults. Together, we can make diagnosis and treatment – and life in general - easier for FPIES children and families.

Every day is a good day to raise awareness about FPIES, but National FPIES Awareness Day is probably the best day. Here are some ways that you can help to raise awareness and spread the word:

  • Change your Facebook or Twitter profile picture to the official event logo, available from I-FPIES, the FPIES awareness ribbon:

 

  • Share your personal FPIES story, photos, and words of encouragement on social media
  • Use the hashtags #NationalFPIESDay and #FPIESontheRise
  • Donate in honor of someone you know with FPIES to an organization dedicated to creating a better tomorrow for those living with FPIES (more below)

Pies in the face for FPIES 

We saved our favorite awareness-raising idea for last: Pies in the face challenge for FPIES! This genius idea came from I-FPIES, and we personally can’t wait to pie our coworkers (to help raise awareness, of course!). Read more here, but here’s the low-down:

  1. Post a video of yourself being "pied" on the I-FPIES Facebook page or using the hashtag #pieface4fpies
  2. In your video, make sure to:
  • State why you are doing this: to raise money and awareness for FPIES and for National FPIES Awareness Day on May 4th.
  • Name who you are honoring with this challenge.
  • Refer to fpies.org to learn more about FPIES.
  1. Make a donation to help fund initiatives that make a difference in the lives of FPIES patients and families.
  2. Get family, friends and others involved! Nominate 4 more people to complete the challenge in 48 hours!

I-FPIES – The International FPIES Association

I-FPIES, founded by a mom who had a very personal experience with FPIES, is a nonprofit organization that provides education, support, and advocacy for individuals with FPIES and their families. I-FPIES partners with leaders in the medical community to develop evidence-based research, with a focus on early detection and new treatment options. Ultimately, I-FPIES represents families and medical professionals united by a common focus: finding a cause and a cure for FPIES. Learn more about I-FPIES here, including how you can help to support this great organization.

The FPIES Foundation

The FPIES Foundation is a collaborative effort of several families affected by FPIES who want to help other families find their way. The FPIES Foundation is committed to providing support resource to families to make their everyday lives easier. Learn more about The FPIES foundation and view their resources here.

Gee, we should have an FPIES conference!

Wouldn’t it be great if a national conference for FPIES took place the same week as National FPIES Awareness Day? We’ve got news for you: there is one, and it does! If you have a loved one with FPIES, there's still time…

The 2016 FPIES Education Conference takes place later this week, on May 7, in the great city of Chicago. Presented by I-FPIES, the conference brings together parents and caregivers to share experiences and learn the latest about FPIES from leading researchers and healthcare professionals. Read more about this great event here.

How will you help promote and raise awareness of FPIES this year?

-Rob McCandlish, RDN


Neocate Mixing & Storage Questions Answered – Round 2

Posted 4.28.16 | Nutrition Specialist

When it comes to mixing and storing formula, we’ve heard every question, usually more than once! A few months ago, we answered questions about mixing and storing Neocate products. This post was so popular that it helped spark additional questions from our Facebook followers as well as comments posted on our blog.

So here we go, Round 2!

Once Neocate formulas are prepared, how long until they go bad? Can I keep them longer in the fridge?

The important thing to remember is that our recommendations help to make sure that Neocate stays fresh and that it doesn’t have time to “go bad.” (Good Neocate is a nice guy; Bad Neocate is just plain mean!) “Going bad” is a nice way of saying that a food or formula sat around too long, and bacteria showed up and multiplied! This can make food or formula taste bad, smell bad, and possibly make you sick. Here’s a breakdown of the times we recommend:

24 hours – This is the amount of time that prepared Neocate powdered formulas can stay in the fridge, IF you put them in right after mixing. This also applies to Neocate Splash that’s been opened, but not if anyone has taken a drink directly from the container! If Neocate has been in the fridge longer than 24 hours, we recommend throwing it out.

4 hours – This is the amount of time that prepared Neocate powdered formulas (or opened or poured Neocate Splash) can sit out at room temperature. This can be either after being freshly mixed, or after being removed from the fridge. If it’s been on the counter at room temperature longer than 4 hours, throw it out!

1 hour – This is the amount of time that Neocate can be kept after someone starts to drink it. Like it or not, our mouths are full of bacteria that just love nutrient-rich formulas like Neocate. Once your baby, child, or you take a drink, start the clock and throw out what’s left after 1 hour. Safety first!

Can I make Neocate in advance and use it at a later time?

Sure! As long as you follow the rules above for storage times, you can prepare Neocate formulas in advance. We always recommend that freshly prepared formula is best, but we know it’s not always easy to mix it exactly when you need it. For further guidance, check with your healthcare team!

Note: We don’t recommend preparing Neocate Nutra - our hypoallergenic semi-solid - in advance, because the texture will actually become thicker over time AND thicker with refrigeration. However, the storage instructions for Neocate Nutra would be the same as for the Neocate formulas if your healthcare team is okay with the thicker texture.

 

Once I’ve mixed Neocate to store for later, do I put it straight into the fridge or do I need to cool it down first?

It’s best to cool the prepared Neocate quickly to get it below the “danger zone” at which bacteria grow best. Straight into the fridge for a bottle is fine, regardless of the water temperature used. That’s because small items will cool quickly in a fridge. However, if you mix a large volume of Neocate, such as for a full day, and store it in a large container, it will cool pretty slowly in the fridge. Here are two options:

  1. Use cold water to prepare the Neocate, so it doesn’t have much cooling to do.
  2. If you prepare the Neocate formula with warm or room temperature water, start by pouring it into the container you’ll store it in. Put the lid on. Then fill a large bowl or pot with ice water. Nestle the container with Neocate in the ice water. Rotate it every few minutes. This will cool it down quicker than the cold air in the refrigerator would. After about 20-30 minutes, it should be plenty cold, and you can move it to the fridge.

It’s important to note not to use hot water when mixing your formula.
(See what temperature water should be when used to mix Neocate formulas.)

What temperature should the fridge be when storing Neocate?

Ooh, good question! We actually don’t get this one very often. For storing anything perishable (food, leftovers, prepared Neocate, you name it), a refrigerator should maintain a temperature below 40° F (4° C).

Did you know that some spots in your refrigerator are colder than others? It’s true! In general, the door is the warmest part of the fridge. The coldest parts can vary based on the layout of the fridge (i.e. where the freezer and icemaker are).

Want a surefire way to know if your fridge is cold enough? Take it’s temperature! Place a cup of water in the fridge, add a thermometer, and wait a few hours. You can even move it around to different parts of the fridge to see the differences – just make sure you give the water a few hours to adjust to the new “climate.”

What is the best temperature for storing Neocate Splash? Can Neocate Splash drink boxes be stored in the refrigerator?

The best temperature for storing unopened Neocate Splash long term is room temperature. That’s because some nutrients don’t hold up well under heat, and some don’t do well in cold. So keep Neocate Splash away from sunny windows, air vents, hot appliances, and cold, drafty spaces. That goes for unopened cans of other Neocate products, too!

That said, you can put unopened Neocate Splash in the refrigerator ahead of time to cool down, such as for tomorrow’s lunch box. If it hasn’t been opened, we suggest you can keep it refrigerated for up to a week. This is because we just don’t know the effects that cold (but not freezing) temperatures over extended periods of time might have on levels of some nutrients. Remember though: If the drink box is open, it can only be refrigerated for up to 24 hours, but no more. And if someone has already taken a drink from the box, you’ve got 1 hour!

How should I prepare Neocate when going on a trip?

Ooh, you’re going on a trip? Where? Can we come? No, seriously, you don’t have to bring us with you, but feel free to share a picture of you traveling with Neocate on our Facebook or Instagram!

When you are going on a trip with prepared Neocate formula, follow these rules:

  • Mix no more Neocate formula than you need in 24 hours - otherwise you’ll have to toss what's left!
  • Keep it cold – below 40° F (4° C) – and store it for no more than 24 hours. That means you’ll need a well-insulated cooler and plenty of cold freezer packs or bags of ice.
  • If you use powdered Neocate formula, take extra cans, just in case.
  • If you use Neocate Splash, take extra drink boxes, just in case.
  • If you use Neocate Splash, keep unopened drink boxes away from extreme temperatures. That means don’t throw it in the trunk in the extreme heat of summer or bitter cold of winter for long periods of time, like road trips.
  • Check out this post about flying with Neocate for more helpful tips.

Can you store Neocate frozen?

We don’t recommend it. Why, you ask? Plenty of other foods can be kept safely in the freezer longer than they can in the fridge, so why not Neocate? The short answer to this question is: we don’t know. Okay, that’s not a very fair answer, and it’s not the whole truth! The mid-range answer is that freezing temperatures can affect Neocate’s quality in ways we can’t predict. Still want more information, or don’t believe us? Here goes…

Freezing temperatures (below 32° F, or 0° C) can affect some nutrient levels. Some vitamins just don’t hold up well under really cold temperatures, and home freezers can actually get very cold! Also, frozen Neocate that thaws may discolor and/or separate into different layers. Gray Neocate in layers is not appealing! We cannot guarantee nutrient content or quality of Neocate products when frozen, which is why we don’t recommend it.

That said, some recipes that call for Neocate products are frozen, and frozen treats can be downright delicious. Ask your healthcare team for advice before you prepare Neocate in any of these recipes, or any way other than as directed on the packaging or as we suggest above. Find more information about cooking with Neocate here.

Can I still use Neocate past the expiration date?

Nope! We absolutely don’t budge on this one. If you don’t like this simple, straightforward answer, you can read this post that spells out in detail why we can’t recommend using Neocate past the expiration date.

How do I ensure Neocate dissolves properly?

Like any powdered formulas, sometimes clogged nipples happen. Following these steps can help ensure that Neocate formulas dissolve well:

  • In general, the warmer the water, the better the vitamins, minerals, and amino acids in Neocate powders will dissolve.
  • The warmest water you should use is 122° F (50° C) to ensure the nutrient levels are not affected. (Water that temperature is pretty warm, but not uncomfortbly hot is our best description without pulling out a thermometer)
  • DO NOT use boiling water to prepare Neocate powders. While Neocate powders dissolve REALLY well in boiling water, it destroys a lot of important nutrients.
  • Stir or shake vigorously for the best solubility.
  • You can try allowing formula freshly mixed to "rest" for a few minutes and then give it another vigorous stir or shake.
  • If you still have trouble after trying the above tips, give us a call at 800.Neocate to let us know!

Again, if we didn’t answer your question, check this post with other common questions to see if we cover it there. If not, we’re happy to help in the comments section below! What other questions do you have about mixing, preparing, serving, or storing Neocate?

-Rob

You can trust me! I've worked at Nutricia as part of the Medical Affairs team since 2010! My job is answering Neocate questions, and if I don't know the answer to your question, I know where to get it! I'm also a Registered Dietitian Nutritionist.



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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.