Food Allergy Living Blog Tagged Results

If you or a family member has seasonal allergies, which are triggered by environmental allergens like pollen, you probably know that spring can be a rough time of year, especially if you live in an area with a high pollen count. Here at Neocate, we hear from some parents that their children’s food allergy symptoms seem worse at this time of year. Let’s take some time to review the similarities and differences between food allergy and environmental allergy symptoms.

Seasonal Allergies

Allergies that show up in the spring are also called hay fever or allergic rhinitis. They are usually caused by pollen: the body recognizes proteins in pollen as “foreign” and mounts an immune response, like it does to bacteria or viruses. This causes the symptoms associated with seasonal allergies. Most of these symptoms are “above the neck” and include sneezing, itchy eyes, or a runny nose. Some folks are allergic to only one or a few types of pollen, whereas others are sensitive to many types of pollen. Symptoms can show up after a move to a new geographic area where the plants, and the pollen, are different. It seems that allergic rhinitis isn’t limited to older children and adults: infants can have it too.

Food Allergies

Food allergies are a response to the proteins in food. When that food (or even a trace amount of that food) is consumed, the body mounts an immune response. In this way, food allergies can be similar to seasonal allergies. Most of the food allergy symptoms fall “below the neck” because the body responds to the part of the body where the food is: the gut. In older children and adults these symptoms include bloating, diarrhea, and an itchy sensation in the mouth, among others. The symptoms are different for infants who have a milk and/or soy allergy than those of older children and adults.

Similarities

Food allergies and seasonal allergies share some of the same symptoms. For instance, both can cause a runny nose, headache, and congestion as a result of exposure to allergens that are foods or pollen. The two are also similar in that their symptoms can both be minimized by avoiding their respective triggers. Here are tips for minimizing symptoms of seasonal allergies and our past blogs for preventing symptoms of food allergies.

Differences

Fortunately seasonal allergies can also be treated with medications. This is nice because pollen can make symptoms persist constantly, often for weeks at a time. Unfortunately, there aren’t any widely used medications to help treat mild to moderate food allergies. The best treatment for food allergies is avoidance. Along those lines, it’s easier to avoid food allergens than it is to avoid the triggers for seasonal allergies. Even if there were a medication that helped with mild food allergies, some food allergies are so severe that the only treatment is to entirely avoid the food in question.

If your child is exhibiting symptoms that aren’t clearly one allergy or the other, ask yourself these questions:

-Monitor the pollen count: are the symptoms worse as pollen counts go up?

-Monitor the diet: has anything new been added that could cause the symptoms?

-Is your child exhibiting new symptoms, or are the same symptoms getting worse?

If your child has food allergies and his or her symptoms seem to get worse at a certain time of year, it may be that new or worsened symptoms could be due to seasonal allergies, which aren’t helped by avoiding food allergens. Ultimately, it’s probably best to see an allergist, especially if your child has symptoms that are making them miserable. Allergists can help by identifying the cause of a seasonal allergy, suggesting ways to minimize symptoms, and prescribing drugs that might help as needed. Check with the American College of Allergy, Asthma & Immunology to locate an allergy center near you.

Did you have a tough time telling what was causing your child’s allergy symptoms?

- Rob

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FPIES, or food protein induced enterocolitis syndrome, is a condition that I’ve been hearing about more and more lately. It is not particularly well-known, so I thought we could cover some of the basics in today’s blog.

What is FPIES?

FPIES is a disease that typically affects infants and young children. While it can mimic food allergies, the difference with FPIES is that it is a non-IgE mediated immune reaction in the gastrointestinal (GI) system to one or more specific foods. This means that the IgE antibodies associated with other food allergies are not involved in an FPIES reaction.

Cow’s milk and soy are the most common FPIES triggers, but ANY foods can cause an FPIES reaction (even ones that aren’t typically considered to be allergens like rice and oats).

Common Symptoms of FPIES

Most FPIES reactions happen when a child is very young – just a few weeks or months old. Often it happens when the first formulas or solid foods are introduced (breastmilk doesn’t usually cause an FPIES reaction, even if the mother has eaten a trigger food).

Each child is different, but the most common symptoms of FPIES involve the GI tract and can include projectile vomiting and diarrhea, which means that it is often mistaken for a stomach bug. There is almost always a delayed onset of symptoms - often vomiting occurs 2 hours after eating a trigger food, with diarrhea following 5 hours after eating. Some children experience relatively mild symptoms, while others have such severe vomiting and diarrhea that they can become seriously dehydrated and go into shock.

Diagnosing and Treating FPIES

It can be difficult to diagnose FPIES because blood allergy tests only look for IgE-mediated responses. Usually a diagnosis occurs after repeated reactions. Keeping a food journal may be helpful in identifying triggers if you think your child has FPIES.

Treating FPIES varies depending on the child, their triggers and reactions. For infants with FPIES an elemental formula like Neocate is often used. For some children who have fewer triggers treatment is simply to avoid those foods. Introducing new foods slowly – one at a time and for up to three weeks – is extremely important to identify both safe and trigger foods. If your child has an FPIES reaction, it is important that they remain hydrated to avoid going into shock.

Outgrowing FPIES

Many children with FPIES outgrow the disease by age three, but this can vary based on how severe their symptoms are and which foods they react to. According to an article from Kids With Food Allergies, one study showed that 100% of children with FPIES reactions to barley had outgrown and were tolerating barley by age three, while only 40% of those with FPIES to rice, and 60% to dairy tolerated it by the same age.

To determine if your child has outgrown FPIES it is important to work with your doctor and evaluate it on a food-by-food basis. Atopy patch testing can help assess if your child is ready for an oral challenge in your doctor’s office or hospital (do not attempt without a doctor’s supervision!).

We hope this helps shed some light on an often confusing disease. If any of you have children with FPIES and can share your experiences, please leave a comment!

- Sarah

One of the most common questions we receive from parents is about the soy oil in Neocate. If your child has a soy allergy, you may wonder how Neocate can be hypoallergenic if it has soy on the ingredient list!

The answer is that the soy oil in Neocate is not just any soy oil – it is highly refined soy oil, which the FDA exempts from being labeled as an allergen. This means that the oil has been through a purification process that removes all of the soy proteins.

Soy Protein: What to Watch For

As with most allergies, soy allergies are usually the result of the body being unable to tolerate the soy protein. So because the highly refined soy oil does not contain any soy proteins, it is typically safe for patients with soy allergies. As always, you may want to talk with your child’s health care provider to determine what’s appropriate for them.

Another important thing to remember is that not all soy oil is highly refined so unless it is specified as such, you should not assume it is safe. If the soy oil in another product is described as “cold pressed”, “expeller pressed”, or “extruded” is not safe for those with soy allergies. Soy can also be a “hidden ingredient” in many products, so be on the lookout for it in unexpected items, such as tuna and even toothpaste.

Hopefully that helps explain! Let us know if you have any other concerns or questions in the comments section.

- Christine

Food allergens can be disguised by alternate names and hidden in the long words of an ingredient list. Unless you know what words to look for, it’s easy to overlook an allergen. As parents of children with food allergies, you all know how serious such an oversight can be. This month, we are doing a blog series on hidden food allergens to help you recognize hidden ingredients so that this doesn’t happen to you and your little one.

Hidden Sources of Soy:

Last week, Nita discussed hidden names and sources of dairy. Today, we’ll focus on soy. Soy is especially tricky to avoid because it is often found in unexpected places such as in baked goods, cereals, crackers, infant formula, canned tuna, prepared meats (like sausage and lunch meats), sauces and soups. In fact, soy is found in an estimated 60% of processed foods! Therefore, if your child is allergic to soy, it’s incredibly important to always read and decipher food labels. Kids with Food Allergies (KFA) provides a great list of “Ingredients to Avoid”. It may be helpful to print this out, laminate it, and take it along to the grocery store as a guide. They also have a travel card that you can take along on trips, when dining out, etc.

Soy Oil:

Refined soy oil is usually safe for patients with soy allergies. The FDA exempts refined soybean oil from being labeled as an allergen. Talk with your child’s health care provider to determine what’s appropriate for your child. It’s important to note that not all soy oil is refined so unless it is specified as such, you should not assume it is safe. For example, the ingredient list for Neocate Infant specifies that it contains refined soy oil because our purification process removes all soy proteins to make it safe for patients with soy allergies. Soy oil described as “cold pressed”, “expeller pressed”, or “extruded” is not safe for those with soy allergies.

Managing a Soy Allergy:

Deciphering labels can be time-consuming and avoiding soy may seem to limit your child’s diet drastically. However, there are still many soy-free food options and plenty of soy substitutions for recipes. The main food limitations are with processed foods, which we could all probably use less of in our diets anyways! Plus, research shows that half of kids grow out of their soy allergy by the age of 7[1].

I must say, I was most shocked by the fact that soy is in canned tuna! Have you come across any other surprising hidden food allergens?

-Mallory

[1] Kaeding AJ, Matsui EC, Savage JH, Wood RA. The natural history of soy allergy. J Allergy Clin Immunol. 2010 Mar;125(3):683-6.

Fortunately, her son was ok, but this is a great reminder that sometimes milk and other allergens can show up in unexpected places and it’s important to carefully read all labels. To read the entire story, click here.

(As a side note, if you have a baby with a milk protein allergy, check with your doctor about whether your little one might also be allergic to soy. According to the American Academy of Pediatrics, as many as 70% of babies with milk protein allergies are also allergic to soy.)

Be sure to post advice on any other labeling pitfalls you come across!

-Mallory

We would like to thank Jodie DiMisa for guest blogging for us and sharing her family's allergy story.

I'm a mother of 3, which keeps me busy enough. But to have a son with milk and soy allergies and severe reflux, life became crazy.

My son Sam was born early and spent extra time at the hospital. It was very hard to come home without my son but I knew he was in the best place to remain safe and become healthy. When the day came to bring him home, it was very exciting buy also a little scary. He came home with a visiting home nurse who could monitor him on a regular basis to make sure he continued to thrive. Shortly after he came home the signs of allergies and reflux started to show. He was cranky and cried all the time, losing weight, a stool after every bottle, spiting up all the time and more. Then he was labeled "failure to thrive." I sat at the doctor's office and cried. No parent wants there child to suffer and not be able to eat. Unfortunately, I was no stranger to these symptoms. My first child Patrick also had allergies and severe reflux.

My pediatrician Dr. Liu was wonderful and knew I had the experience of knowing what to look for. I took several samples of Sam's stools to the doctor and they were full of blood. His intestines were bleeding out and his stomach was a mess. With the positive stools samples, we immediately changed his formula to Neocate. The amino acid based formula is what he needed. Within a short period of time, he started gaining weight back and the bloody stools stopped. As a parent you vow to do anything and everything for your child, so when you’re told your child has a medical issue causing you to have to purchase an expensive formula to eat and survive, you find a way to buy it.

When my oldest son was diagnosed with these same issues, I fought hard with the insurance company. Appeal after appeal, writing letters, phone calls, going in front of a board of doctors and nurses, just to be turned down time and time again. They said since it was formula and that was a means of food, it was a nutritional issue and not a medical issue, therefore not covered by insurance. I felt so defeated and very alone.

When Sam came along I started my fight all over again. Even though he was my 3rd child and I had experience dealing with these problems, it was still exhausting and mentally draining. You feel like you’re the only one out there with a child that is not the "text book baby". The questions of "why me?" played in my mind over and over again.

I ended up having to quit my job to take care of Sam. He was such a demanding baby and not happy 24 hours a day. Between the medication schedule and his medical issues, my daycare provider just couldn't handle him. We then became a one income family with 3 children and the expense was overwhelming.

When I was informed the Governor Martin O'Malley (D) signed into law that insurance companies now have to provide benefits for families of children like mine and many other families for medically necessary formula in Maryland, tears came to my eyes. This is such wonderful news and parents of these children will now have the help they so desperately need and deserve. I encourage every parent to be in contact with their insurance company to find out about the benefits you’re entitled to.

Sam will be turning 1 in November and hopefully by then will have out grown his allergies and reflux. I may not benefit much from the new law, but it warms my heart that other parents like me with these children will no longer have to fight the battle with insurance companies so they can feed there kids.

Remember, many parents are in your same position and you’re not alone. Just look down at your son or daughter and the smile will make it all worth it.

- Jodie DiMisa

When your baby starts showing signs of a milk allergy, it’s normal to think that soy might be a good replacement for cow’s milk. After all, if you became lactose intolerant, you may switch to soy milk. However, similar to what Steven blogged about earlier this week, lactose intolerance is a negative response to the sugar in milk, while a milk allergy is a reaction to the protein. Soy milk or a soy based formula is most likely not the best choice for a baby with a milk allergy.

Marybeth and I talk to a lot of mothers with kids that have milk allergies who either switch to a soy formula or, if breastfeeding, replace the dairy in their diet with soy to try to relieve the symptoms. We understand that this seems to be the most logical and healthy next step.

However, some parents don’t realize that about 50 percent of kids with milk allergies are also allergic to the protein in soy. That’s one of the reasons the American Academy of Pediatrics recommends not to use soy to manage milk allergies in babies. (AAP actually also recommends not to feed soy based formula to any infant because soy allergies are much more common in infants than children or adults.)

Similar to what we have suggested for managing milk allergies, if your baby has an allergy to soy, remove all soy from his/her diet immediately.

A few symptoms of soy allergy are:
- Acne
- Asthma
- Diarrhea
- Eczema
- Fever
- Itching
- Lethargy
- Hives
- Vomiting
- Wheezing

So, if you’re changing your child’s formula because he/she has a milk allergy, the most effective option is an amino acid-based formula – which is clinically proven to relieve the symptoms of a milk allergy. As always, feel free to send comments and questions my way.

Take care,
April