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Food Allergies and Intolerance

Focus on Food Intolerance
Food intolerance does not involve the immune system, but it can be just as bothersome as a food allergy. Youngsters often outgrow food allergies, but a food intolerance may hang around forever. On the bright side, you may not have to completely eliminate "intolerable" foods as long as they don't also trigger allergic reactions. Food allergy and food intolerance can produce some of the same symptoms, so it may be difficult to differentiate the two when trying to figure out what's going on.

Milk Allergy
Milk protein is a common allergen in young children, yet milk allergies are actually quite rare in adults. That's because upwards of 85 percent of youngsters allergic to milk outgrow their sensitivity by the age of four.

If you think your child is allergic to milk, consult your doctor immediately. Removing all dairy foods and processed foods with milk-based ingredients without competent dietary advice is risky. Dairy products provide calories, protein, calcium, and a wide variety of vitamins and minerals essential to a young child's growth and development. Milk is the only dairy product that consistently provides vitamin D, which promotes strong bones by helping the body absorb calcium. Kids who cannot drink milk can count on fortified foods such as 100 percent fruit juice for calcium. However, despite their calcium content, these foods lack vitamin D. That's why you should work with a registered dietitian to plan a healthy diet for your youngster whenever food allergy is an issue.

Lactose Intolerance
Due to the absence of adequate lactase, people with lactose intolerance cannot properly break down lactose, the carbohydrate present in milk and other dairy foods. Lactase is the enzyme the small intestine makes to digest lactose. Symptoms ranging from mild gas to severe diarrhea that appear within minutes to hours after eating dairy products characterize the condition. Some people are so sensitive to lactose that they have trouble digesting processed foods that contain whey, casein, and whey protein concentrate, all of which contain small amounts of lactose. Certain medications even have a lactose base that makes them intolerable for some super-sensitive individuals. While the symptoms of lactose intolerance are uncomfortable, they pass within a few hours and are far less serious than those caused by milk allergy.

When it comes to lactose intolerance, quantity counts. Many people can tolerate small amounts of milk products without any side effects but become uncomfortable when they eat large quantities of cheese or ice cream, or drink lots of milk on an empty stomach.

Lactose intolerance ranks high on the list of common food intolerance in adults. When it comes to children, premature babies are at greater risk for lactose intolerance. An unborn baby's ability to process lactose develops during the third trimester. Since premature babies do not finish their term in utero, they are born with reduced lactase activity.

It's unlikely that your baby would have lactose intolerance if he or she was a full-term, healthy infant, but he could develop it with age. In fact, lactose intolerance is rare in African-Americans under the age of three and in Caucasians less than five years old.

A child of any age can develop a temporary form of lactose intolerance after intestinal infections. Youngsters who have conditions including chronic diarrhea may also be unable to properly break down the lactose found primarily in dairy products.

You or your child can still enjoy dairy foods even when you cannot tolerate lactose. Lactose-reduced foods such as Lactaid milk, Lactaid cottage cheese, and Lactaid ice cream are either free of lactose or contain minute amounts that won't produce stomach upset in nearly all lactose-sensitive people. Another option for reducing lactose in dairy foods is over-the-counter drops of the enzyme lactase that can be stirred into foods such as milk, cottage cheese, yogurt, and pudding. Tablets containing lactase can be consumed along with more solid foods such as pizza, lasagna, and ice cream to make them more tolerable.

Looking for Lactose
Dairy foods are the most concentrated lactose sources, but they are not all created equal. Try smaller amounts of lower-lactose foods to avoid symptoms of lactose intolerance.

Food Lactose (in grams)

Mozzarella cheese, part skim. 1 ounce .08-. 9
Cheddar cheese, sharp, 1 ounce .4-6
Ice cream, ½ cup 2-6
Cottage cheese, 1 cup 1.4-8
Yogurt, 1 cup 4-17
Milk, 8 ounces 9-14
Evaporated milk, 8 ounces 24-38
Sweetened condensed milk, 8 ounces 31-50

Gluten Enteropathy
An inability to tolerate gluten is not common among children, but when it happens, it has serious repercussions.

Gluten enteropathy is the official name for a condition also known as celiac disease. In gluten enteropathy, the body cannot process gliadin, a part of the protein gluten, which is a constituent of many grains. When a child with gluten enteropathy consumes gluten, it damages the cells of the intestinal lining, which leads to inadequate nutrient absorption. As a result, the body does not properly absorb fat, carbohydrate, protein, vitamins, and minerals, and that leads to malnutrition. Weight loss and a failure to grow properly, nausea, and diarrhea are all hallmarks of gluten enteropathy. Children with gluten enteropathy run a significant risk of developing a host of medical problems, including abnormal bone formation and anemia, that could permanently affect their growth and development. Any child who has been diagnosed with gluten enteropathy should have a registered dietitian as part of her treatment team.

The treatment for gluten enteropathy is total avoidance of gluten, which would mean leaving out wheat, barley, oats, and rye products from the diet. Unfortunately, that's easier said than done, especially when it comes to processed foods. Many processed foods contain gluten in forms you wouldn't recognize. For example, modified food starch, vanilla extract, and vegetable protein all have gluten as an ingredient. However, several companies make many types of tasty gluten-free breads, pasta, and other grains that are suitable substitutes.

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Copyright © 2002 by Elizabeth M. Ward. Excerpted from Healthy Foods, Healthy Kids with permission of its publisher, Adams Media Corporation.

To order this book visit Amazon.com.


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