Back in our vitamin series we often referenced the ingredient list on formula & food labels and helped identify some of those long words as vitamins.  This sparked us to think about ingredients in general and the importance of understanding ingredients when dealing with food allergies.

There is so much more to ingredients then what’s listed on the label.  So, of course, we decided to blog about it!  Understanding fats, carbohydrates and proteins will be the topic of our next series.   Within the next few months we hope to cover some common inquiries such as types of fat, healthy vs. unhealthy fats, types of carbohydrate including corn, identify sugars, and hidden allergens such as dairy, and explain the building blocks of protein.

A few things to keep in mind while reading those labels and looking at ingredient lists: 

• The FDA requires all manufacturers to list all ingredients in the food on the label.
• Based on the Food Allergen Labeling and Consumer Protection Act of 2004, manufacturers are required to list the top eight foods which account for the most food allergies in commonly used terms.  This does not include allergens accidently introduced during manufacturing or packaging through cross-contamination. 
• Ingredients are listed in order of predominance.  The ingredient used in the greatest amount is listed first, followed by those in smaller amounts listed next, in descending order.
• There are several different types of ingredients such as:
  • Preservatives (ascorbic acid, citric acid) to prevent food from spoiling
  • Emulsifiers (soy lecithin, mono-and diglycderides) which allow smooth mixing and prevent separation
  • Sweeteners (saccharin, aspartame, acesulfame potassium) to add sweetness with or without the extra calories
  • Color Additives (citrus red no. 2, beta-carotene) which offsets color loss due to exposure to light, air, temperature extremes or moisture

Don’t forget to check back with us next week as we kick-off our ingredient series with the topic of fats.  Do you have any questions on what’s listed in the ingredients on food labels?

- Sarah

Through our 1-800-Neocate information line we get a lot of questions but we also hear a lot of great stories from parents who deal with the effects of their child having a milk allergy every day.  We love hearing those stories and we love to share them with other food allergy parents who are coping with the same situations. 

With that in mind the old way of sharing your stories, recipes and photos – via snail mail –  is slow, cumbersome and just a little tough for most busy parents to put together, pack it up and send into us.  So our team of nutritionists has worked diligently to provide all of you with easier ways to share what you love to share the most.

If you have an account on Facebook, feel free to become a fan of our Neocate Fanpage where you can:

• Post questions, comments, suggestions, recipes & stories
• Add your photos (parents love to share their before & after photos of their children)
• Add videos
• Start discussions about relevant topics like the new Texas State Insurance Reimbursement Laws

If you are an avid user of MySpace, we just started our MySpace Neocate profile and you can read snippets of our blog posts over there (so you can decide quickly if our latest informational post is of interest to you), see photos and interact with us there by commenting on our wall.

And for those avid Twitter users out there, we didn’t forget you either.  We’ve got our own Neocate Twitter account where we tweet out links to our latest blog posts, answer questions about Neocate and give suggestions where we can.  We’re also looking into hosting some Tweetchats in the future about dealing with food & milk allergies, so keep your eyes open for that!

We recognize that in today’s busy world sometimes it’s just easier to connect with us through the places where you are already actively participate and we wanted to make it easier for all of you to do so.  So come on over and join the discussions, we’d love to hear what you have to say!

- Sarah

As a follow up to our “Failure to Thrive: My child is underweight, what should I do?” blog, I would like to further explain the product Duocal.  It may be a good option for a child with failure to thrive (or FTT) as well as other conditions such as multiple food protein intolerance and conditions related to food allergies such as Eosinophilic Esophagitis (or EE), Gastroesophageal reflux disease (or GERD), and Atopic Dermatitis (or AD).

Duocal is a high calorie, protein-free powdered nutritional supplement that can be added to foods or beverages when additional calories are needed to gain adequate weight. Keep in mind that Duocal is not a formula and should not be used as a sole source of nutrition.

Duocal is made up of carbohydrates and fats. It is flavorless and super soluble so there are no changes to the taste and/or texture of the food it is being added to (which also helps with diet compliance). The Duocal 400g can comes with a scoop which provides about 25 extra calories per scoop.

The reason Duocal is unique is the fact that it does not contain proteins. This is important for a child who needs extra calories due to FTT or weight loss secondary to severe food allergies (keep in mind; only proteins can cause an allergic reaction).

Duocal is 100% milk free and is made in a milk free environment to ensure tolerance. Duocal is for children ages 1 and over. The amount of Duocal you or your little one may need per day is to be determined by your doctor or dietitian. The amount of Duocal needed per day really depends on what the specific nutritional needs are for the patient. Duocal is for children ages one year and older, so it can be used throughout ones life stages.

Duocal can be mixed with a wide variety of foods. Here are some quick tips on how to use Duocal to get you started.

(These are approximations, please check with your doctor or dietitian for exact amounts)

When using Duocal for:

· Beverages: Add 2 scoops of Duocal per 4 fl oz.

· Toddler Foods: Add 2 scoops of Duocal per ¼ cup of food.

· Mashed potatoes: Add 3-4 scoops Duocal per ½ cup of mashed potatoes.

· Soups: Add ~6 scoops of Duocal for a 16 oz serving (or one can) of soup.

The MyDuocal.com site has a lot of helpful recipes and complete nutritional information to help you better understand how to incorporate Duocal into your child’s diet.

Have you tried Duocal before? What kind of recipes did you make with it?

We are always excited to hear of new ways to use Duocal in helping patients thrive.

Christine

As a parent, it’s hard to hear that your child has been diagnosed with Failure to Thrive, often written as “FTT.” I often talk to parents who are confused by the diagnosis and not sure exactly what it means, so I thought I’d take the time today to answer some basic questions.

For those who don’t know, FTT is a medical term and is used to describe poor weight gain over an extended period of time. It is often used when diagnosing infants, children and the elderly.

What’s the background on Failure to Thrive?

FTT has been used for more than a century when diagnosing those who are unable to grow or maintain their weight properly; however, it still lacks concise guidelines because it describes a condition and not a disease.

Most diagnoses of FTT are in infants and children and can be a result of something else that may be going on — such as food allergies. The first few years of life are very important for growth and development; therefore it is important to ensure that your little one is gaining the proper amount of weight and has proper nutrition.  Most babies double their birth weight by 4 months and triple it by age 1; however, children with FTT often don’t meet those milestones and are lagging on their growth charts.

What causes Failure to Thrive?

FTT can be the result of a variety of social and medical factors.

Social Factors. With obesity on the rise, many parents fear that they are “over-feeding” their children, so they may restrict calories.  You will be happy to learn that children (especially young ones) are excellent self-regulators.  They lack the desire to eat simply because food is present or out of boredom, which many of us do not!  They eat out of necessity and because their body needs the nutrients the food will provide.  With that said if you have a young child, follow their hunger cues.  If you feel that they are gaining weight too quickly later in life, you may want to consult your doctor or dietitian.

Medical Factors. Most often FTT is caused by allergies or GI conditions such as:

• Gastroesophageal Reflux Disease (GERD), which can cause an irritated esophagus which may cause a child to refuse to eat;
• Chronic Diarrhea which causes the body to rapidly lose important nutrients and calories provided by food;
• Food Allergies to proteins in things like milk which require a restrictive diet that may lead to the inability to maintain or gain weight; or
• Illness when the body goes into overdrive trying to fight the infection, using up all of the nutrients it has stored to do so.

How is Failure to Thrive treated in infants and children?

Depending on the cause of FTT, it may be easier than you think to help your little one gain the proper weight he or she needs to get back on the growth charts.  If it’s caused by a disease or condition such as GERD, Short Bowel Syndrome or a milk protein allergy, you may want to introduce an elemental formula such as Neocate. This will not only aid in weight gain, but can also help with the condition itself.  Another option would be to add a product that contains additional fats and carbohydrates like Duocal. It is protein-free and virtually tasteless, allowing you to add it to foods or drinks consumed by the most picky and allergy-ridden eaters.

If you have been told that your child has FTT, make sure that you have your doctor note it on any medical necessity letter or documentation.  This may provide some leverage when applying for reimbursement for elemental formulas.

Have any of your little ones been diagnosed with FTT? How are you helping them to gain weight?

-Nita

References:

http://kidshealth.org/parent/food/weight/failure_thrive.html#

http://www.lpch.org/diseasehealthinfo/healthlibrary/growth/thrive.html

January is coming to a close (I can’t believe January is almost over!), so we will end our Vitamin Series with a run through of the vitamins we haven’t discussed yet. We have already covered Vitamin D, Calcium, and all of the B vitamins. (Calcium snuck its way into the Vitamin Series even though it is a mineral because it is very closely linked with Vitamin D).

As you may recall, the B vitamins are all water soluble. Vitamin C (also known as ascorbic acid) is also water soluble and acts as an antioxidant. In addition, vitamin C is important for wound healing. A deficiency in vitamin C, results in a disease called scurvy.

• Good sources of vitamin C are colorful fruits and veggies such as red peppers, broccoli and strawberries.

You may notice lots of fruit juices out in the market have added vitamin C, as a result deficiencies in this vitamin are rare in today’s world.

Vitamins can be either water soluble or they can be fat soluble. Vitamins D, E, K, and A are all fat soluble vitamins. These vitamins are absorbed into the GI tract with the help of fat. They are also easier to accumulate in the body vs. the water soluble vitamins. Vitamin E and vitamin A are both useful antioxidants. Vitamin A also plays an important role in eye sight.

• Good sources of vitamin A are broccoli, carrots and most fruits or vegetables that are orange or yellow in color.
• Good vitamin E sources are asparagus, avocado and eggs.

Lastly, we will discuss Vitamin K (also known as phylloquinone). This vitamin is interesting because it helps for wound clotting and coagulation. Any scab you may get is a result of vitamin K at work! It is rare to be deficient in this nutrient, unless there is significant damage to your intestine.

• Good sources of vitamin K are leafy green vegetables.

When a child is on a restricted diet due to allergies, ensuring they are getting adequate amounts of each nutrient can be tricky. This vitamin series was developed to help families understand these nutrients and find ways to ensure your little one is getting the amounts they need to thrive. If your little one is on a very restricted diet, it may help to look for nutritionally complete amino acid-based formulas, like Neocate Infant or Neocate Junior, that will ensure these vitamins (along with minerals and macronutrients) are being taken in adequate amounts.

Do you often find it hard to ensure your little one is getting all the vitamins he/she needs? What have you done to help this?

Christine