Grocery shopping is always a hard task, but it is even harder when you are shopping for someone with food allergies!  Worse, the ingredients your little ones may be allergic to can be hidden within the food label.  With our latest series, we will aim to uncover some of the sources of hidden allergens.

New food labeling laws require the top eight food allergens to be listed on food labels.  This is really helpful for those reading food labels; however, sometimes allergens can be hidden in the long words in the ingredient list.

Dairy is one of the ingredients which tends to be hidden in foods that you may have otherwise thought were safe. I wanted to share with you a list of some ingredients to watch out for. Some of these definitely contain diary, while others only possibly contain diary.

When viewing the list below, it’s important to always err on the side of caution.  If you think there may be traces of dairy in something, call the manufacturer of the product you would like to purchase and inquire.  If they cannot guarantee that the product is free of dairy, avoid it!

Foods with dairy ingredients:

• Milk and milk products(including condensed, derivative, dry, evaporated, goat’s milk and milk from other animals, low-fat, malted, milkfat, milk protein hydrolysate, nonfat, powder, protein, skimmed, solids, whole)
• Butter, butter fat, butter oil, butter acid, butter ester(s), buttermilk
• Casein, casein hydrolysate, caseinates (in all forms)
• Cheese
• Cream
• Diacetyl
• Ghee
• Lactalbumin, lactalbumin phosphate, lactoferrin, lactulose
• Pudding
• Recaldent®
• Rennet casein
• Sour cream, sour cream solids, sour milk solids
• Tagatose
• Whey (in all forms), whey protein hydrolysate
• Yogurt

Foods with potential dairy ingredients:

• Artificial or natural flavorings (anything which is derived from butter, cream and egg flavors)
• Chewing gum
• Deli meats
• Fat replacers
• Many types of chocolate (although dark chocolate is often free of dairy)
• Margarine
• Prebiotics (galactooligosaccharides, also known as GOS, are derived from dairy sources. Don’t worry, Neocate Junior with Prebiotics only contains prebiotics in the form of fructooligosaccharides, also known as FOS, which are derived from vegetables.)
• Salad dressings

For a more complete list of foods to avoid when accommodating for a dairy allergy, visit the Food Allergies and Anaphylaxis Network website or check out Alisa Marie Flemming’s book Go Dairy Free: The Guide and Cookbook for Milk Allergies, Lactose Intolerance, and Casein-Free Living and website for more resources.

Can you share any foods you have found that have surprising hidden dairy ingredients?

- Nita

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

I often speak with parents of milk allergic babies and I hear a lot about rashes that appear on the baby’s face and body.  It is heartbreaking to hear how much they itch and scratch uncontrollably. And for many parents it is hard to determine if their child has just a typical baby rash or if it is a symptom of something more serious – like a rash caused by an allergic reaction to cow’s milk.

Atopic Dermatitis or eczema are two types of rashes that are commonly caused by a milk allergy. But without a diagnosis from the doctor of a cow’s milk allergy, how would a parent know that this is the cause?

You should always refer to your pediatrician to help you understand what is causing your little one’s eczema, but it’s also important to look at the big picture. Sometimes a baby with cow’s milk allergies, will also display other symptoms in addition to a rash. For instance, you may also see symptoms of diarrhea, vomiting, gassiness, wheezing, runny nose, and 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 doctor so that your little one can get diagnosed and treated faster.

Also, make sure to work with your pediatrician to come up with a plan for healing your baby’s skin –  no matter what is triggering the rash, it is important to heal your baby’s skin as soon as possible. Some recommendations the doctor might suggest include:

• Bathing your baby in soothing lukewarm water

• Using a milk soap or non-soap cleanser

• Avoiding bath oils and perfumed powders

• Applying an over-the-counter lubricant to your baby’s skin

• Keeping your baby’s fingernails filed short so the scratching won’t do as much damage

• 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

Did your little one have a rash due to a milk protein allergy? Tell us about your experience and what you did to treat it.

-Christine

Does it seem like your baby spits up all the time? Do you have to constantly change their clothes (and yours) because they have trouble keeping formula or breastmilk down? If this sounds like your little one, you might be dealing with either GER or GERD.

Gastroesophageal reflux disease (GERD) a more serious form of Gastroesophageal reflux (GER), which is very common.  According to the National Institutes of Health, GER occurs when the lower esophageal sphincter (LES) opens spontaneously, for varying periods of time, or does not close properly and stomach contents rise up into the esophagus. GER is also known more commonly as acid reflux, because digestive juices (acids) rise up with the food.

Occasional GER is common, so if this sometimes happens to your baby it doesn’t necessarily mean they have GERD. If the reflux is persistent and happens more than twice a week, then it is considered GERD, which can lead to more serious health problems for babies including failure to gain weight, bleeding, respiratory problems or esophagitis.

So how can you tell if your child is spitting up a lot or has the more serious GERD? According to Dr. Samuel Nerko, MD, MPH from Children’s Hospital of Boston, gastroenterologists often look for the following symptoms to diagnose GERD in infants:

• Vomiting or spitting up frequently
• Pain associated with regurgitation
• Back arching
• Refusal to eat
• Constant or sudden crying
• Chronic hiccups
• Irritability or fussiness

If you think that your little one might have GERD, check in with your doctor or a pediatric gastroenterologist. They will probably recommend an infant dose of medications typically used to treat heartburn in adults. A hypoallergenic amino acid-based formula can often help babies with GERD too because it is sometimes caused or made worse by allergies to milk or soy protein.

What treatments have helped your little ones with GERD? Are there any tricks that you rely on to manage their reflux?

-Nita

One of my favorite parts about being a nutrition specialist is talking to parents. While sometimes I just answer questions, other times I am able to hear a family’s actual allergy story. This is great because it helps me understand what parents are really going through.

Unfortunately, one thing I constantly hear from parents is that it took months and several doctor visits before their child was finally diagnosed with milk protein allergy.

Since there seems to be a lack of awareness about the symptoms of milk protein allergy, I wanted to quickly run through some of the most common symptoms – the more allergy parents or soon-to-be parents know, hopefully the better the diagnosis process.

Because one of the symptoms of a milk protein allergy is extreme fussiness, doctors often dismiss the other symptoms and diagnose the baby with colic. This happens all too often, causing little ones to suffer for far too long.

For more information on colicky babies and milk allergies, check out the article: What is Colic.

Other common symptoms of a milk protein allergy include:

• Diarrhea
• Bloody stool
• Vomiting
• Skin rashes
• Fussiness
• Low or no weight gain
• Gassiness
• Wheezing
• Failure to thrive

If you’re baby is experiencing any of these symptoms, visit your doctor. And in the mean time check out testforallergy.com to take a free test online that will help you determine if your baby has a milk allergy.

- Nita
Neocate is now on Facebook!