Caring for a child with food allergies

 allergy

Most food allergy reactions start  within minutes to a couple of hours after exposure to foods that contain the allergen.  These symptoms can include:

  • ·         Stomach or intestinal problems, such as vomiting, colic, diarrhea, or bleeding
  • ·         Skin reactions, such as hives, swelling, or eczema
  • ·         Breathing problems, such as upper respiratory congestion, throat swelling, or wheezing
  • ·          

Preparing Meals and Snacks

Your child’s food allergies will change your family’s eating habits.  You also need to learn as much as you can about what foods contain the allergen that poses danger to your child and how to avoid it.

Families have to learn how to prepare safe meals and snacks from whole foods and also how to find allergen-free convenience items.

You’ll need to master the art of reading product labels. The FDA requires that the eight major dietary allergens (milk, eggs, wheat, soy, peanuts, tree nuts, fish, and shellfish) be noted on product and ingredient labels. But other minor ingredients may not appear on packaging. If you have questions about something your child might eat, you should call the maker before you serve it to them.

Preparing meals and snacks at home gives you more control what’s in your child’s food. There are many cookbooks and web sites that have allergy-friendly recipes.

For special events like birthday parties, let the host know about your child’s allergies, and make sure your child knows what’s off limits.

Dining Out

Let your server know that your child has a food allergy. Don’t just ask if a menu item includes your child’s allergy trigger. Ask to speak to the manager or chef who will be preparing the food, so you can find out about the ingredients used and the methods of preparation.

Ask that your food be prepared using clean hands and clean cooking surfaces, utensils, and equipment because you don’t want the hamburger for your child with milk allergies to be prepared on the same grill as another customer’s cheeseburger.

Think about where you eat For instance, if your child has a peanut allergy, you might want to avoid restaurants that cook with peanuts or peanut sauces, and if you’re allergic to shellfish, you might want to avoid seafood restaurants.

Always have emergency medications on hand. If you think your child is having an anaphylactic reaction, call 911 immediately and use your epinephrine auto-injector.  Even after that injection, your child will still need to go to the hospital.

 

Dr. Jennie Yoon

Food substitutes for people with wheat allergy:

allergy

Having a wheat allergy is different from having gluten sensitivity. Gluten is a type of protein that’s in wheat and many other grains as well.

If you have a wheat allergy, remember that gluten-free isn’t the same as wheat-free. While many gluten-free products don’t have wheat, that’s not true for all of them. Read ingredients lists to avoid wheat.

Substitutes for Wheat

You may be able to eat these grains instead of wheat. Always check with your doctor before trying them:

  • Amaranth
  • Arrowroot
  • Buckwheat
  • Corn
  • Millet
  • Quinoa
  • Rice
  • Tapioca

Recipe Substitutes

  • Wheat flour. Use rice flour, potato starch flour, soy flour, tapioca flour, or corn flour instead. If you’re allergic to gluten, look for gluten-free baking powder. When you’re baking, remember that wheat-free and gluten-free flour may be drier, may not rise as much, and may have a crumbly texture.
  • Noodles. Use wheat-free pastas instead. They can be made from lots of different grains including quinoa, corn, potato, rice, or beans.
  • Breadcrumbs. In recipes like casseroles, fried chicken, eggplant parmesan, or meat loaf, substitute shredded parmesan, crumbled wheat-free crackers, or cornmeal.
  • Thickeners. Thicken sauces and gravies with cornstarch or rice flour. Pureed tofu can work, too.
  • Beer. Instead of beer in recipes, use apple juice or wine.

Know the source of gluten/wheat

allergy

As you know gluten is one of the proteins in wheat that can cause allergic reaction.  Avoiding wheat if you or your child is allergic to it can seem like a big challenge.  Living with gluten or wheat allergy starts by knowing where you’re likely to find wheat and what you can eat instead.

 

Here is a breakdown of different foods

Foods With Wheat

These foods have wheat protein:

  • Bran
  • Bread crumbs
  • Bulgur
  • Couscous
  • Durum, durum flour, and durum wheat
  • Einkorn
  • Farina
  • Farro (also known as emmer)
  • Kamut
  • Semolina
  • Sprouted wheat
  • Triticale
  • Wheat (bran, germ, gluten, grass, malt, starch)
  • Wheat berries
  • Wheat flour (all types, including all-purpose, cake, enriched, graham, high protein or high gluten, and pastry)

Foods That May Have Wheat

Check labels when buying food or ask at restaurants whether a dish has wheat or wheat products in it. These foods often do:

  • Acker meal
  • Ale and beer
  • Baking mixes
  • Baked goods, including cookies, cakes, and crackers
  • Breaded and batter-fried foods
  • Cereals
  • Hot dogs and processed meats
  • Ice cream
  • Salad dressing
  • Pasta
  • Sauces and soups
  • Soy sauce
  • Surimi (mock crab meat)

Ingredients With Wheat

If you see any of these listed on a label, the food may have wheat in it:

  • Gelatinized starch
  • Gluten or vital gluten
  • Hydrolyzed vegetable protein
  • Natural flavoring
  • Starch, modified starch, modified food starch
  • Vegetable gum or starch

Here are 4 tips in avoiding foods that maybe harmful to you:

  • Ask your doctor about other grains. When you have a wheat allergy, you may or may not be allergic to some other grains, too. Gluten, one of the wheat proteins that can cause a reaction, is also in barley, rye, and oats. Ask your doctor if they are safe to eat.
  • Always check labels. Allergic reactions to wheat can range from stomach upset to asthma-like symptoms to anaphylaxis, which is an emergency. Foods that have wheat must say so on the label. Check them to avoid a reaction.
  • Beware of wheat outside the kitchen. Wreaths and garlands may include wheat or wheat products as decorations. Some children’s play dough also has wheat in it. Other non-food items may, too.
  • Bake with other flours. If a recipe calls for wheat flour, try rice flour, potato starch flour, corn flour, or soy flour instead. Experiment to find the one that gives you the best texture.

Gluten-free? What does that mean?

gluten

Gluten is a protein found in wheat, barley and rye.  People with diseases called sprue or celiac disease are allergic to gluten.  When these people eat gluten, it triggers an allergic response in their small intestine.  This allergic response can damage the lining of the small intestine leading to difficulty in absorbing nutrients.  This can lead to pain, diarrhea, bloating, gas, weight loss.  Long-term gluten allergy can lead to extreme damage to the intestine impairing its ability to absorb nutrients.  This chronic malabsorption of nutrients can lead to unexplained infertility, chronic diarrhea, premature bone loss leading to osteoporosis and loss of teeth.
Like everything else, gluten is a relatively new concept that we hear more often now.  Why is gluten all of a sudden important allergen?  According to studies, allergic reaction to gluten is four times more common now that it was 50 years ago.  Celiac disease affects 1 in 100 people. 
Even during my medical school in the late 1990’s, I never saw a patient with celiac disease.  It was a rare disease.  For whatever reason, it is fairly common now.  So what changed? 
Theories include changes in food processing technique.  According to nutritionists, gluten makes food more elastic and edible.  It maybe a way that the grains are processed.  No one knows what the exact reason is.  What is clear is that if you eat more processed food than natural food, there’s higher chance that you may get gluten.  Gluten is found in a lot of foods including even things like soy sauce.  If you are allergic to gluten, it is very important to read the food label and make sure it says gluten-free. 
How do we diagnose celiac disease?  Screening test includes a blood test that looks for antibodies that indicate you have an allergic reaction to gluten.  It is very important that you do not stop eating gluten before you undergo test because if you remove gluten from your diet your body no longer suffers from this allergic reaction thus causing the test result to be negative.  Make sure you continue your regular diet until you get tested to make sure the test result is accurate.
If this blood test is abnormal, then you may need to undergo an endoscopy which is a test very similar to colonoscopy but looks at the small intestines and a small biopsy is taken.  This sample is then checked for damage.  An alternative to regular endoscopy is called capsule endoscopy which uses a tiny wireless camera that is swallowed in a capsule form (size of a vitamin capsule).  This camera travels down your intestines and takes pictures.  Although it is not as invasive as putting a scope down your intestine as in regular endoscopy, capsule endoscopy does not allow your doctor to take a biopsy.
If you have celiac disease, how do we treat it?  We treat it by removing the allergen-gluten.  About 50% of the patients with celiac disease may need help even with gluten-free diet.  Medications such as steroids and immune-system suppressors can help control intestinal inflammation and improve nutrient absorption. 
Patients with celiac disease may also have a skin condition called dermatitis herpetiformis which presents with itchy, blistering skin rash.  It can be treated with gluten-free diet and drug dapsone. 
Gluten-free is a necessity for many people with celiac disease.  There maybe many more who have mild symptoms and have not been diagnosed.  A lot of these people may have been misdiagnosed with irritable bowel syndrome.
If you are experiencing symptoms such as bloating, pain, diarrhea, talk to your doctor about being tested.  It may save your life as untreated celiac disease can kill you prematurely.

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Schar Naturally Gluten-Free Penne, 12-Ounce Boxes (Pack of 5)

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