method is a “food challenge” by an
allergist, where graded amounts of
food are given to the child in a double-
blind testing manner.
Changed reaction
We certainly hear far more about food
allergies and intolerances now than
we did in the past. Winnie Wong, a
nutritionist with Heinz Baby Club
says, “Studies show food allergies are
common in young children below
four years old, but as they grow, the
gastrointestinal tract and immune
system become more developed, and
some allergies tend to go away.”
Although there are theories that
suggest food allergies and intolerances
might be a result of living in a cleaner
environment and overuse of antibiotics
(
which render the immune system
incapable of fighting bacteria) or the
lack of vitamin D (which leads to an
over-exuberant immune reaction) the
case really might just be that parents
are now more savvy and concerned
about the existence of such allergies
than they were before.
Watch the culprits
Common food allergies in children are
often caused by milk, eggs, wheat, soy,
fish, shellfish, peanuts and tree nuts
(
such as almonds, walnuts, etc.). These
foods contribute to 90 per cent of the
food allergies in the world. While milk,
egg, wheat and soy allergies are often
seen during infancy and the younger
years, children often outgrow them.
Allergies to fish, shellfish, peanuts and
tree nuts creep out later in life and are
more unlikely to go away.
It can be tricky managing a
child with an allergy, but with some
prudence and extra care, it can be less
stressful. June Chan, senior dietician
at the Allergy Centre at Hong Kong
Sanatorium & Hospital, notes there
are some simple actions a parent of
an allergic child can take: scan labels
on packaging or food containers;
have your child wear a tag or bracelet
indicating his allergy; communicate
closely and clearly with teachers
and caretakers on how to react in
emergencies; and, if needed, draft
an allergy-management plan with
an expert like a dietician, doctor or
allergist.
Allergy Cow’s Milk
Includes
•
All dairy products, such as milk, yogurt, butter, margarine,
or anything with milk solids, milk protein, whey, casein
•
Lactalbumin / lactoglobulin / bovine serum albumin
•
Lactose
Commonly
found in
•
Baked goods / pastries / commercial breads
•
Puddings / mousse / custards / Chinese desserts
•
Chocolates / soft candies
•
Coffee creamers / coconut cream
•
Sweetened sachet drinks / instant soups
•
Processed meats / hams / sausages
•
Vegetable margarines
•
Sauce mix / gravies
Note to
parents
•
About five per cent of children with a cow’s milk allergy are
allergic to beef as well.
•
When a child has a cow’s milk allergy, the most appropriate
treatment formula for infants would be “extensively hydrolysed
formula” or “amino acid formula”.
• “
Partially hydrolysed formula”, which is widely available
in the market, should be used as prevention rather than
treatment.
•
Soy formula is not appropriate for children under six months,
and should only be given to children with known tolerance
for soy.
•
Goat’s milk or other mammalian milk should not be used,
because their milk protein is very similar to cow’s milk
protein, which can cause reactions in children allergic to
cow’s milk.
•
Lactose intolerance can be misinterpreted as milk-allergy,
which can cause diarrhoea. However, this is because of
insufficient lactase in the gut to digest lactose, which has no
involvement of the immune system. Therefore, it is not an
allergy, and lactose-free milk or soymilk can be a treatment
choice.
•
For older children: you can substitute calcium-fortified
soymilk (best alternative nutritionally), calcium-fortified
oatmilk, or calcium-fortified almond milk for calcium.
Calcium-fortified rice milk is not suitable for children under
five years old because of its high arsenic level, and it should
not be used as the sole source of calcium.
Allergy Peanut and Tree Nuts
Includes
Peanuts, tree nuts
Commonly
found in
•
Cakes / cookies / pastries / mincemeat / all nut butters /
chocolate nut spread
•
Soba sauce / salad dressing / pesto / pasta sauce / flavoured
cream cheese
•
Asian fried rice / noodles / stir-fried dishes
•
Breakfast cereals / cereal drink / cereal bars.
•
Satay sauces
•
Flavoured drinks
Note to
parents
•
One in three nut-allergic people react to more than one nut.
In addition, allergen cross-contamination is very common
between nuts.
•
Unless you know that the child does not react to certain nuts,
it is best to avoid all nuts. The only safe way to eat other nuts
is to buy them with their unbroken shells on, wash them
before cracking them open and eat them as they are or in
homemade foods.
•
Most nut oils you find in regular supermarkets are refined
oils, which are considered safe because the allergens are
removed during processing. However, gourmet nut oils are
often unrefined and, therefore, should be avoided.
December 2012
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