FAQ’s Allergy and Intolerance - part 3
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For Non IgE Mediated Food Allergies:
There are some specific tests available for these conditions such as a particular blood test for coeliac disease which if positive is followed by a confirmatory biopsy of the bowel wall under anaesthetic.
For Non Allergic Food Hypersensitivities/ Food Intolerances:
There are many tests available privately often at great cost, such as hair analysis, kinesiology etc. None of them are accurate and are not recommended.
Stool (poo) sample for reducing substances is available to diagnose lactose intolerance.
Dietary Manipulation as a Test For Food Intolerance: For all other intolerances, this is the only effective method of diagnosis (note this is NOT for diagnosis of food allergy which is different- see above). This is where the suspected food is excluded (completely) from the diet for minimum of 2 weeks and then reintroduced and a symptom diary is kept.
Where there is significant difficulty identifying the cause a “few foods diet” may be recommended and other foods gradually reintroduced.
Please note dietary manipulation and the reintroduction of potential “problem” foods must NEVER be done if there are any features of an actual allergic reaction as this could be extremely dangerous. It must only be done under the recommendation and supervision of paediatric allergy specialists and dieticians. Food challenges should NEVER be done at home.
Can Allergy Be Prevented?
In short- probably not.
Maternal diet in pregnancy: There is currently no conclusive evidence that omitting allergy causing foods in pregnancy or breastfeeding will prevent children developing food allergy. In fact, there has been some recent evidence that suggests the opposite may be true.
Before weaning: There is some evidence that exclusive breastfeeding for 3- 6 months can slightly reduce the risk of a child developing allergy.
For those babies who are at high risk of developing allergy/ atopy (tendency to illnesses such as asthma, eczema and hayfever) ie those who have a strong close family history of severe allergy/ atopy, there is some evidence that if breast feeding is not possible, a special formula (hydrolysed formula) may reduce allergy development. No hydrolysed formulas are currently available on prescription for allergy prevention.
Weaning: There is currently no conclusive evidence that early diet restriction helps to prevent allergies. In fact, the weaning diet in many developing and non-Western countries is very high in peanut containing products from as early as 3-4 months and the incidence of peanut allergy in these countries is extremely low.
Cows Milk Sensitivity
If your child has been diagnosed with an allergy or sensitivity to cows milk, their milk will need to be changed to a suitable alternative formula. If breastfeeding, a mother may need to exclude all cows milk from her diet. This can be tricky to do to ensure a balanced diet rich in calcium and a dietician should be involved. There are many alternative formulas available and which one is suitable will depend on the severity of the allergy/ sensitivity symptoms. If your child has been diagnosed with an actual cows milk protein allergy and is not going being breast fed, an “extensively hydrolysed” formula will be needed on prescription. The “partially hysrolysed” formula that is available to buy over- the- counter for allergy prevention is NOT suitable for cows milk allergic infants.
Soya based formulas should NOT be used for babies under 6 months. For those over 6 months, soya formulas are sometimes used when hydrolysed formulas are not tolerated. However, there is a large cross over between cows milk protein allergy and soya allergy.
Lactose free formulas contain cows milk protein and should NOT be used in cows milk allergy.
Goat and sheep milk should not be used as they contain inadequate nutrients for babies and young children and there is a high incidence of allergy to these in cows milk allergic children.
In any child who is on a cows milk protein free diet, there needs to be an assessment of their calcium intake. Calcium supplements may need to be prescribed.
