Making the Switch: Assessing Food Allergies
I realized that there is so much information that goes with this subject that I have informally begun to do a post a week (apparently every Wednesday) on it. I'd rather slow down and give the info in manageable chunks rather than dozens of paragraphs that are hard to read in a blog format. So let's go with what works, and I'll keep trying to add new info every week. I am so glad that this is helpful.
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IF food allergies are suspected, OR food seems to affect behavior, OR you are just curious to see if special diet can make a difference, there are three steps that I would recommend first.
- Keep a food diary. Before a special diet is embarked upon, I would strongly recommend that a journal is kept of every thing that is eaten for a month (on a 'normal' diet, no changes made). In addition, I would try to jot down any observations from the day- behavioral, emotional, environmental (like, we had a very busy day to day, had to run lots of errands- what is happening in the child's environment that day). Try not to think about it or edit or assess for trends, just "do it". At the end of the month, set aside some time to read through and evaluate the journal. What trends can be seen? Are there "trigger" foods where a noticeable change occurs? And so on and so forth. Sometimes it's really obvious- like - had milk today, had four over the top temper tantrums. Other times, it's not so clear. Looking at it over a month of trend will make those less clear allergies clearer. This is valuable information, as it creates a 'baseline'. Honestly, if you realize that there is a serious food allergy right away, go ahead and take the offending food out. There is no reason to continue damaging the child's health and well being. But a lot of the time, the allergy isn't that obvious.
- Consult your pediatrician or family practitioner. At this point, hopefully you have found a doctor that is willing to work with you, not against you. If you haven't, keep looking. Regardless, ask your doctor to perform the kind of evaluations that would normally occur during a yearly physical- growth, height, weight, BMI (Body Mass Index), CBC. The idea, again, is to have a baseline for your child- what is "normal". Children who struggle with undiagnosed food allergies often are under-weight and under-height for their growth curve. Make sure you tell your doctor about any obvious signs: chronic constipation, chronic loose bowels, skin that is cracked and dry. Sometimes skin is is sandpaper rough with white raised bumps, sometimes it just looks like a case of teenage angst. Also, mention behavioral issues: inattention, moony-ness (that sort of 'vacant' look), outbursts. Developmental issues always start their evaluation with your family doctor, who then refers out to other specialists, so make sure they know any thing that concerns you. My whole adventure with Isaiah began with me saying to his pediatrician: " Isaiah is really floppy all the time and I don't understand why." (I was describing low muscle tone and lack of coordination, but I didn't know that.) It was enough of a flag for my doctor to do some simple coordination tests (touch your nose, stand up straight, etc.) and realize that Isaiah had a serious problem. As he began to be evaluated for the physical issues, his occupational and physical therapists all responded back to my doctor that they suspected he may struggle with Sensory Processing Disorder. My doctor was also the one that connected his GERD with a dairy allergy.
- Try to get a referral to a dietitian or nutritionist, if your insurance will pay. Unfortunately, Isaiah's insurance does not pay for this in any shape or form, so his doctor and I have had to cobble together what we know and I am constantly doing research to improve his diet. But I would strongly recommend this valuable help if it can be had, because they have the specific training to individualize and tailor a diet to fit your child's need. For example, if you are taking milk out of the diet, is essential to make sure that other sources of calcium and protein are increased to make up the difference. A dietitian can help you figure out what is best for your child. They also can do very specific evaluations that will help in ways a normal pediatrician or family practitioner would not be able to do.
Once you have a "base line" for your child and the doctors and specialists you need are on board (if they can be had), you can begin an elimination diet to determine what foods offend or cause issues. I'll get into what this is in much more depth next time. Basically, you take what you suspect out (based on your food journal) and note any changes. Eventually, the offending food is added back into the diet, and the reaction is watched. Again, continuing to track food intake in journal form is important. Remember when your child first began eating table food? You would give her one food at a time, about one a week, to make sure there wasn't an allergy. Same idea, just in reverse.
One thing to keep in mind is that it's not forever. It can seem so overwhelming at first- restrictive diets, having to avoid offending foods. If food wasn't a battle ground before, it definitely will seem like it is now. But the evaluation time is relatively short- between three and six months. After that, a new 'normal' begins where most foods are okay. Be patient and you will be rewarded, I promise.
(Make sure you read the comments in these posts- so much good stuff has been mentioned there- the discussion continues in them. I've switched the comments to threaded comments so we can respond directly to each other in a clearer sort of way.)
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