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Treating Food Hypersensitivity with an Exclusion Diet 191
Managing Diagnosed Food
Hypersensitivity
Once an allergy or intolerance to a food is
diagnosed, the current management is to avoid the
culprit food or foods.
The extent to which the food needs to be avoided
will vary from child to child. Some infants and
children with IgE-mediated food allergies need to
completely avoid the food – even in trace amounts.
Others may be able to tolerate small amounts of the
food they are allergic or intolerant to.
All children with food allergy should be under
the care of a paediatrician or GP. Children with
severe food allergies may need an adrenaline
auto-injector prescribed for them (Figure 7.1.2).
Figure 7.1.2 An adrenaline auto-injector pen
All children should know which foods they need to
avoid and should be encouraged to tell others about
their food allergy or intolerance.
Clothes, stickers, t-shirts, watches and jewellery nutritional inadequacy and therefore all children
that alert people to food allergy are available from
certain websites (e.g. www.kidsaware.co.uk, www.
medicalert.co.uk, www.sostalisman.com).
Recent research suggests that, in the future,
treatment for food allergy may change to exposing
children to small quantities of the suspected food
and increasing that quantity over time to induce
tolerance of that food (Fisher et al. 2011). This is
still very much in the experimental phase.
Coeliac Disease
This disease is not a food allergy or a food
intolerance but is an autoimmune disease. Infants
and children with this condition cannot tolerate
the protein gluten which is found in the three
cereals: wheat, rye and barley. All food and drinks
made from these three cereals need to be eliminated
from the diet. Some children may also need to
avoid oats if they are also sensitive to a protein in
oats which is similar to gluten. Often oats are
contaminated with traces of wheat, rye or barley
and so children may be advised to avoid oats along
with wheat, rye and barley as a matter of course.
Coeliac disease is discussed further in Chapter 7.3.
Treating Food Hypersensitivity
with an Exclusion Diet
Children may be hypersensitive to more than one
food. Exclusion diets which exclude the food or
foods the child is hypersensitive to can lead to a
should see a paediatric or allergy specialist dietitian
for nutritional assessment and advice.
An excluded food can often be substituted
with other foods from the same food group (see
Chapter 1.2). However, if the food suspected of
causing a reaction is milk then that whole food
group must be excluded. A dietitian can
recommend suitable alternative milks which may
be prescribable by a doctor.
The responsibilities of a dietitian managing any
exclusion diet are to advise:
●● which foods a child can eat and which foods he
or she will have to avoid
●● which family foods to use in place of excluded
foods
●● how to check food labels for food ingredients
that must be avoided
●● on any food products or milks a child may be
entitled to have prescribed