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194 7.1 Food Hypersensitivity – Food Allergies and Intolerances
European legislation now requires that all Adapting Family Foods for a Food
pre-packed food must be clearly labelled if it Allergy or Intolerance
contains any of the following foods:
Many recipes can be adapted but there are now
●● cereals containing gluten (i.e. wheat, rye, recipe books for particular food allergies in all
barley, oats, spelt, kamut or their hybridized good bookshops. Dietitians or others with a food
strains) allergy may be able to provide some well-tested
recipes.
●● eggs
To prevent cross-contamination of foods that
●● fish need to be avoided by a child:
●● shellfish ●● cooking utensils must be washed thoroughly
●● peanuts or ground nuts ●● special care taken when washing chopping
boards or work surfaces
●● soybeans
●● hands must be washed thoroughly before
●● milk and lactose preparing special foods for the food-allergic child
●● nuts ●● oil for cooking different foods must not be
re-used
●● celery
●● the same spoon must not be used when dishing
●● mustard up different foods.
●● sesame seeds Eating Outside the Home
●● sulphur dioxide and sulphites Eating outside the home presents several
challenges, especially if a child has an IgE-mediated
●● lupin allergy. It is best to avoid foods if the full list of
ingredients is not known rather than taking risks.
●● molluscs.
In the United States it has become common for
These foods must be included in the ingredients list people to carry a ‘chef card’ that outlines the foods
if they are included in the food. that a child must avoid. The card can be presented
to the chef or manager and serves as a reminder of
However, foods sold loose, in small packages the food allergy. However, chefs often have a poor
and bottles and catering packages are exempt understanding of food allergies (Bailey et al. 2011).
from this guidance and will not usually display
this information. Because of this risk the guidance At nursery and school
on foods sold loose is under review and some
changes should be seen in the UK in the next few Teaching staff and carers need written information
years. about a child’s food allergy or intolerance that
includes what to avoid and which foods can be
‘Free-from’ foods and lists offered in their place. It is important that nursery
staff understand:
Some supermarkets and manufacturers also
produce ‘free-from’ lists on which all their ●● how to check food labels
own-brand products are listed according to their
suitability for various diets. Clients can telephone ●● how to ascertain ingredients in catering packs
customer care lines to request a list of ‘free-from’ even if it means that the company should be
foods for the food allergy or intolerance that a child contacted
has. This does not replace checking the food labels
prior to purchase or offering to the child as the
recipe may have changed since the ‘free-from’ list
was last updated.
