Should you See a Registered Dietitian Nutritionist
for Your Child With A Food Allergy?
The folks at Foublie want to help make your life easier. If you are the parent of a child with a food allergy you are probably used to a heavy mental load: having to read labels, cooking a lot of your own food, calling ahead to restaurants before you eat at them, and basically having a running checklist in your head that feels never ending.
We’ve got an idea for you. How about having some help in the FOOD department? At Foublie, we believe a Registered Dietitian is who you need on your team!
Many people don’t know what a Registered Dietitian Nutritionist does or how they can be helpful. When most people hear nutrition we think of diets and weight loss. This is just a tiny part of the equation. So let’s talk about what a Registered Dietitian does and how one can help a family managing a food allergy.
A RD = a Registered Dietitian Nutritionist. Great, what do they do?
A registered dietitian is an expert in food and feeding. They have gone to college and studied nutrition AND they have done a full year of practice in nutrition/dietetics. They then have to pass a test to get certified. RDN’s are experts and are different than health coaches. Also, not everyone who calls themselves a nutritionist is also an RD.
So are all RDN’s the same?
No. So just like doctors have different specialties (some see only kids, some are surgeons) RD’s usually subspecialize too. Food allergies are super specific and not all RD’s have experience in them. Also, not all RD’s have experience with kids! All of Foublie’s coaches are RD’s with specific pediatrics expertise. Those that list food allergy as a sub expertise have been vetted further to make sure they actually have food allergy training or experience!
So why would I even consider seeing an RD?
We have several reasons but these are our top 3:
- Many professional groups including the American Academy of Asthma, Allergy and Immunology actually recommend it (scroll all the way down to see which others do too)!
- The main medical reason is that multiple studies have shown that kids with food allergies are at risk for poor growth compared to kids without food allergies. This is because the mainstay treatment for food allergies is an elimination diet and that can put you at risk for nutritional deficiencies. If your child has both food allergies and eczema they may especially benefit from dietary guidance. Especially if they have multiple food allergies. More food allergies in kids with eczema has been linked to worse growth. In more extreme cases seizures due to low calcium have been reported in food allergic kids as well as rickets (vitamin D deficiency) and protein deficiencies.
- The most compelling reason however is that we know parents take on a lot, and many parents with food allergies have told us they want to become an expert in their child’s allergy. A dietitian can help get you there! Remember, a registered dietitian is an expert in food and special diets and they are uniquely positioned to help with food allergies.
Are there any kids at higher risk for growth problems?
- If your child has a milk allergy they are at higher risk.
- If your child has multiple food allergies. As the number of allergies goes up, so does the risk of poor growth.
- If your child does not outgrow their food allergies when they are young kids and they persist through adolescence
- If they also have eczema
- If your child has Eosinophilic Esophagitis
Ok so now you have peaked my interest about getting in touch with an RD. What can they actually do for me?
- Figure out if you’re missing any big nutrients your kid needs to grow.
- Figure out how to help you mix up what you eat so it’s not boring, but is practical to your situation.
- Help you eat the right foods so your kiddo doesn’t lose weight or gain too much weight
- Teach you how to read labels and identify foods that are no-go’s to prevent accidental reactions
- Find substitutions for those foods you have to eliminate so your kid still gets the right nutrients
- Give you recipe ideas, cookbook ideas, internet resources, and point you to support groups
- Take you through different stages: from introducing solid foods and what that means for your food allergic kid to tackling picky eating in toddlerhood
- Support your diet if you are breastfeeding a food allergic child
- Many more!!
More importantly, they will personalize all the support to your specific situation. You don’t need to take the burden of all of the above all by yourself.
Does meeting with one actually make a difference?
Kids that are being followed by a dietitian through their elimination diets may have better growth outcomes. When compared head to head, specifically in the case of an egg allergy, it was also found that consulting with a dietitian can help reduce your risk of accidentally exposing your child to the allergen.
But my pediatrician follows my child’s growth and nutrition. Isn’t this enough?
For some kids it is. But as a pediatrician myself I say this- as your child gets older we see them in clinic less and less frequently. By the time they are 3 years old we only see them once a year. A lot could happen in that time! Also, even though we know a lot, we do not have the same expertise as RD’s do when it comes to food and feeding.
So where does Foublie come in?
We’ve heard that these first appointments with Registered Dietitians and allergists in clinic are totally overwhelming and scary. At Foublie we try to break down the advice into small pieces so you are not so overwhelmed. Beyond just getting up to speed with information, RDs can help you figure out what your new normal will be.
It is really scary to try new foods in a child with a food allergy. A registered dietitian can help you with the elimination diet, making sure you are not eliminating too many things and that you are making substitutions that will help your kids get the nutrients they need. This relationship is important over time, as they become toddlers and picky eating becomes a thing, if they refuse some of the substitutions, develop new allergies, or some of the allergies persist. Every child is different, what they like to eat is different, and their allergies are different. That is why each needs personalized support.
Want to read more about the professional orgs recommendations? Links are here:
The Joint Task Force on Practice Parameters representing the American Academy of Allergy, Asthma & Immunology (AAAAI), the American College of Allergy, Asthma and Immunology (ACAAI), and the Joint Council of Allergy, Asthma, & Immunology (JCAAI) recommend nutritional counseling and growth monitoring for all children with food allergies, and especially meeting with a dietitian for growing kids on elimination diets, those with multiple food allergies, or poor growth. Read their recs here.
World Allergy Organization when releasing cow’s milk protein allergy recommendation include involving a dietitian to help manage elimination diets and ensure parents know acceptable options and adequate substitutions in a way that is adapted to each patient’s situation.
Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel: Though they do not specifically mention an RD, they recommend “The EP recommends nutritional counseling and regular growth monitoring for all children with FA.”
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