Most parents will have seen their child experience an adverse reaction to food at some point, but how do you know if it’s a food intolerance? And if it is, how can you make sure your child still gets a varied diet? We got the lowdown from registered dietitian Laura Tilt on spotting the symptoms and what to do next...
"Intolerances are any non-life-threatening adverse reaction to food"
Definitely an intolerance?
First, you need to get to grips with the difference between a food intolerance and an allergy. "A food allergy is a serious condition, which can be life-threatening, and affects up to 8% of children in the UK*," explains Laura. "The immune system reacts to a usually harmless protein in food, which then triggers an immediate reaction.
"Intolerances are any adverse reaction to food. They’re not life-threatening, though, as they don’t involve the immune system. Information on the number of children with at least one intolerance is scarce, partly because there are no reliable tests available, which makes diagnosis difficult.
"A lot of the symptoms, such as bloating and diarrhoea, overlap with other conditions, like irritable bowel syndrome. This makes it tricky to tell if it’s a food or something else that’s causing the problem."
IS YOUR CHILD AFFECTED?
Think your child might have a food intolerance? Follow Laura’s expert step-by-step tips...
Speak to your GP
"They will take a full history of your child’s health and may then refer your child to a specialist dietitian."
Keep a food and symptoms diary
"Record what your child eats and any responses, including how long after eating the reaction comes on."
Cut out suspected foods
"The way a dietitian will diagnose a food intolerance involves cutting out the suspected problem food from your child’s diet to see if symptoms improve."
Add them back in
"The dietitian will then reintroduce the suspected problem food to see if symptoms return. Removing foods in this way should only be done under the supervision of a GP or registered dietitian."
"Lactose is a sugar found in milk and dairy foods," explains Laura. "Children with lactose intolerance don’t make enough lactase, the enzyme needed to digest lactose. This then triggers symptoms like bloating, wind and diarrhoea. The amount of lactose that causes symptoms will vary, so find out how much – if any – your child can comfortably manage." Major sources of lactose? "Think cow, sheep and goat’s milk, soft cheeses, yogurt and ice cream," advises Laura.
"Removing milk and dairy can mean missing out on calcium, protein and B vitamins, so you’ll need to get these elsewhere," says Laura. "Try to go for brands with added calcium. Lactose-free milk and yogurt are ideal swaps as they’ve had the lactose removed, but are nutritionally similar. Other options include unsweetened dairy alternatives made from soya, oats, almonds or coconuts – suitable for kids from the age of one as part of a healthy balanced diet. Rice milk is not recommended for children under five."
"Not to be mistaken for coeliac disease, which is a serious autoimmune condition that affects one in 100 people, gluten intolerance (non-coeliac gluten sensitivity) describes symptoms, such as tummy pain and diarrhoea, that arise after eating gluten, a protein found in rye, wheat and barley," explains Laura. "Things to avoid include bread, pasta, cereals, biscuits, cakes and pastries made from wheat, rye or barley – and sauces thickened with flour may contain gluten. It is a controversial topic, though, as there’s limited evidence to suggest it exists, and no test to diagnose it. It’s also possible the symptoms may actually be down to difficult-to-digest sugars in wheat.
"You don’t have to miss out on your favourite meals – go for gluten-free versions of all of the above, as well as naturally gluten-free grains such as quinoa, buckwheat, polenta, potatoes and rice," advises Laura. "If you suspect gluten is a problem for your child, a gluten or wheat-free diet should only be adopted under the direction of a dietitian or doctor."
And the rest
While the two most common intolerances are lactose and gluten, there are others. Read on for a beginner’s guide...
Fructose is a sugar found in many fruits and veg, as well as honey and some sweeteners. High intakes can be hard for some children to break down, resulting in tummy pain, wind and diarrhoea. Keep things varied by serving lower fructose fruits and veg such as kiwis, bananas, berries, peas, spinach, sweet potatoes, sweetcorn, carrots and courgettes.
Egg intolerance is when the body can’t digest or has an adverse reaction to certain parts of an egg. A child with an egg intolerance may find that, in time, they grow out of it. Some foods that contain eggs may surprise you: fizzy drinks are sometimes made with eggs and eggs are a key ingredient in ice cream and marshmallows.
Soya is a legume found in many manufactured goods, including cake, bread, crisps, biscuits and sauces. Symptoms of a soya allergy include skin rashes like eczema or hives, abdominal pain, nausea and diarrhoea. It can be difficult to avoid soya, but many fresh foods that have not been processed or had additional ingredients or seasonings added during cooking are soya free. Or you can find soya-free foods in the supermarket aisle.