1. Food Allergy – The Dietitians Perspective 2007 Amber Parry Strong

2. The Food Reaction Spectrum ALLERGY INTOLERANCE

3. The Allergen Free Diet Parents usually need help in cutting out the offending allergen/s Particularly multiple allergies Hidden sources of allergen – e.g. cosmetics, egg cartons in kindy etc Label reading – may contain Resources – Manufactured food database, Allergy NZ, handouts

4. Balancing The Diet Parents often scared to introduce new foods With several allergies the more difficult it is to come up with weaning foods esp wheat free Ensure normal growth and a range of foods as much as possible Suggesting alternatives to milk/soy and wheat

5. Developmental Milestones Children with allergies are just like any other child – need to progress through the same milestones Texture – from purees to lumps Finger foods Progressing to normal foods Reducing formula and increasing solids

6. Macronutrients Fat is often lost from the diet as convenience and junk foods are limited. A dairy free diet loses the fat in cheese and yoghurt. Margarines usually contain soy and milk hence limit spreads. Avocado, oils and fried foods become important sources of fat in the diet, along with milk or infant formula replacements.

7. Macronutrients Protein may also be low as dairy is a significant source of protein in a childs diet – cheese, milk and yoghurt Ensure varied sources of protein – meat, chicken, legumes and milk replacements

8. Micronutrient Deficiencies Iron deficiency is particularly common – lost through eczema and restricted diet Micronutrients likely to be low are zinc, B vitamins, vitamin C (if no fruit), calcium and phosphorus when neither milk or soy are taken Calcium supplements often not recommended for children under 3 but need to be encouraged when neither milk/soy is used – even neocate not adequate for over 1 yr old

9. Treatment Options Encourage children to eat a balanced diet – replacing allergens with suitable sources of protein, iron and calcium Ensuring a good calorie supply and enough fat for growth Ensuring a wide range of foods are eaten within the restrictions

10. Future Allergy Advice Pre-pregnancy counselling for mothers wanting to minimise allergy in the next child Children should be re-assessed if allergy status changes

11. Questions? Sweet Millet Snacks 200g millet flakes, 300ml milk replacement, 300ml water, dash of oil Cook this until the millet is cooked, then form the millet mixture into flattened balls. Fry these in shallow oil until golden. Drizzle with honey or golden syrup to serve. Thank you