What is the difference between food allergy and food intolerance?
A food allergy occurs when your immune system reacts to a harmless food protein. Symptoms can appear soon after the food has been eaten (also called an immediate-type reaction) or even some days after eating the food (called delayed reaction). It is estimated that 1 – 10% of adults and children have food allergy and/or food intolerance.
It is important to understand that food allergy is different to food intolerance. A food intolerance does not involve the immune system and is rarely life-threatening. There are many food intolerances; the most common is lactose intolerance. This occurs when an individual has little to no lactase – an enzyme needed to break down lactose (milk sugar). Lactose intolerance in children is usually temporary and occurs after an infection e.g. gastroenteritis. It may take several weeks to resolve. Symptoms range in severity and can include nausea, bloating, diarrhoea and excessive wind.
What foods are likely to cause an allergic reaction?
In theory, any food can cause an allergic reaction, however there are 14 major food allergens as listed below. You will notice that these foods/ingredients are always emphasised on food ingredient labels so they can be easily identified:
-Cereals containing gluten
-Sulphur dioxide (sometimes known as sulphites)
Cow’s Milk Allergy (CMA or CMPA) is one of the most common food allergies and affects 2 – 3% of infants and children in the UK. CMA is an immune reaction to milk protein, resulting in at least one or usually several of the symptoms listed below. Most children will outgrow their CMA by the time they go to school, with only a very small number persisting into adulthood.
What are the main signs and symptoms of Cow’s Milk Allergy?
-Persistent irritability (colic)
-Refusing or disliking being fed
-Loose or frequent stools
-Significant blood and/or mucous in stools
-Constipation (especially straining to pass a soft stool)
-Itching and redness of the skin
-A tendency to rashes
When would a dietitian see an infant or child with a food allergy?
We accept referrals for infants and children with a clinically diagnosed food allergy and also when a food allergy is highly suspected. We accept referrals from a Paediatrician or GP or other health care professional.
How does a dietitian help?
When a food allergy is suspected, a paediatric dietitian can undertake a detailed allergy-focused history by asking relevant questions and then providing advice for the diagnosis and management of the allergy. For diagnosed food allergies, we can assess diet as a whole and ensure it is nutritious, balanced and appropriate for growth even if multiple foods need to be excluded. We can educate on meal planning, label reading, allergen free foods and support the whole family with changes to diet. We can also support with the reintroduction of allergens into the diet, to ensure this is done safely and in a timely manner.
Paediatric dietitians are also well trained in the diagnosis, management and reintroduction of cow’s milk for infants and children with CMA. We work closely with paediatricians and health visitors and can advise and support with breastfeeding and/or use of appropriate specialist infant formulas. We educate and support with milk free weaning and where appropriate assist in gradual reintroduction of milk into the diet.
Follow the links below to webinars created by specialist paediatric NHS dietitians for advice with cow’s milk free and/or soya free diet.
Weaning on a Cow’s Milk and/or Soya Free Diet – 13 minutes
FAQs – Cow’s Milk & Soya Free Weaning – 23 minutes
Dairy and Infant formulas – 19 minutes
Milk & Soya Challenge for Infants – 12 minutes
Explanation on Different Types of Dairy Allergy – 7 minutes
Below are some useful links to websites that can provide further information on Food Allergy and CMA.