Halloween used to be pure fun, but now that so many kids have food allergies, it’s definitely complicated. Somewhere between 8-10% of US children have a life threatening food allergy. Among those, about 40% are allergic to more than one food. I’ll bet food allergies may be underreported – just in my own pediatric nutrition practice, I often meet kids who have never been screened by their pediatricians or referred to allergists – and lo and behold, we find food allergies.
Then there are also food sensitivities, and food intolerances. These can occur with or without allergy reactions (which is why your child may still feel or function poorly eating a certain food even if your allergist said it tested ok). Sensitivities involve layers of the immune system different from allergy reactions and tend to emerge more insidiously or slowly, with eczema, anxiety, stomachaches, picky weak appetite, or irritable stool pattern. Intolerances can be immune-mediated or purely digestive in nature, and can include those wacky behavior changes some of you see when your kids eat stuff heavy on dyes and sugar…. like, Skittles! Kids can have one or all of these problems at once – allergy, sensitivity, and intolerance – to some of the same foods, or entirely different foods.
There are ways around it. It’s not like it used to be when kids could go door to door (without parents even!) grabbing goodies indiscriminately, and bickering over who got what with siblings once home (always interesting at my house growing up with five kids). Here are tips to help your kids have fun on Halloween even if they have food allergy and dietary restrictions.
- Teal Pumpkin Project – if you haven’t heard about it yet, dive in! Look for the Teal Pumpkin for non-food treats and little toys.
- Trick or Treat Fairy who takes your child’s candy cache and leaves a coveted toy (or toys) in its place – like the Tooth Fairy, only better.
- Bake some allergen friendly treats to trade for candy. Cookies, bars, cupcakes, or even Halloween themed fat bombs – the choices are endless.
- Organic-ingredient candies are often allergen-friendly. They are pricier, but worth it if it means avoiding that ER co-pay or Epi-Pen drama, or just for your kids’ joy and peace of mind. Here are some examples (I have no affiliate relationships with these brands BTW – I just like these a lot)
- Alter Eco makes non GMO organic chocolates in several varieties. They aren’t certified gluten free, but have no gluten ingredients, and many have no nut ingredients. Some do have milk ingredients. Check out the Quinoa Crunch or Burnt Caramel, two of my favorites.
- The Natural Candy Store lets you choose candy by dietary restriction and by organic candy status.Give their grid a try, see what you get – it’s genius! Here’s what I got when I selected strict gluten free, strict peanut free, certified non GMO, no corn syrup, certified organic candy.
- Yum Earth makes certified GF, organic, nut free, non GMO and vegan (that means strictly dairy and egg free) candy ready for Halloween sharing.
Be Sure You Don’t Make This Halloween Food Allergy Fail! …Here’s a mistake I witness often working with well meaning parents: Feeling sorry for your child. Or, unwittingly, for yourself.
When a parent comes in after we’ve started nutrition care process and spends a lot of time explaining why this can’t work because it is too hard to find or prepare substitute foods ….Hmmm. That’s not where we need our focus, and it is not what your child needs to hear from you. It’s also more about you than your child. You’re in charge of what is in your house to eat, and you do have a large measure of influence over what your child eats at school. Let’s strategize about how to do it, not about how hard it is. And truth is, it’s not so hard – once you decide it isn’t, commit to it, roll up your sleeves, and get started. It’s not too different from a weight loss project: Ultimately, you just get your butt in the gym and change up some eating habits you know aren’t helping, and you make it a lifestyle commitment.
Forget the drama about how they’re missing out. Talk about that in front of your kids, or worse – to your kids – and they will believe they are missing out and will feel bad about it. Talk up all the new choices there are to explore, and engage your kids in the discovery process, whether it’s making homemade treats, taste testing new store bought ones, or dreaming about the toy-trade options. Happy Halloween!
Let me tell you the five most helpful to-do’s I have seen parents use for their children’s health, as we start a new year.
These come from my twenty years’ experience working with families in my pediatric nutrition practice – with mostly complex, difficult cases who couldn’t find improvement elsewhere. In other words, even if your child is really challenged with feeding, growth, chronic illness or disability, developmental trials, allergy or more, I can tell you that these five tips are still my top picks, for setting up the healthiest foundation possible for your kids.
You might think I am going to talk about stuff like picky eating, junk food versus organic, gluten, food allergies, eating more vegetables, probiotics, vitamins, the latest autism protocol, whether or not you should do GAPS, gut biome… Nope. I definitely do cover all that and more in my clinical practice and in my blog, so have a look around.
These tips are about you – and how subtle shifts in your approach to health and what your family eats can cause unexpected benefits to unfold in everyone’s health.
1 – Get fierce about this: Adopt the mantra that health – not illness, disability, endless doctors’ appointments, or dependence on prescription or over-the-counter drugs that bring unwanted side effects – is your child’s birthright. It’s the baseline they are entitled to. Picture them at their healthiest and happiest. Imagine the unimaginable, if that is what it takes. Start with that picture of the joy good health brings.
If they’re not there, if your children are saddled with chronic illness, don’t lament, and definitely don’t feel sorry for them – they have you as their advocate and model, and they need positivity and possibility. Hold that image of total health that they need and deserve. Assume they have it already, and lead the way toward it, quietly and persistently. Expect a good outcome. Their bodies are built to grow, heal, and restore. There is always potential for healing.
2 – Chill out about food. Robyn Obrien’s 80/20 rule is a comfortable sweet spot. Her suggestion is to work for “progress not perfection”. Unless you know your child will sustain severe injury or consequences from eating certain verboten foods which must be avoided, don’t pathologize food. Don’t judge. Don’t chatter about how horrible this or that food is.
I encourage parents to use empowering language, even with small children. I discourage labeling food as “bad” or something that will “make you sick”. This can burden children – even teens – with unnecessary anxiety.
Instead, use words that show the power to choose. If your child eats something that backfires into discomfort or behavioral disintegration, ask which food might feel better next time, if they’re old enough to consider that question for themselves. If not, tell them what you will do next time: “Next time I’ll have xyz ready to eat instead, and you can see if that feels good”. Or “I’ll give your teacher a new snack for you at school. Maybe that will feel good instead.” Don’t harp on what a mistake a transgression was, especially if your child made the choice or if the choice was beyond their control. That is too easily internalized into feelings of powerlessness or failure by a child.
Notice your phrasing, demeanor, and tone when talking about food and health. Leave out the dark, judgmental stuff and emphasize food feeling good, tasting good, or being fun to share or experiment with.
3 – Read food labels? Now try this. If you’re like most parents I work with, you read food labels ad nauseam. You scrutinize every ingredient that passes your child’s lips – especially if you faithfully eat only organic food, avoid corn syrup or dyes, or if your kids ever needed an Epi Pen for eating the wrong thing!
Great. Now try this: Read a vaccine package insert. Read the whole thing, including the ingredients (often listed under the word “Description”). If you care about what’s in your child’s food, you will definitely want to know what is injected into them.
This is a great resource to see the full insert for each vaccine in the schedule. To see ingredients, search for the word “description” (which – as you may wonder – does not necessarily disclose all the ingredients, some of which are allowed to be proprietary, per the FDA).
I’ve met many a mom worried about letting their kids eat, say, corn chips or dairy (because they heard either was “bad” for everyone) – but never knew that Prevnar 13 – just one of dozens of shots on the schedule – has GMO soy fragments in it. Or that Recombivax has yeast, soy, formaldehyde, dextrose, and aluminum in it.
Recombivax is given to newborn babies. If you wouldn’t let even traces of GMO soy, formaldehyde, or aluminum touch your newborn baby’s tongue, why would you let these be injected? Note that eating any protein – or toxin for that matter – is far safer than injecting it, especially if your child is prone to any sort of reaction.
No need to dwell on what a contentious conversation anything with the V-word is, or indulge the drama and emotional reactions to this topic (I’ll delete comments that do). I get it. My graduate training in public health was full-on pro vaccine. I don’t need any instruction here, thank you very much.
It’s just that it’s high time for common sense. We talk a lot about food ingredients, including traces of glyphosate in GMO foods. Nobody talks much about ingredients in your kids’ shots. The “trace amount” argument loses traction once you see that kids receive anywhere from 70 to 100 doses in their first five years, when they are the most vulnerable to the burden of toxic exposures.
It would be fabulous if there was a pharmaceutical or biological product that actually was reliably, equally safe and equally effective for every kid or baby, every single day. But that is just magical thinking. There is no such thing, anywhere. Not a food, not a medicine, not even a fragrance. Can you imagine if it were mandated that all public school children eat Adderall every day, because some kids are too hard to manage in the classroom due to ADHD?
So this is why my Number 3 is for you to learn exactly what’s in your kids’ shots (or yours, if you’re planning on getting pregnant). They are potent. Don’t take them lightly. They may be helpful, or like anything else, they can be harmful. Too many may overstimulate the immune system to cause problems later on. Learn what is in vaccines, when they’re given and how often, and scrutinize if your child really needs them all.
For example: Your child won’t need boosters if they retain immunity from a prior dose – more may not be better.
If you’re upset because someone gave your kid a bag of Skittles at school, then wig out about the kid next door who skipped chickenpox vaccine, I think you’ve got it backwards. Just my opinion.
Besides, don’t you believe your own kid’s chickenpox shot worked – ?
In this scenario, the candy may be the lesser of two evils. Chickenpox vaccine is made with human fetal DNA, guinea pig embryonic tissue, sucrose, glutamate and MSG, and fetal bovine serum. Check out page 6 under “Description”.
4 – Heed your intuition. It’s a powerful healer, guide, and protector for your kids. And at the same time, remember that intuition is not a mandate for you alone to know everything!
In all my years as a clinician, I can’t tell you how many times I’ve heard a mom say “I just had a feeling” …and how often that feeling was right. I’ve certainly had that moment many times myself as a mom.
It can be tough to go against the advice of the expert specialist at the Mayo Clinic, but you can do it if you simply feel you must, even if you don’t know quite why just yet. You know your child best.
Don’t confuse intuition with fear, or with the egocentric idea that only you can help your child. While I’ve often seen a mom’s intuition impressively steer a child to a good outcome, I have also seen families withhold good care options or block alliances with good providers, out of fear that they shouldn’t trust anything, or a belief that only mom can know what to do. Neither approach is very successful.
Look for your allies and resources, know your own strengths as well as spots where you could use help, allow the help in, and remember – you do know your child best.
5 – Drop the drama. When we have kids with struggles, it’s so easy to be seduced by the drama of what it takes to be their parent.
It’s easy to over-identify with the tasks of caring for kids with learning disabilities, developmental concerns, feeding and growth delays, allergies, and more.
Don’t do that. It messes up your kids. They’re not here to fulfill you in some way, or address your needs. They’re just here. Pretty much, to be themselves.
I meet traumatized families. Families who have had too many trips to the ER for severe allergy reactions from an accidental walnut, for seizures because a medication keeps failing, for passing out because of FPIES reactions and non-stop vomiting. For these families, a plain old broken arm sounds pretty good. Families isolated by too many dietary restrictions, by developmental disabilities including autism, anxiety disorders, or processing disorders.
I meet families who have been verbally battered or treated with great insensitivity by doctors, teachers, neighbors, or even friends or family members. Trusting becomes hard. As a parent, it’s hard at times not to feel victimized, to feel like the hardship with your kids may never end, and to lapse into the trap of believing that this whirlwind of medical/developmental/educational crises is… your whole and sole self.
But this isn’t about you.
Underneath and in between all that, there is your child, endeavoring to just be. Like any other kid.
The kids who come out of these tempests with the best outcomes, in my experience, are the ones whose parents can remain aware of this. These parents do not attach their own pain, ego, fears, sadness, disappointment, frustration, or feelings of inadequacy to the child, or to the outcomes. They don’t focus on diagnostic labels, whether it’s eosinophilic esophagitis, PANDAS, autism, Crohns, FPIES, or whatever. They rarely if ever use the labels around their kids, because they know their kids are not the labels. They obtain the labels as a path to health and wellbeing as is useful – that’s it. They don’t spend too much time on Facebook groups devoted to their kids’ labels. They focus on actionable solutions. They trust the fact that as parent, they are doing the best they can.
You’re in charge. You set the tone. Your kids will follow suit, even if they have seemingly insurmountable challenges on their plates. I used to hate it when my mother advised, “don’t complain, don’t explain” …but, she was right.
When parents hear “nutrition matters for baby” or “kids need a good breakfast”, what does that really mean? There are plenty of vague platitudes out there filling parenting web and print media, cereal box side panels, and TV ads. But how important is this, really?
Even before pregnancy, what we moms eat and what toxins we are exposed to affect our unborn children. Whole foods organically grown in healthy toxin free soil without genetically modified seeds or feed grains will safely nourish you and your kids – and it really does matter. For example:
– Vitamin D status before and during pregnancy may affect growth of the fetus, length of pregnancy, and immune function for baby after birth. Babies may be at more for risk intrauterine growth retardation in moms who are vitamin D deficient. Even adult outcomes for mental illnesses may be impacted by mom’s vitamin D status during pregnancy.
– Ideal iron status – not too much, or too little – is crucial for normal fetal development. Iron can cause lasting damage to fetal organs and brain tissue, if the wrong amount is on board.
– Toxic exposures for you now may influence whether your grandchildren get cancer.
– Ultrasounds may damage DNA expression in your baby’s brain. Limiting exposure to these while pregnant may be safest.
– Missing folic acid, a single simple nutrient, can have catastrophic outcomes for baby. Taking it before you conceive may prevent birth defects.
– Unvaccinated babies have fewer allergies, ADHD, and chronic disease than vaccinated children. Toxins in vaccines along with early and aggressive exposure to injected antigens may be making our children more chronically ill. This bolsters the need for strong nutrition to support strong immune response. Even vaccinations taken by mom prior to pregnancy may have a negative impact too.
– Breastfeeding is as or even more powerful than vaccination at preventing infectious diseases – so powerful in fact, that the CDC has promoted cessation of breastfeeding to keep natural antibodies from negating those in vaccines! Score another point here for nutrition solutions over pharmaceutical ones.
– Genetically modified organisms in food crops (GMO) are linked to increased allergies and organ damage. These foods are unlabeled in the US – so that means you’re probably feeding them to your family. Look for foods that tell you they contain no GMO ingredients. Livestock and farm raised salmon are typically fed GMO corn. Splurge on organic meats to avoid this when you can.
These are just a few bullets from the staggering amount of information on nutrigenomics – that is, how nutrients (and toxins) impact gene expression and outcomes for our babies. But one fact is too often overlooked for parents nowadays: Nutrition really matters, and it’s up to us to engage it. Your child’s immune system depends on a steady flow of toxin-free nutrients and foods, and a well functioning digestive tract, in order to mount a vigorous response to fight infection. Your child’s brain needs the same, to grow and function to potential. Nutrition is an ensemble piece if there ever was one. Nutrients and foods work together, relying on each other in cells and processes in the body, to create a hale and hearty human. No pharmaceuticals – vaccines included – do these jobs. Food and nutrients do this.
Despite this old wisdom – documented by decades of nutrition science and practice – pediatrics today pays little due to helping parents build kids’ nutrition. Nutrition studies are not part of your pediatrician’s training. Emphasis is heavy on pharmaceuticals, a shift that has happened in the last generation. As a child, I visited the pediatrician very rarely; I have not a single memory of me or any of my four siblings going to the doctor with an illness. We each passed through the rites of chickenpox, mumps, and measles; we never got ear infections; we very rarely got colds or flu. My friends came from families of three, five, or even six or seven children. I knew no one with asthma, allergies, diabetes, epilepsy, or other conditions or disabilities. With all the pharmaceuticals now given to children beginning from birth, we must ask if these are making kids less well, and more debilitated. Over half of US children now have a chronic disease or disability – obviously, using more pharmaceuticals has not improved health for our children.
Pay as much attention as you can to real food for your family. Cooking from scratch is a lot of work, but start – somewhere. Even a few more whole food meals or snacks a week will give your kids fewer toxins, more minerals, varied protein, and essential fats and oils – all key for brain and immune function. Even busy families can begin with these ideas:
– Trade processed fortified breakfast cereals (infamous for delivering too much corn syrup, sugar, additives, or even too much iron for some children) for whole grain oatmeal, eggs, or additive-free organic breakfast meats
– If cereal is non-negotiable, transition to organic brands that use whole grains. Add raw nuts and seeds like cashew, sunflower, or pumpkin seeds.
– Once a week, try a session with your kids of making your own cereal. Use whole oats, nuts, seeds, cinnamon, honey – any granola recipe can do.
– Trade sugary GMO concoctions like Ensure, Pediasure, or Carnation Instant Breakfast for power shakes made from organic almond, hemp, or coconut milk; add whey powder, nut butters like tahini, honey, and ripe banana. Let your kids experiment with ingredients, within your parameters of fruits, seeds, nut butters, cacao nibs.
– Stuck on Cheezits and Goldfish crackers? Rotate in crunchy nut and seed mixes, Justin’s Nut Butters, raw young asparagus, or crisp bell peppers. Add dips like guacamole or hummus. If all else fails, offer nut butters and dips rich in brain building fats with the crunchy cracker favorites.
– Is Friday pizza night? Give your own homemade a try, and let your kids in on the project. If making your own dough is daunting, purchase an empty pizza round from your grocer’s freezer section and build from there. Use organic cheeses. Experiment with toppings like olives, fresh basil leaves, raw tomato slices, scallion, or barbeque chicken; let your kids spice the pie with fresh minced oregano, raw minced garlic, or fresh hot pepper.
– Use a crock pot once a week for a home cooked meal. Meatballs and sauce, meatless minestrone, pot roast and vegetables, and lentil dahl are just a few meals that cook themselves and offer protein, minerals, fats, and oils.
What I usually hear in my nutrition practice is this: The more families get into preparing real food, the more they get into it. It grows on you. And the best part is seeing your children become healthier and happier, from the inside out.
When do kids need supplements?
If you’re reading this, then you have probably already discovered, hopefully with some guidance from your team of health care providers, that your child has a nutrition problem. Or maybe you’ve come to suspect there’s a deficit for some nutrients in your child. Should you fix it with a supplement? Does that work? What’s the best way to use those?
These are important questions for children with special needs like diabetes, food allergies, asthma and inflammatory conditions, developmental concerns like Down’s syndrome or autism spectrum disorders, inherited metabolic disorders, seizures, or growth and feeding problems. As many as 60% of children with special needs have nutrition problems that can potentially impair their functioning, learning, growth, or development (1). It has been known for decades that keeping children well nourished, whether they have special needs or not, helps them reach their functional potential, by supporting learning, growth, and development.
Supplements may fit into this, and part of my job as a pediatric dietitian is figuring out if, when, and how they do. This is something to discern based on individualized nutrition assessment. I take into account several pieces: Medical history, signs and symptoms, a food diary, a child’s growth history, circumstances of the child’s gestational period, delivery, and early infancy, and so on. The last piece to fill in the blanks would be lab data, because lab data alone can’t describe a child’s nutrition status. Here are some tips to help you use supplements more effectively. More tips are in my book Special Needs Kids Eat Right (2009, Penguin/Perigee) which you can pick up in most bookstores or libraries, or order via your favorite on line bookseller.
– Kids need food! In fact, they need much more food per pound than adults. If an adult were to eat what a toddler needs per pound, that adult would need 8,000-10,000 calories per day just to maintain normal weight. Giving lots of supplements without enough food means your child will probably not be able to use those supplements as intended. So, before buying supplements, do the footwork to give your child adequate and nutritious foods. How to do this for picky eaters with special needs is covered in Special Needs Kids Eat Right.
– Supplements don’t fix problems caused by inadequate food intake in kids. Anxiety, insomnia, irritability, rage/reactivity, behavior, low muscle tone, fatigue, cognitive difficulties, frequency of infections or illnesses, and school performance are all affected by total food intakes in children. Give a balance of healthy fats and oils, clean carbohydrates that aren’t too sugary, and easy to digest proteins every day.
– If you’ve been given a list of supplements to buy based on lab results, beware. Giving a pill for each lab finding out of reference range is a cumbersome, ineffective strategy, in my experience. For nutrition interventions to work well, children need the right amount of food, foods they can digest well, and good digestion and absorption. Your provider can help you assess whether your child needs to repair digestion and absorption before giving supplements.
– Rule out bowel infections in your child with your health care provider before beginning a complex supplement regimen. Remember, whatever you feed your child will be eaten by his resident bowel bacteria first. New research is emerging to describe how important this bowel flora can be – from helping us prevent inflammatory conditions (2), to encoding our own GI tracts with the skill to make digestive enzymes (3). Other research shows that unhealthy bowel bacteria can impact behavior or even seizures in children (4, 5) – making it all the more crucial to balance this piece before using supplements that might “fertilize” the wrong bowel flora.
Those are just a few reasons why supplements need to be worked into a total care plan for your child, rather than given without thoughtful strategy. Work with your health care providers to get it right; given in the right total context, the right supplements can work very well for children. If you need more help and information, contact me or schedule an appointment at NutritionCare.net.
1. Nutrition In The Prevention and Treatment of Disease, 2nd ed. Ann Coulston and Carol Boushey, Eds. Elsevier Academic Press. Burlington, MA and London, UK: 2008
2. Maslowski KM et al. Regulation of inflammatory responses by gut microbiota and chemoattractant receptor GPR43. Nature 2009 Oct 29;461(7268):1282-6.
3. Hehemann JH et al. Transfer of carbohydrate-active enzymes from marine bacteria to Japanese gut microbiota Nature 2010 April 8;464 (7269):908-912
4. MacFabe DF et al. Neurobiological effects of intraventricular propionic acid in rats: Possible role of short chain fatty acids on the pathogenesis and characteristics of autism spectrum disorders Behavioural Brain Research 2007;176:149–169
5. Herawati R et al. Colony count candida albicans of stool in autism spectrum disorders. Clinical Pathology and Medical Laboratory, Airlangga University E-Journal 13(1):November-2006