A child’s body is growing and developing at a rapid rate and they need a healthy balanced diet to fuel that process. Eating a wide variety of foods is ideal but sometimes their bodies just can’t cope properly with certain foodstuffs.
It’s never a good idea to randomly cut out food groups and restrict the nutrition your child so desperately needs. However there are signs that you can look for if you are worried that your child may have a food intolerance. By watching, monitoring and keeping a food diary (1) you can be a diet detective and help your child grow healthy, strong and fit for the excitement and challenges that lie ahead.
What is food intolerance?
Let’s face it, lots of children can be downright picky about what they will eat and when. Turning their nose up at a food or spitting it out doesn’t make them intolerant, in fact they may absolutely love a food and still not be able to tolerate it.
Food intolerance is a medical condition where an individual is sensitive to an ingredient, which makes it difficult to digest the food. It’s different from a food allergy, which is a severe and potentially life-threatening reaction from the body’s immune system to even tiny amounts of a substance, for example a peanut.
Intolerances can be tricky to identify. A kid needs to have eaten a fair amount of the food to have a reaction but there may be many different symptoms and the response can be delayed by many hours, so that it can be difficult to make the connection. The good news is that although intolerances are unpleasant they are not dangerous or life threatening. By keeping a close eye on all food eaten and any symptoms, problems or behavior changes, you may be able to spot a pattern.
Reflux and Regurgitation
Spitting up, or bringing back the milk your baby’s just been fed is totally normal and the reason why no new parent goes anywhere without a muslin square. However for some babies the regurgitation can be severe and associated with crying, distress and sometimes failure to gain weight. This can be due to acid and milk coming back up their developing food pipe, which is known as reflux. But up to 40% of babies with severe reflux are found to have intolerance to the protein in cow’s milk (1) and cow’s milk may actually make reflux worse (2) so if your baby is suffering it’s certainly something to consider.
They could be getting small amounts of the cow’s milk protein through your breast milk, so it may be worth cutting dairy from your diet to see if that makes a difference. In bottle fed babies, the formula could be the culprit, so see your doctor for a hypoallergenic alternative.
2. Funny Tummy
Does your little one have to sprint to the loo, have runny poos, crampy pains, bloating or constipation? The symptoms that many of us associate with an irritable bowel may actually be down to food intolerances.
A deficiency of the enzyme that breaks down lactose, the sugar in milk, can lead to discomfort and diarrhoea after eating dairy products. Your baby could be born with this, or develop it temporarily after a tummy bug. But it’s not just lactose that can irritate the bowels, cow’s milk protein has been linked with chronic constipation in children, so if laxatives are not helping see your doc for more advice (4).
Did you know that one of the chemicals that control our body’s allergic reactions can actually be found in some of the foods we eat? Histamine is found in pickles, cheese, tofu, soy sauce, processed meats and, unfortunately chocolate too.
Some of us don’t have the ability to break it down properly and can suffer symptoms including itching all over, rashes and hives after eating histamine containing foods. If your little one is sensitive, they may also notice headaches, flushing, chronic tummy pain and diarrhoea (5). Keep a diary and see if histamine intolerance is causing your child’s health problems.
Burps and bloating
Is your child a little…errm…windy? If your little one is a farting, burping or belching machine, they may have an underlying intolerance. Sensitivity to wheat, dairy or amines can all predispose to bloating and problems with absorbing fructose, the sugar in fruit, juices, table sugar and loads of packaged and fast foods, can cause abdominal pain, diarrhoea and lots of gas- and it has to get out some way!
My head hurts
Headaches and migraines can be miserable for your child and frustrating for you as parents, who can feel powerless to help. Always see your doctor for support and advice if your little one is suffering regularly and keep a record of any foods that may trigger their attacks.
Foods containing chemicals called amines may be the guilty parties for some children. As with histamine, not all of us have the ability to break these substances down and they can act to trigger symptoms. The foods implicated include the usual culprits chocolate and cheese but pork, citrus fruits, onions and caffeine may also kick off a migraine is sensitive children. Find out much more information and detail here (6)
Tired all the time
Is your little one tired and lacking in energy? There is some evidence that sensitivity to gluten in wheat, rye and barley can trigger symptoms of fatigue, a foggy mind and just general grumpiness as well as tummy ache and diarrhoea, in some sensitive people (7). This is not the same as Coeliac disease in which the gluten actually damages the bowel lining and it won’t show up on bowel biopsies or tests, so it can be tricky to identify, the food diary is your friend here and chat to your doctor about eliminating gluten from the diet for a trial period, so that you can monitor any changes.
Does your child struggle to concentrate; are they disruptive in school or at home?
The role of diet in attention-deficit/hyperactivity disorder (ADHD) has attracted lots of debate and controversy. Many foods have been implicated, from those containing salicylates like grapes, apples and hot dogs, to artificial colourings, sugar and artificial sweeteners have also been held to account. Less informed people have argued that it’s just an excuse for bad behavior but there is evidence that elimination of certain foods may be beneficial in some children (8), and you may prefer trying dietary options to stimulant drugs. But dietary measures can be tricky to impose and difficult for family life, so chat to your GP or paediatrician for advice.
- Allergy UK (https://www.allergyuk.org/downloads/diary-examples/food-symptoms-diary.pdf)
- Gastroesophageal reflux and cow milk allergy: is there a link? (Pediatrics 2002; 110:972) Salvatore S, Vandenplas Y.
- Cow’s Milk Allergy among Children with Gastroesophageal Reflux Disease (Gut Liver. 2011 Sep; 5(3): 298–301) Fatemeh Farahmand, Mehri Najafi, Pedram Ataee, Vajiheh Modarresi, Turan Shahraki, Nima Rezaei
- Chronic Constipation and Food Hypersensitivity – An Intriguing Relationship (Aliment Pharmacol Ther. 2006; 24(9):1295-1304) A. Carroccio; G. Iacono
- Histamine and histamine intolerance (American Journal for Clinical Nutrition, 2007) Laura Maintz and Natalija Novak
- NHS and Migraine Action report (http://www.nhs.uk/ipgmedia/national/migraine%20action/assets/migraineandfood.pdf)
- Non-Celiac Gluten Sensitivity: The New Frontier of Gluten Related Disorders. Carlo Catassi, Julio C. Bai, Bruno Bonaz, Gerd Bouma, Antonio Calabrò, Antonio Carroccio, Gemma Castillejo, Carolina Ciacci, Fernanda Cristofori, Jernej Dolinsek, Ruggiero Francavilla, Luca Elli, Peter Green, Wolfgang Holtmeier, Peter Koehler, Sibylle Koletzko, Christof Meinhold, David Sanders, Michael Schumann, Detlef Schuppan, Reiner Ullrich, Andreas Vécsei, Umberto Volta, Victor evallos, Anna Sapone and Alessio Fasano
- The Diet Factor in Attention-Deficit/Hyperactivity Disorder (Pediatrics February 2012, VOLUME 129 / ISSUE 2) J. Gordon Millichap, Michelle M. Yee
Dr Jane Gilbert is a qualified medical doctor born and educated in the U.K with a degree in psychology. She has written extensively on diet and nutrition, and has been featured in publications such as the Sunday Express and Radio Times as well as featured on the BBC, and worked with companies such as Boots, Roche Pharmaceuticals and Intelligent Labs. She has also researched and presented a series called “You Are What You Eat” for ITV Yorkshire about eating your way to a healthier life and worked with a team of nutritionists and chefs on Wellbeing, the health channel.