When your child has more than one food allergy, it can be a challenge to nourish him well. Learn how multiple food allergies may affect your child’s nutritional status, growth and eating.
According to the Food Allergy Research and Education (FARE), about 1 in every 13 kids under the age of 18 has a food allergy. Most of these kids are allergic to the Big 8, or eight foods including milk, soy, egg, peanut, tree nut, fish, shellfish and wheat.
About 30% of children who have food allergy have multiple allergies to food, or what is called multiple food allergies.
In other words, 1 out of every 3 kids is allergic to more than one food.1 out of every 3 kids with food allergies is allergic to more than one food. Click To Tweet
As a pediatric nutritionist, I’ve noticed a growing trend of kids who have more than one food allergy. My son is a good example of this.
Initially diagnosed with a tree nut allergy (which for him included cashew and almond), he later showed sensitivity to raw pumpkin.
In this article, I’ll dive into the challenges associated with living with multiple food allergies, particularly focusing on nutrition, growth and eating.
Food Allergens & Cross-Reaction
It’s not uncommon to see children with an allergy to milk, egg, and peanut, or another combination of food sensitivities.
Some food allergens seem to go hand in hand, such as milk and soy allergy, and peanut and tree nut allergy.
Certain foods may “cross-react” due to the similarity of their protein structures, making the likelihood of having an additional food allergy reaction possible.
For example, in my son’s case, he’s allergic to almond, which can cross-react with hazelnut. He’s also allergic to cashew, which can cross-react with pistachios.
We steer clear of all four of these for this reason.
7 Nutrition Risks with Food Allergies
Living with more than one food allergy presents a unique set of challenges, from possible growth problems to potential nutrient deficiencies.
If your child has more than one food allergy, you’ll want to be aware of the risks.
1. Multiple Allergies = Restricted Diet
When a child has a food allergy, it requires complete elimination of the offending allergen from the diet. For example, if your child is allergic to milk, all milk and milk products must be removed.
The same goes for the other allergens — even the not-so-common ones. Whatever your child is allergic to, that food allergen, and all foods and products made from it or with it, must be avoided.
Avoiding whole foods or food groups, such as egg or dairy, respectively, may significantly limit the variety of food that your child eats.
A child who eats a diet with low food variety will always be at an increased risk for nutrient deficiencies and poor growth.
2. A Risk for Nutrient Deficiencies
As mentioned above, avoiding certain foods and food groups may place some essential nutrients at risk. Here are some of the most common nutrients at risk, based on food allergy:
- If your child is allergic to milk, then calcium and vitamin D may be challenging to supply in recommended amounts, unless you find alternate food sources. Many families use either natural or fortified sources of calcium and vitamin D to include in the diet. [Read: The Calcium Handbook]
- If your child can’t eat wheat, you’ll need to ensure that your child eats other sources of B vitamins and folate.
The bottom line is this: If your child has many food allergies, you need to know the ‘at risk’ nutrients so you can find other foods that will fill those gaps.
3. Poor Eating in Kids with Multiple Food Allergies
Kids who have more than one food allergy may be poor eaters. They may get bored with their diet, or stuck on eating the same foods, reducing the overall diet variety.
Add to this a fear of an allergic reaction and eating can become limited. When toddlers are going through picky eating, this can really put pressure on the situation. Food variety, appetite and a willingness to try new food may suffer, especially in the chid with food allergies.
If you really want to raise a healthy eater, I bet you understand there’s more to feeding your child than just putting good food on the table.
4. Not Eating Enough
You can see where this is going. Poor eating may mean your child isn’t getting enough calories and nutrients. Inadequate calories can lead to weight loss, lack of weight gain and/or stagnated growth in your child.
This can lead to poor weight gain and growth. One way to avoid this is to seek and offer a wide variety of foods. A routine with meals and snacks helps create opportunities for your child to eat as well.
5. Multiple Allergies can Lead to Food Boredom
Another risk is eating the same “safe” foods day in and day out. It’s easy to get repetitive in this area!
While safe foods are essential for managing allergic reactions to food, truth be told, this may get boring for your child.
Food boredom can cause poor eating, inadequate nutrient intake, poor nutritional status, and weight disturbances.
Thankfully, there are so many options for food allergic kids to eat a variety of foods and stay safe. Check out my 25 Food Allergy Friendly Snacks for School to get some quick ideas.
6. A Higher Risk for Poor Growth
Multiple food allergies are a known risk factor in the development of nutrient deficiencies and inadequate growth in children, as I’ve described above.
Milk, wheat, egg and soy allergies appear to be the most troublesome for children.
A study in the UK looked at children with food allergies and evaluated their weight status. The authors found that children with food allergies tended to be more underweight than the general, similar-aged population without food allergies.
The children with more than three food allergies were more likely to be underweight, presumably due to dietary restrictions and inadequate intake.
[Read: Feeding the Skinny Kid]
Another study reviewed six research articles looking at the impact of food allergies on weight and growth.
The authors concluded that children with food allergies have a higher risk of growth failure and may have a higher risk of inadequate nutrient intake than children without food allergies.
For this reason, I advise you see your pediatrician regularly to evaluate your child’s growth and development. Make those routine appointments with your food allergy care team, including a registered dietitian to help with food balance and variety.Make sure your child attends his regular food allergy appointments w/ his health care team. Click To Tweet
7. Multiple Food Allergies Can Lead to Other Problems
In addition to the above potential consequences, long-term medical conditions can develop when your child’s diet is poorly managed.
For example, if you don’t have a replacement for the bone nutrients calcium and vitamin D for the child with milk or soy allergy, your child will be at higher risk for poor bone health (ie, fractures) and a vitamin D deficiency.
Make sure to find other sources of calcium when a milk allergy exists, and pay particular attention to vitamin D foods while getting reasonable sun exposure.
What You Can Do About Multiple Food Allergies
The good news is that these nutrition risks and negative outcomes can be prevented. With a variety of nutritious foods, adequate nutrients, and sufficient monitoring by your health care team, your child’s food allergies can be managed healthfully.
I dive into this subject on my podcast with food allergy expert Marion Groesch — Tune in to hear her sage advice and deep experience with kids who have food allergies.Multiple Food Allergies: 7 Real Nutrition Risks for Kids Click To Tweet
Written by: Jill Castle, MS, RDN
Published on: July 17, 2019
Updated on: July 29, 2019