What is the management for pediatric food intolerance?

From the Guidelines

Managing food intolerances in children involves identifying and eliminating trigger foods while ensuring proper nutrition, and the most recent and highest quality study 1 suggests that a hypoallergenic formula can be effective in treating food protein-induced enterocolitis syndrome (FPIES).

Key Considerations

• Start by keeping a detailed food diary to track symptoms and potential triggers.
• Once problematic foods are identified, eliminate them from your child's diet for 2-4 weeks to see if symptoms improve.
• Common intolerances include lactose (dairy), gluten, certain food additives, and fructose.
• For lactose intolerance, consider lactase enzyme supplements like Lactaid (typically 1-2 tablets with dairy-containing meals) or lactose-free alternatives.
• For other intolerances, focus on complete avoidance of trigger foods while working with a pediatrician or dietitian to ensure nutritional needs are met.

Introduction to Food Allergies and Intolerances

Food intolerances differ from allergies as they typically cause digestive discomfort rather than immune responses, so symptoms like gas, bloating, diarrhea, and stomach pain are common indicators.

Management Strategies

• Gradually reintroduce eliminated foods one at a time, in small amounts, to confirm triggers and determine tolerance thresholds.
• Always consult healthcare providers before making significant dietary changes to ensure your child's nutritional needs continue to be met during the elimination process.
• According to 1, referral to an allergist-immunologist can help in diagnosing and managing food allergies and intolerances.
• As noted in 1, patient education on avoidance and management of accidental ingestion of foods known to produce anaphylaxis is crucial.
• Additionally, 1 emphasizes the importance of teaching patients to effectively read and interpret labels on foods and to inquire about ingredients in restaurant meals.

From the Research

Management of Food Intolerance in Kids

• The management of lactose intolerance, a common type of food intolerance, involves reducing or eliminating lactose from the diet until symptoms disappear 2, 3, 4, 5, 6.
• Treatment options include:
  • Dietetic restriction of lactose-containing foods
  • Administration of lactase as an enzymatic food supplement
  • Use of probiotics to aid in lactose digestion 2, 4, 6
• It is essential to ensure that kids with lactose intolerance still consume enough calcium and other nutrients found in dairy products to prevent conditions like osteopenia and osteoporosis 3, 4.
• Labeling of lactose-free products can be helpful in guiding kids and their parents to choose safe and suitable products, but a universal standard for "lactose-free" labeling is currently lacking 3.
• Other therapeutic options include the use of exogenous enzymes, prebiotics, and selection of milk containing specific types of beta-caseins 5.