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Sometimes babies just can't tolerate cow's milk, so their mothers, or caregivers, put them on a grain-based milk substitute.

Most of us know of--or are parents to--an infant or a young child who just can't tolerate certain kinds of foods. The itching, rashes, diarrhea, and gas caused by offending foods aren't allergies in the sense they trigger the rapid reactions in the immune system that occur in, for instance, hay fever, but they are slower and more systemic reactions to certain proteins in foods.

Different food allergies occur in different parts of the world.

In the USA, children and infants who are already on solid food tend to have problems with peanuts, tree nuts (especially almonds, walnuts, and pecans), wheat, soy, milk, eggs, fish, and shellfish. In the EU, children most commonly react to mustard, celery, sesame seeds, lupine flour, mollusks, soy, peanuts, eggs, fish, and shellfish. In Asia, allergies to peanuts are almost unknown, but some experts refer to an epidemic of allergies to shellfish and to some kinds of milk sugars that occur in formula but not in regular cow's, sheep's, goat's, yak's, or camel's milk. Some foods that people in the West would consider "exotic," such as bird's nest and sea squirts, even in minute amounts, cause serious problems for children in Asia.

When kids get food allergies, their parents naturally put them on hypoallergenic substitutes.  Rice is especially popular, as are fruit, meat, and vegetables. In Europe, Australia and New Zealand, and the USA, parents who see that their children don't do well on cow's milk often offer them a substitute, such as goat's milk. Researchers tell us that the problem with substituting foods, however, is that the list of problem foods is longer than most of us have been told.

Food-protein induced enterocolitis syndrome, an especially problematic set of gastrointestinal symptoms triggered by certain foods, usually occurring in infants and children, almost never in adults, can be triggered by a variety of foods including the usual suspects.
  • Cow's milk is a common problem food in the US, in the EU, and in Australia and New Zealand. Goat's milk, surprisingly, is a problem food in the Middle East, Latin America, and Asia, where it is more commonly consumed than cow's milk.
  • Severe allergies to peanuts are not rare in the US. They are almost unknown in Africa and Asia.
  • Reactions to beef are relatively common in beef-eating countries, such as Argentina and the US. Reactions to lamb are relatively common in Australia, New Zealand, and the Middle East.
  • Children in Asia, Africa, and Latin America tend to have more skin reactions than gastrointestinal reactions to foods. Children in Australia, New Zealand, the EU, the UK, and the United States tend to get both the diarrhea, bloating, and gas and the rashes and itching that can be caused by "slow" immune system reactions to food proteins.

Potential problem foods also include peas, lentils, squash, yam, jicama, orange juice, tomatoes, potatoes, carrots, green (string) beans, barley, lentils, chicken, and lemon. Sometimes it is necessary to eliminate all of these foods to get the problem of food-protein induced enterocolitis syndrome under control. But if you eliminate a long list of foods, how do you make sure your child gets enough nutrients?

Continue reading after recommendations

  • European Union. Directive 2007/68/EC of the European Parliament amendment of Directive 2000/13/EC. Official JEur Union 2007. L310:11.
  • Katz Y, Goldberg MR. Natural history of food protein-induced enterocolitis syndrome. Curr Opin Allergy Clin Immunol 2014. 14:229–239.
  • U.S. Food and Drug Administration. Food allergens guidance. Accessed 8 June 2014.
  • Mindmap by
  • Photo courtesy of Andrew Malone by Flickr :

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