3 Nutrients Your Milk-Allergic Child May Be Missing: 5 Solutions

Milk Allergy, Nutrition, Children's Health
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If your child is allergic to milk, he or she may be missing these three nutrients important for growth, but here are 5 solutions for parents.

The number of children with food allergies is increasing in the United States and, with the need for a restricted diet, parents can unwittingly be shorting their child of some essential nutrients. A new study has found that having a strict diet due to a food allergy may be responsible for growth delay in children.

Study author Dr. Brian Vickery, of the University of North Carolina at Chapel Hill reported data on his evaluation of 245 children with food allergies in a news release by the American Academy of Allergy, Asthma, and Immunology (AAAAI). Children who had food allergies were smaller than other children, indicating growth impairment. Those with milk allergy were smaller than those with other types of food allergies, and those with multiple allergies also experienced greater growth delay.

"The relationships uncovered between food-allergic children, particularly those with more than two and those suffering from milk allergy, and the examined growth markers stress the need for nutritional assessment and intervention to ensure that food allergies do not contribute to any growth delay," AAAAI president and study author Dr. A. Wesley Burks said in the news release.

As children with milk allergy were "particularly vulnerable, with weight and BMI significantly lower than those with other food allergies," if your child is unable to tolerate dairy foods, hopefully your physician has recommended dietary counseling to ensure he or she is receiving all of the essential nutrients for growth.

The top nutrients contained in a glass of milk include three that are essential for bone health – calcium, vitamin D and potassium. The 2010 Dietary Guidelines for Americans recommend children 9 and older consume three servings of dairy foods each day; those 4 to 8 should consume 2 ½ cups each day.

Calcium
Each glass of milk contains around 300 mg of calcium, regardless of the fat content. For an alternative to liquid milk, try soy or almond milk, which is now readily available in most grocery stores. Dark, green vegetables such as kale, broccoli, or collard greens also contain a fair amount of calcium. One cup of spinach, for example, contains 245 mg. Nuts and seeds are other foods packed in calcium – just one tablespoon of sesame seeds offers 88 mg (a cup is just over 1400 mg!) and a cup of almonds has 378 mg. Tofu, beans, and calcium-fortified cereals are also good non-milk choices.

Vitamin D
Vitamin D works with calcium to not only for bone health, but also for optimal brain growth. In 2008, the American Academy of Pediatrics revised its recommendation from 200 IU to 400 IU for children in the US. Non –milk foods rich in vitamin D include fatty fish (salmon, tuna, cod, or mackerel), shrimp, eggs, non-dairy milks fortified in vitamin D and fortified cereals.

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Remember that sunlight helps the body produce its own vitamin D. Your child should be getting 5-30 minutes of sun exposure each week.

Potassium
One glass of low-fat milk provides about 366 mg of potassium, another nutrient your bones need for mineralization and growth. Thankfully, potassium can be found in many non-dairy foods including potatoes (a medium baked potato with skin provides 926 mg), bananas (362 mg for one), almonds (200 mg in 1 ounce), and beans (1004 mg in 1 cup of cooked white beans). Encouraging a diet plentiful in fruits and vegetables each day should ensure your child of reaching his or her potassium goal without the need for milk.

Five Additional Steps You Should Take:

1. Ensure adequate protein and fat intake. In children, milk is typically a major source of protein, but it is easily obtained without dairy foods through lean meats and beans. Remember that plant foods also contain protein in varying amounts – just read the Nutrition Facts guide to ensure your child is reaching his or her daily minimum.

2. Read ingredient labels carefully. There are some hidden sources of milk that could trigger a reaction in your child. These include casein (a milk protein) and whey. Ingredients that sound suspicious but are actually safe for the milk allergic person to consume per the Food Allergy and Anaphylaxis Network include calcium lactate, calcium stearoyl lactylate, cocoa butter, cream of tartar, oleoresin, sodium lactate, and sodium stearoyl lactylate.

3. Stay on top of food recalls through the FAAN website for foods that may have milk as an ingredient but have been mislabeled.

4. When eating out, ask your server about food additions not listed on the menu, such as butter melted on a steak. Also, ensure your favorite deli meats aren’t cut on the same slicer as cheese to prevent cross-contamination.

5. Check with your pharmacist about medications your child takes – some may contain whey.

Source references:
Vickery B, et al "Impact of food allergy on growth in the pediatric population" AAAAI 2013; Abstract 361.
American Academy of Allergy, Asthma and Immunology, news release, Feb. 24, 2013
Food Allergy and Anaphylaxis Network - Milk Allergy

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