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New Recommendations for Introducing Complementary Foods for Prevention of Allergies in Children

As a mom of a baby boy who recently started complementary foods, aka: “solids,” these new findings are really exciting! Released in January 2013, the recommendations were written after finding that delayed introduction of solid foods, including the top allergenic foods, as previously recommended (in 2000), did not lead to fewer food allergies among children at risk for developing allergies based on family history. In fact, over the past decade, the incidence and prevalence of food allergy and allergic diseases in general have increased substantially, leading to the re-evaluation of the 2000 recommendations.

Food allergies affect mostly young children, and about 90% of these allergies are caused by 8 foods: cow's milk, eggs, soy, peanuts, tree nuts, wheat, fish, and shellfish. With the exception of peanut allergy, the majority of children outgrow their food allergies.

The Nuts & Bolts of Introducing Complementary Foods (aka: “Solids”) per the 2013 Recommendations

  • The AAP prefers moms exclusively breastfeeding until baby is 6 months old. There are also a couple developmental milestones your baby should achieve before introducing any complementary foods. Baby should be able to sit upright with support and have sufficient head and neck control.
  • In an unselected population of children, feeding solids before 4 months old is associated with a higher incidence of atopic dermatitis, which was also detected 10 years later.
  • No current evidence suggests delaying the introduction of solid foods beyond 6 months of age will prevent allergic disease.
  • In fact, interestingly enough, delaying the introduction of solid foods, especially the highly allergenic foods, may increase the risk of food allergy or eczema.

General Advice for Introducing New Foods to All Children

  • Most pediatric guidelines suggest first introducing single-ingredient foods between 4 and 6 months of age, at a rate not faster than one new food every 3 to 5 days.
  • Complementary foods in the United States are typically rice or oat cereal, yellow/orange vegetable (ie: sweet potatoe, squash, and carrots), fruits (ie: apples, pears, bananas), green vegetables, and then age-appropriate vegetables with meats.
  • It is common for acidic fruits (ie: berries, tomatoes, citrus fruits, and vegetables) to cause, on contact with the skin, a localized skin reaction or rash. However, these do not usually result in a systemic reaction so delayed introduction of such foods is not recommended.
  • The committee doesn't recommend introducing one of the highly allergenic foods as one of the first complementary foods. Once a few typical complementary foods mentioned above are tolerated, highly allergenic foods may be introduced.
  • Offering whole cow's milk as the infant's main drink should be avoided until 1 year old for reasons unrelated to allergic disease, but rather increased renal solute load, and low iron content.
  • It is ok to introduce other cow's milk-based products, such as cheese and yogurt before age 1 year.
  • Whole peanuts and tree nuts, but not peanut/tree nut butters, carry aspiration risk and should be avoided until your baby's primary care physician feels they are safe.

How to Introduce Highly Allergenic Foods

  • Give the initial taste of one of these foods at home, rather than at day care or at a restaurant.
  • For some foods, such as peanuts, most reactions occur in response to what is believed to be the initial ingestion.
  • If there is no apparent reaction, the food can be introduced in gradually increasing amounts.
  • Introduction of other new foods should proceed at a rate of one new food every 3 to 5 days if no reactions occur.

New Recommendations for Eating Allergic Foods During Pregnancy

While pregnant, I heard varying information about whether or not to eat allergenic foods. The thought was, if I ate a lot of peanut butter, my baby would have an increased risk of having a peanut allergy. With the new recommendations, we know this is not true. Avoidance diets during pregnancy and lactation are not recommended at this time, but more research is necessary for peanuts.

Note: These recommendations come from a collaboration between the American Academy of Pediatrics (AAP), the joint guidelines of the European Society for Pediatric Allergology and Clinical Immunology, and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods


For more information, please visit: Fleischer, DM et al. Primary Prevention of Allergenic Disease Through Nutritional Interventions. J of Allergy and Clinical Immunology: In Practice. Vol. 1, Issue 1: 29-36, Jan. 2013.

 

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11 Health Benefits of Spirulina

The Aztecs discovered spirulina, a type of blue-green algae, thousands of years ago and soon made it a staple in their diet. Now days, spirulina is considered a “superfood.” The bright green color of spirulina indicates it is full of antioxidants and also contains many elements necessary for a healthy functioning immune system and nervous system. Give it a try!

11 Health Benefits of Spirulina

1.  Spirulina is rich in protein. In fact, amino acids make up 62% of spirulina and provide 4 grams per 1 Tablespoon.

2.  Spirulina is high in B-vitamins: vitamins B-1 (thiamine), B-2 (riboflavin), B-3 (nicotinamide), B-6 (pyridoxine), B-9 (folic acid).

3.  Spirulina is high in other vitamins and minerals, including vitamin E, manganese, zinc, copper, iron, and selenium.

4.  Spirulina contains gamma linolenic acid, an essential fatty acid. It has amazing anti-inflammatory properties especially when taken with other quality Omega-3 supplements.

5.  Spirulina can be used for increased exercise performance. In one study, taking spirulina for 4 weeks was associated with a significant increase in exercise performance and fat oxidation.

6.  Spirulina has potent antioxidant activity, particularly phycocyanin and beta carotene—antioxidants that can help protect cells from damage.

7.  Spirulina was clinically effective on managing allergic rhinitis through its anti-inflammatory and/or antioxidant properties.

8.  Dried spirulina contains 8 mg calcium per 1 Tablespoon serving, which is more than raw spirulina.    

9.  Spirulina contains chlorophyll which is used for “detoxification” by helping remove toxins such as heavy metals and other pollutants from the blood.

10. Spirulina is often alternated with chlorella for detoxifying the body. 

11. The very high concentration of bioavailable iron makes it excellent during pregnancy and for those with anemia.

How to Eat Spirulina

When choosing Spirulina, make sure to choose a product that is organic, as others can have nitrate compounds as additives.

Some common ways to take Spirulina include: 

  • Add spirulina to a smoothie or fresh juice
  • Add spirulina to a small amount (1/4-1/2 cup) of organic apple cider
  • Mix spirulina with organic applesauce
  • Simply mix spirulina into water and drink it straight, though many people have trouble with this. Some would go as far as saying it tastes horrible! You can decide for yourself. If you ask me, the nutrition punch spirulina provides makes it worth it!

How Much Spirulina

Recommendatins vary, but start with a small amount of Spirulina, maybe ½ tsp. at a time and slowly increase your intake until you are eating 2 teaspoons per day. Take more—2 or more tablespoons—during illness, after radiation exposure, or during pregnancy. 

Precaution

If you have an autoimmune disease, such as multiple sclerosis, rheumatoid  arthritis, or lupus, you should avoid spirulina. Theoretically, it could  stimulate your immune system and make your condition worse.

What are your favorite ways to incorporate Spirulina into your life?

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

 

References:

1.  Kalafati M, et al. Ergogenic and Antioxidant Effects of Spirulina Supplementation in Humans.  Med & Sci in Sports & Ex. 2009 DOI: 10.1249/MSS.0b013e3181ac7a45

2.  Spirulina.  University of Maryland Medical Center.

3.  USDA National Nutrient Database for Standard Reference; Seaweed, spirulina, dried

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How To Use a Neti Pot

A stuffed-up nose is so annoying, especially when you’re trying to sleep! If you’re in need of a natural solution, consider trying nasal irrigation, or Neti. It’s an ancient tradition gaining popularity in the modern world for its effectiveness at treating allergies, sinus infections, and colds, among other things.

What does the neti pot do?

Basically, what the neti pot does is gently wash away excess mucous, bacteria, pollen, allergens and viruses from the sinuses. There's one main sinus a neti pot flush can reach—the maxillary sinus, which is on either side of your nose. It's basically inside the "cheek bone."  When they fill with pus or mucous, it hurts. Not only does it hurt, but it provides a further haven for more bacteria and viruses as the immune system cannot enter. The door is closed.

Nasal irrigation opens that door by washing out the pus and mucous. Then, the immune system's IgA antibodies, which live on the mucous membranes of your nose, once again get back to work.

How to use the neti pot

I’ll admit, neti pots are an odd device to get used to but once you get the technique down, your sinuses will appreciate it. Not to mention your friends as you'll stop sniffing constantly.

  • Fill your neti pot with luke warm, distilled, sterile, or previously boiled water. Not cold or hot water. Must be warm.
  • Add 1/4 teaspoon of pure salt. Your mucous membranes are naturally salty and a pinch of salt in your neti pot will help to wash out the stuck mucous. Do not use mineral salts or sea salts. Some people are allergic to shellfish and this will not help the situation. One can buy pure neti salt and it's not expensive. Normal table salt is fine also but it is processed like crazy - they use about 15+ chemicals to end up with pure white table salt. You didn't want to know that did you?
  • You can add a pinch of baking soda also. This softens the water a bit so it's easier on your mucous membranes.
  • I recommend doing this procedure in the shower. This way you cannot make a mess. You can also do it over a sink or sitting down with a big bowl on the table in front of you.
  • Insert the neti pot spout into one side of your nose. Lean your head slightly to one side and forward a bit. This allows the medicated water to flow from one side of your nose to the other. This action pushes out the mucous and also drops off the medicated water in your sinuses.
  • Stay in this head bent and tilted position while the water runs out - say for about 15 seconds.
  • When 15 seconds is up, remove the spout and gently blow your nose. Do not block one nostril while blowing your nose as this forces the mucous up closer to your brain. Also do not blow forcibly as this will push the mucous into your ear canal. Just blow lightly - like a soft outward snort.
  • Repeat on the other side. Do this about 2-3 times each side. Refill the neti pot as needed. Typically this can be done sufficiently with one full neti pot.
  • This takes about 3 minutes. Sounds like a lot of work but it's fast - especially as you do it more and more.
  • Rinse out the neti pot or place it in the dishwasher to sterilize. Let your neti pot dry out after each use. I recommend buying one for each person of the family. This way you don't have to wash it so hard every time.

If you feel the neti pot technique is not working for you and causing burning, consider:

  • Adding a bit more salt.
  • Adding a bit less salt.
  • Adding a pinch of baking soda as this softens the water.
  • Use filtered water as chlorine is an irritant and definitely can burn your nose.
  • Warm the water in the neti pot to body temperature.
  • Only neti when your nose is plugged up.

Should you have questions about the technique, please post a comment.  

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods 

Pieces of this article by Dr. Ben Lynch, ND, posted 04/2007 on Healthy Goods.


 

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Air Purifiers for Healthy, Happy Homes

I’m a sucker for a good store demo!  As a result, about one year ago my husband and I purchased an air purifier for our house…actually, two air purifiers.  One for upstairs and one for downstairs.  Since my husband is allergic to our indoor cat, and at the time I had a toddler crawling around and was pregnant with my second child, I wanted to reduce the amount of pollutants and allergens in our home.  I keep a clean house, but I knew there was more I could do. 

Why I love my air purifier?

Since using the air purifier, I’ve actually had people walk into our house and tell me “it smells so clean” or “so fresh.”  Gotta love that!  I simply move the air purifier around the house depending on where I need it most.  If my 2-year-old’s room has a funky stench, I keep it there for a day.  If I use a bathroom cleaner that leaves a strong smell, I move it there and the smell disappears surprisingly quicker than you’d think—30 minutes max with my purifier.  I’ve even been known to take it with me when I travel to get rid of that stale air smell hotel rooms often have.  I literally keep the thing running 24/7. 

What is the air purifier actually doing? 

According to U.S. government standards, a HEPA (High-efficiency particulate air) air filter must remove (from the air that passes through) 99.97% of particles that have a size of 0.3 micrometers or larger.  Here’s an idea of what is 0.3 micrometers or larger—pet dander, mold, dust mite debris, pollen, skin flakes, bacteria, and most household dust, to name a few.

As the sun shines through my windows, I no longer see tiny dust particles floating in the air.  My husband’s allergies don’t seem to bother him anymore.  We don’t wake up with “sandman” in our eyes.  Our air purifier is extremely versatile and best of all—effective!  Turns out I wasn’t a sucker after all!  It feels good to know I’m reducing my family’s exposure to all the dust and germs that can cause colds, allergies, or asthma.

Air purifiers aren’t cheap, so it’s a purchase to research, but I’m very pleased with mine and feel it was well worth the money. 

In Health and Happiness,

Kelly Harrington, MS, RD

Registered Dietitian Nutritionist

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Coping With Your Child’s Food Allergies Away From Home - Part 3

This is a follow-up to two previous postings:  Coping with Food Allergies – Part 1 and

Coping with Food Allergies & Picky Eaters - Part 2.

Once you have your home life squared away, what happens when the control of your young child’s diet is no longer yours, such as when you drop him off at daycare or school?  It’s troubling to wonder if another caregiver will really understand your child’s allergy. 

Tips For Managing Food Allergies Away From Home

#1:

  Raise Awareness!  Quite frankly, raising awareness may be up to you, which will lead to a much more joyful experience.  Food will be a part of every daycare setting, and assume food will also be a part of every preschool or kindergarten classroom. 

#2:

  Become involved in your child's school as much as possible.  Most teachers appreciate parental support! 

#3:

  Talk to the teacher/daycare provider about your child’s allergy and create a letter to give other parents, informing them of your child’s food allergy. 

#4:

  Talk to the school/daycare about possibly offering allergy-free food alternatives for snacks or special classroom occasions.  Suggest parents only bring treats for sharing which are clearly labeled with the ingredients. 

#5:

  Offer to provide the teacher/caregiver a “how-to” video on using an epi-pen, and give the teacher/caregiver a detailed personalized management plan in case your child experiences a reaction.

These are only five ways to cope with a food allergy in your family.  The best course of action usually involves discussing with others what worked best in similar situations in order to determine the right course for your family. 

What are some helpful ideas which have worked for your family you might share with us on the blog?

In Health and Happiness,

Kelly Harrington, MS, RD

Registered Dietitian Nutritionist for Healthy Goods

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Coping with Food Allergies and Picky Eaters - Part 2

This is a follow-up to a previous posting, Coping with Food Allergies – Part 1.

As discussed in my last blog posting, it can be scary, frustrating and time-consuming trying to figure out how to manage your child’s food allergy, and understandably takes a big toll on the entire family. 

Tips for Managing an Allergy

I would like to offer parents some tips for managing such an important aspect in your child’s life. 

#1: Spend some time looking for allergy-free recipes, specific to the food you are avoiding. Building a collection of recipe’s your family enjoys will reduce cooking frustrations. Where would you find these recipes? There are many allergy-free resources available, such as allergy-free cookbooks, the internet, mobile phone applications, magazines, and your local library and county health department. Home life will become easier if you are able to prepare one delicious meal for everyone to eat. I discourage you from becoming a short order cook. As an additional time saver, purchase allergy-free, ready-made products so you don't have to make everything yourself.

#2: Meet parents who also have kids with food allergies and share tips with them. Support groups and allergy free blogs are both good avenues for pursuing this. 

#3: Discover tricks for dealing with a “choosy” eater. It can be frustrating when kids want to eat the same thing every day, but it is not uncommon. Kids are often slow to accept new tastes and textures, so you may have to present a food 10 to 15 times before they will try it. Don’t give up! As the parent, also don’t forget the influence you have on your child’s food preferences. Children often eat what they see their parents eating, so try to be a good role model. 

Tips for Navigating Your Picky Eater

Some children are simply less likely to try new foods, but here are some tips that may work for your child:

#1: Keep mealtime positive. Do not force your child to eat or make “deals” with your child (ie: “eat your vegetables and you will get dessert”). 

#2: Allow your child to feed him/herself and offer safe finger foods. 

#3: At each meal, make sure there is something your child knows and likes on the plate. Alongside the familiar food, place the unfamiliar food or food your child is typically “choosy” toward.    

#4: When introducing a new food, encourage your child to touch, smell, lick, or taste the new food. Let them take their time “exploring” the new food.

#5: Kids love to dip! Use healthy dips such as yogurt, hummus, mustard, ketchup or low-fat salad dressings to encourage your child to eat fruits, vegetables, and meats.

#6: Involve your child in preparing the meal (like dropping cut-up fruit into a bowl for a fruit salad). Handling, smelling and touching the food helps your child get comfortable with the idea of eating it.

#7: Always offer your child what the rest of the family is eating, in toddler-sized portions. Over time, these choices will become as liked and familiar as their favorites.

For more information/resources on food allergies, please visit the following links:

1.    www.mayoclinic.com, “Food allergies: Watch food labels for these top 8 allergens.”

2.    www.eatright.org, American Dietetic Association

3.    www.foodallergy.org, The Food Allergy and Anaphylaxis Network

4.    www.babyandkidallergies.com

Please stay tuned for my third and final blog post about food allergies!

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

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Coping with Food Allergies – Part 1

Imagine dissecting the food label for every food product you want to put into your mouth, and upon dissecting that label, needing to understand where every single ingredient comes from!  It would be difficult, tedious and frustrating, but absolutely necessary for someone with a food allergy. 

Prevalence among Children:

  Food allergies are a growing concern in the United States as approximately 1 in 25 people and 1 in 100 children suffer from a food allergy.  Among these children, 0-5 year olds have the highest food allergy rate, affecting boys and girls evenly.  According to The National Center for Health Statistics, food allergies among children have unfortunately increased by 18% from 1997 to 2007.  This also correlates to an increase in the number of visits to ambulatory care clinics due to adverse allergic reactions, which all parents know is stressful, scary, tiresome and costly!  

More than 160 foods are known to cause food allergies. 

Surprisingly, eight foods account for 90% of all food-allergic reactions:

  • Milk
  • Egg
  • Peanuts
  • Tree nuts (walnuts, cashews)
  • Fish (pollock, salmon, cod, tuna, snapper, eel, and tilapia)
  • Shellfish (shrimp, crayfish, lobster, crab)
  • Soy
  • Wheat

Regulations:

  Manufacturers are required to state on the food label if the product contains protein from any of the top eight allergens; for example, the label will say, “this product contains milk.”  Manufacturers may also indicate if the food was made in a facility that contains these allergens, but this is not yet mandatory.  Overwhelming?  Being a parent can be challenging, let alone being the parent of a child with a food allergy.  There are so many things to think about! 

Two helpful things a parent can do to ease the transition into this new way of life. 

#1:  Understanding what ingredients indicate a specific food allergen is very important.  To expand your food label reading capability, take a look at the links below.  The links name ingredients to avoid based on your child’s specific allergy.  Don’t worry about memorizing all those hard to pronounce ingredients!  You can print your list and use it as a reference while you shop.

#2:  As your child grows older, another extremely important aspect of coping with a food allergy is teaching your little one about their food allergy.  Of course, your child’s age will determine the skill and information you give them, so start with the basics.  Gradually increase the information so they are eventually able to manage their food choices on their own.

The more you know about your child’s allergy, the easier it will be to manage and increase the variety in your family’s diet, prepare meals, and prevent unwanted reactions. 

For more information on hidden milk ingredients, please visit:  http://www.foodallergy.org/allergens/milk-allergy

For more information on hidden egg ingredients, please visit:  http://www.foodallergy.org/allergens/egg-allergy

For more information on hidden peanut ingredients, please visit:  http://www.foodallergy.org/allergens/peanut-allergy

For more information on hidden tree nut ingredients, please visit:  http://www.foodallergy.org/allergens/tree-nut-allergy

For more information on hidden soy ingredients, please visit:  http://www.foodallergy.org/allergens/soy-allergy

For more information on hidden wheat ingredients, please visit:  http://www.foodallergy.org/allergens/wheat-allergy

 

For more information on hidden fish ingredients, please visit:  http://www.foodallergy.org/allergens/fish-allergy

 For more information on hidden shellfish ingredients, please visit:  http://www.foodallergy.org/allergens/shellfish-allergy

Please stay tuned for the next blog post when I will discuss more on food allergies!

In Health and Happiness,

Kelly Harrington, MS, RD

Registered Dietitian Nutritionist for Healthy Goods

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