Is My Child with Food Allergies Getting the Nutrients They Need to Grow and Thrive?

Feb 16

By: Kerry Lett, MPH, RDN, LDN, CLC

Balanced Meal for Child with Food Allergies

When your child is diagnosed with a food allergy, feeding them suddenly feels a lot scarier than it used to. Foods that were once easy or familiar may now be off-limits and many parents begin to worry about whether their child is still getting what they need nutritionally to grow and thrive.

We know that food allergies are on the rise in United States (1). Approximately 33 million Americans, including about 5.6 million children, have food allergies, with roughly 5-8% of children diagnosed with at least one food allergy (1, 2, 3, 4). Among those, about 40% are allergic to multiple foods (3).

How Do Food Allergies Affect Growth & Development?

Avoiding foods that trigger allergic reactions is currently the most effective way to keep someone with food allergies safe. However, when someone must restrict multiple foods, especially multiple food groups, there can be concerns about whether they are still getting all the nutrients they need. This is especially true for children, who are rapidly growing and developing and who rely on a wide variety of nutrients from food to get everything they need.

Research has shown that children with food allergies are at increased risk of inadequate nutrient intake, which can lead to poor growth and vitamin and mineral deficiencies (5,6,7). In one study, children with multiple food allergies were significantly shorter than children without food allergies (5). In rare situations, nutrient deficiencies from very restricted allergen elimination diets have caused children to develop rickets or Kwashiorkor (a severe form of malnutrition) (5,6).

How Can I Ensure My Child Is Getting the Nutrients They Need?

The good news is that research also shows children with food allergies can continue to grow and thrive when the nutrients they are missing from avoided foods are replaced with safe alternatives (5,6). A helpful first step is to consider which nutrients your child may be missing based on their specific food allergen(s).

Below is a simplified list of the nine most common food allergens and the key nutrients those foods typically provide:

Dairy/Cow’s Milk: protein, calcium, iodine, phosphorus, selenium, zinc, and vitamins A, B2, B5, B9, B12, D, & K
Eggs: protein, iodine, and vitamins A, B2, B5, B7, B9, B12, D, & K
Soy: protein, calcium, magnesium, potassium, and vitamins B1, B6, B9, & K
Wheat: fiber, copper, magnesium, manganese, iron, selenium, zinc, and vitamins B1, B2, B5, & B9
Peanuts & Tree Nuts (varies by nut): protein, copper, magnesium, manganese, phosphorus, selenium, zinc, and vitamins B3, B7, B9, & E
Fish & Shellfish (varies by fish/shellfish): protein, omega-3 fatty acids, copper, iodine, and vitamins B1, B3, B5, B6, B7, B12, & D
Sesame Seed: protein, fiber, calcium, magnesium, manganese, zinc, and vitamins B1 & B6

Once you understand which nutrients are most affected by your child’s food allergies, you can begin to find safe alternatives of those same nutrients. Most nutrients are found in many foods, so in most cases, there is at least one allergy-friendly option that can help fill each gap.

Below are examples of important nutrients that may be affected by food allergies along with foods that can provide them:

Omega-3 Fatty Acids: fatty fish (such as tuna & salmon), nuts, seeds, & oils (such as olive oil)
Protein: beans, edamame (soy), dairy products, eggs, fish, lentils, meat, nuts, nut butters, seeds, seed butters, seitan (wheat), tempeh (soy), and tofu (soy)
Calcium: dairy products, calcium-fortified dairy alternatives or tofu, green leafy vegetables (other than spinach), and fish eaten with bones (such as sardines)
Copper: dark chocolate (70% or greater cacao), seeds, shellfish, nuts, and whole grains
Iodine: dairy products, eggs, fish, seaweed, and shellfish
Iron: beans, fortified breakfast cereal, meat, and seafood
Magnesium: beans, green leafy vegetables (such as spinach), nuts, seeds, and whole grains
Manganese: leafy vegetables, legumes, nuts, rice, some seafood (such as clams, oysters, & mussels), and whole grains
Selenium: Brazil nuts, dairy products, grains (such as pasta & rice), meat, and seafood
Zinc: beans, dairy products, fortified breakfast cereal, meat, nuts, some seafood (such as oysters, crab, & lobster), and whole grains
Vitamin A: dairy products, eggs, and most vegetables
Vitamin B1: fish, meat, & whole grains
Vitamin B2: eggs, dairy products, green vegetables (such as spinach), and meat
Vitamin B5: avocado, dairy products, eggs, fish, meat, seeds, some vegetables (such as broccoli, mushrooms, & potatoes), and whole grains
Vitamin B6: fish, fortified breakfast cereal, meat, non-citrus fruit, and starchy vegetables (such as potatoes)
Vitamin B7: eggs, fish, meats, nuts, seeds, and sweet potatoes
Vitamin B9: beans, dairy products, eggs, fruit, fortified grains (such as rice & bread), green leafy vegetables (such as asparagus & spinach), meat, and seafood
Vitamin B12: dairy products, eggs, fish, fortified breakfast cereal, meat, and nutritional yeast
Vitamin D: fatty fish (such as tuna & salmon), vitamin D-fortified foods (cow’s milk and some yogurts, dairy alternatives, & juices), and egg yolks

For example, a child with both a dairy and egg allergy may have a harder time meeting their needs for calcium, vitamin D, and iodine, since these nutrients have fewer safe food sources. This can be especially true if the child does not eat fish or enjoy green leafy vegetables. In this situation, we would want to look for fortified dairy alternatives or explore ways to introduce fatty fish or leafy greens in ways the child is more likely to accept.

Should My Child Take a Multivitamin?

In many cases, children with food allergies can meet their nutrient needs through food alone. However, if your child has multiple food allergies or other factors that impact their food intake, such as picky eating or other medical concerns, then it may be helpful to talk with a pediatrician or registered dietitian about whether or not they would benefit from a multivitamin to support their nutrition and growth.

When Should I Seek Professional Help?

Childhood is a time of rapid growth and development and meeting nutrients needs can be challenging, especially when managing food allergies. If you are struggling to identify safe, nutrient-dense foods for your child or if you have concerns about your child’s growth or weight, then it is important to seek guidance from a pediatrician and a registered dietitian with experience in food allergy management. Healthcare professionals, such as myself, are always happy to support you and your family!

Kerry Lett, MPH, RDN, LDN,CLC is the pediatric & maternal registered dietitian and owner of Milestones Pediatric & Maternal Nutrition in Cary, NC. Kerry is passionate about helping growing families navigate life and achieve all of their milestones along the way. Schedule an appointment today.