In this series, we ask dietitians across Canada to answer your questions on nutrition and dietary support.
This month, we are resharing our article featuring Mun Cho, a registered dietitian and food allergy mom of two based in Ontario. In this interview, Mun gives her advice on how to stay healthy and eat well during self-isolation, and the information is still relevant.
Tell us about yourself. How are you impacted by food allergy, do you or your children have food allergy?
I’m a registered dietitian and food allergy mom of two. My son was diagnosed with a peanut allergy around 12 months old. And then we discovered our second baby had FPIES (food protein induced enterocolitis syndrome) at 7 months. When my son was first diagnosed, I learned very quickly that being a dietitian who knows about food allergy is very different from being a food allergy mama. The fear and anxiety were overwhelming and I found myself making emotional decisions. If you just discovered that your child has a food allergy, please know that it is totally normal for you to feel grief, sadness, and anxiety all at once. You are not alone! (Check out our newly diagnosed section for additional support).
What does a dietitian appointment entail usually?
Dietitians can provide personalized nutritional advice based on your child’s (and family’s) unique circumstances. The first appointment usually involves a detailed assessment to learn more about your family, the challenges that you face, and what you hope to achieve. Next, they can help come up with a strategic plan that is realistic and tailored to your family’s needs. During this time of self-isolation, many dietitians may offer virtual nutrition consults through a secured video conferencing platform.
What information and guidance can a dietitian provide to families living with food allergy, and FPIES and EOE (Eosinophilic Esophagitis)? What were the challenges when educating others on food allergy vs. FPIES?
Kids with food allergy can be at risk for nutritional deficiencies, which can impede growth and development. The dietitian’s role is to identify what’s missing in your child’s nutrition and offer suggestions to help fill the gap. In the case of FPIES involving multiple foods, most parents struggle with introducing solids, and dietitians can guide parents through this process and work with their comfort level. Dietitians are also trained to interpret growth curves and can address concerns from parents regarding their child’s growth. If you are concerned that your child is eating “too little” or “too much”, please speak with a dietitian.
A special note on FPIES, it is a non-IgE mediated food allergy that does not involve anaphylaxis. However, an acute FPIES reaction may include profuse vomiting up to a point of shock, requiring immediate medical attention. The FPIES Foundation (fpiesfoundation.org)is a great resource for families.
There can be challenges when educating others on the different types of food allergy. While IgE mediated food allergy is often viewed as the most serious, non-IgE mediated food allergy can also have a significant impact on families.
What are the benefits of seeing a dietitian? How can a dietitian help overcome nutritional challenges?
It is easy to find lots of information online nowadays, which can be overwhelming. When working closely with a dietitian, we can narrow down on a plan that fits your unique circumstances. Dietitians can help clients make informed decisions based on best practice guidelines, personal preferences, family dynamics and capacity.
Where can you find a dietitian?
You can find a dietitian at dietitians.ca. Many dietitians offer virtual services as well.
What advice can you give to families on how to stay healthy and eat well during this self-isolation time?
Families with food allergy face an additional layer of challenge in the midst of the COVID-19 pandemic. Adequate access to allergy-friendly foods is critical to ensure you continue to have a steady supply. It can be difficult to have friends or family shop for you as they may not be trained in reading food labels. Using pick-up or online grocery delivery services does not allow for full control over what kind of foods you receive or substitution depending on availability. Due to high demand, some grocery delivery or pick-up services may have a wait time.
Here are tips on dealing with these challenges:
- Plan ahead and start a running grocery list to ensure you have a steady supply of allergy-friendly foods. If possible, try to plan 1-2 weeks ahead of time.
- If you have friends or family members shopping on your behalf, send them a picture of the brand of food. Always check food labels before consuming. Do the triple check.
- Consider bulk cooking and freezing. This can act as your stash of “emergency” meals.
- For fruits and vegetables, used canned, frozen or dried goods. They are still highly nutritious.
- Check out the website of your favourite brands and see if the company will ship directly to you. Do this ahead of time as there could be a delay due to high demand.
- For families using specialized formula, call the pharmacy or manufacturer to check on availability and order supplies ahead of time.
- For those needing to access emergency food services and food banks, contact your local public health unit. Do not be afraid to inform staff at food banks about your food allergy!
This is a time of crisis and families are under a lot of pressure juggling multiple stressors. Set realistic expectations and do not put undue pressure on yourself to “eat healthy”. Use convenient foods to help you build a meal (e.g., canned spaghetti with canned vegetables and/or frozen meatballs). If you are struggling, reach out and seek support. Know that you are not alone. Stay safe everyone!
Do you have a question you’d like to ask a dietitian in the months to come? Send it along to us at firstname.lastname@example.org.
Please note: The dietitians featured in this series answer questions on general topics, please talk to your doctor if you have questions about your own health or the health of your child.
Tags: ask the dietitian, Ask the expert