How Food Allergies Affect Behavior and Development In Kids

Episode Transcript

Dr. Nicole:

Hi, everyone. Welcome to the show. I’m Doctor Nicole and on today’s episode, we’re going to talk about children with food allergies and how these can impact behavior and development. More and more children are being diagnosed with food allergies, some very severe, so this is an issue that’s relevant to many of you listening. Even if your child doesn’t have food allergies but maybe has some food sensitivities or any type of special dietary needs, the concepts and strategies we’re going to talk about today will be helpful for you. We’ve gotten lots of requests to cover the topic of food allergies on the show and as I was thinking about who to invite to talk not just about the science of this but also the personal side of raising a child with food allergies, I couldn’t think of anybody better than my friend, colleague and former classmate Emily Cerda so I’m excited to have her on the show today.

Emily and I went through our masters program in nutrition together and she’s one of the most knowledgeable professionals I know when it comes to the complexities of feeding and supporting a child who has multiple severe food allergies and she’ll share a bit about her story with you but let me tell you a bit about her professionally. Emily Cerda is a board-certified nutrition specialist with a license to practice nutrition in the State of Maryland. She has a masters of science in nutrition and integrative health from Maryland University of Integrative Health where she supports students in graduate-level physiology and pathophysiology courses when she’s not busy with her own private practice. Her passion for food and nutrition stems from her son’s diagnosis with multiple severe food allergies and her determination to see him thrive in the face of this challenge. Emily’s passionate about the need for individualized nutrition and dreams of mobilizing an army of practitioners to cater to the integrative needs of this community. I have been looking forward to this conversation for a while now. Welcome to the show, Emily.

Emily Cerda:

Thank you, Nicole. It’s so great to be here. I appreciate it.

Dr. Nicole:

Absolutely. Before we dive into some of the specifics about food allergies and behavior and all those things, I’d love to take a few minutes to have you share your story of how you got involved with the field of nutrition, doing this kind of work because there’s a lot of personal backstory to this so I’d love for you to share that with our audience.

Emily Cerda:

Sure. I started as just a mom who was raising my first child. He had a lot of behavioral, some sleep problems. We were really up against so much behavior with my first child that I thought that this is just … You take that on as a mother almost, like what am I doing wrong? We took him to testing and he tested pretty much borderline for ADHD and ODD so we were in the midst of trying to figure out how to deal with this when he had an anaphylactic reaction to a sugar snap pea at school. It was one that I had packed in his lunchbox. Being the mom that I am, I had him test it beforehand when he was home that morning. I said, “You try this.” I didn’t want to pack him something that he didn’t like and he tried it and he liked it. There was his first exposure but he was fine.

I sent him off to school and that afternoon I happened to be bringing my daughter to afternoon pre-K and the nurse came rushing out the door and my son was having an anaphylactic reaction so we rushed him away. Got our prescription for epinephrine, our referral to the allergist about a month later and that referral ended up with a diagnosis of about 17 to 20 severe food allergies, life-threatening food allergies. I was really given a list of these foods to avoid and no real guidance other than that, which is why I do what I do.

Being moms and with children who need help, we figure out a way no matter what, so dug into research mode, figured what I could feed him that wasn’t on that list and honestly within about a week and a half I had a new child. All of the sudden I couldn’t stop looking at him because he had color in his face again, which before I just thought this is the way he was. It was really an eye-opened. The behavior stopped. It was such a dramatic turnaround for his health, for his behavior, for his performance in school, everything, that it made me want to know more. I really say that he sent me back to grad school.

Dr. Nicole:

Yeah.

Emily Cerda:

A six-year-old can do that.

Dr. Nicole:

Yeah. When you say that he was diagnosed with 17 to 20 severe food allergies, because I have known you personally now for many years, you’re not just talking about things that kids don’t really eat or might eat once in a while. Can you share … There were some big major food categories.

Emily Cerda:

Yeah, yeah. The top eight food allergens, he has the wheat, the soy, the egg, almost all of them and then some other crazy things like white potato, green bean, obviously the pea from the sugar snap pea so we have to stay away from all peas. Then other things like coconut and these are some of our most challenging ones because when you think of, okay, we could just get gluten free food, a lot of it has a potato starch and stuff like that in it so it becomes very, very difficult when you pile this all up. I really found myself needing to research first of all where are these ingredients found? What are other names for these ingredients? I’m sure that many of your listeners know just how overwhelming that can be. The learning curve is very, very steep.

Dr. Nicole:

Absolutely and even when you think about something like soy, which people might be thinking, “Oh, we don’t drink soy milk or whatever,” soy is in so many packaged processed food products, like just about all of them, and so even something like that can be very overwhelming in terms of reading labels and trying to figure out what you can use.

Emily Cerda:

It’s in a lot of natural products, too, that we don’t think about. I know he had a reaction to I gave him a calcium supplement because I was thinking in terms of nutrition and where he was missing some of these nutrients and there was soybean oil in the calcium supplement and so he did have a reaction to that. Of course mom guilt, you feel terrible but who thinks to look at that? Yeah.

Dr. Nicole:

You had this firsthand experience with a child who was struggling with behavioral regulation issues and focus and attention and all these things. Then you discovered this diagnosis of multiple severe food allergies and things really shifted and I think that’s such a powerful story because this goes on more than people realize, right?

Emily Cerda:

Yes.

Dr. Nicole:

I see many families, especially with younger kids, where the kids are exhibiting all of these signs that are obvious to me as somebody who’s experienced in this with something allergy-wise, food-wise is going on here but it hasn’t been diagnosed and they’ve kind of just been running the circuit of behavioral health providers and the pediatrician, whatever. Do you find also in your experience that this is a really under-recognized issue, this connection between food reactions and the behavior piece?

Emily Cerda:

Very, very big. I think that it’s just not the first thing that parents assume and I do think that a lot of times unfortunately the first thing they assume is that they’re doing something wrong as parents and that’s not necessarily the case. Giving them those tools to track the food and try to see where the mood fits in to what they’re eating is one of the first steps that I do so that we can try to identify those.

Dr. Nicole:

Yeah. Absolutely. It occurs to me that maybe we should define food allergy. There’s a lot of terms out there now that people may have heard. There’s food allergies, there’s food sensitivities, food reaction, these kinds of things. We’re really talking about this issue of frank food allergies. What’s your definition of that or how do you think about that?

Emily Cerda:

I think about a food allergy as something that’s going to have a fairly immediate response, so it’s not something that a week later you’re going to notice something. The response … I refer to it for the behavioral side of what I see in my son as a Jekyll-Hyde response. We could be going along in the day fine and if he gets an exposure and it’s not anaphylactic, all of the sudden behavior shifts really on the turn of a dime. It’s that immediate … A lot of times it’s driven by a histamine reaction, so you’ll see the runny nose, clearing of throats, hives, things like that but this comes on fast. It’s not like a couple days later.

Dr. Nicole:

Which differentiates it from more of what we think of as food intolerance or food sensitivities where somebody can eat something, a child can have an exposure to something and it could be several hours to several days later where you may see some impact. This with the food allergy, we’re talking about more of an immediate response.

Emily Cerda:

Right, right. It’s not necessarily dose-dependent like some of those longer reactions are. I know for myself, I’m a bit sensitive to wheat but I can have a little bit of wheat here and there. I know that I have a limit, that if I go over that limit I’m going to not feel that great and I’m going to have symptoms for the next couple days. This is not that. This is you eat the food, you pretty much have a change in behavior or a change in your health within a couple of hours.

Dr. Nicole:

What are some of the standards in terms of testing or diagnosis for this? I know this can be a frustration for a lot of families, too. They feel like, “Okay, we feel like there’s something going on food wise related to our child’s behavior or medical symptoms or whatever it may be,” and a lot of them describe this experience of getting put on this merry-go-round of providers of figuring that out. What do you recommend to families? If a parent is concerned that this may be an issue, are there some gold-standard tests? Is a more conventionally-trained allergist the right person to see? Now that you’ve been through this for years now with your son, what are your thoughts on how parents can pursue looking at whether this is an issue for their child?

Emily Cerda:

I think as far as testing goes, you need to have a board-certified allergist. If I see a child in my practice and we suspect, they get a referral to a board-certified allergist and that allergist will usually do either a skin-prick test or they do little pricks on your skin for each of the allergens they’re going to test the child against or they’ll do a blood test. Really the gold standard is to do an oral food challenge in-office. This has to be done in-office with the practitioner, with the allergist because they’re prepared in case that there is a negative reaction that happens as a result.

We’ll double check with the blood and then it culminates in the in-office challenge to make sure that we are not restricting foods that we don’t need to restrict but also making sure we’re being safe with exposure. We have had the experience in our family of my son testing negative via skin and blood to egg and having an oral food challenge and having a reaction to the very smallest speck they start him on, so it’s really … Like I said, the testing is not perfect and a lot of times you don’t want to jump to oral food challenge immediately because it can be dangerous if there is an exposure.

Dr. Nicole:

Right, because when we’re talking about these anaphylactic reactions, we’re talking about these very severe often potentially life-threatening reactions. Just if you’re listening and aren’t really aware of that term, issues like difficulty breathing, things that can be immediately life-threatening which is another component of being a child who’s living with severe food allergies, being a parent raising these kids is there is sort of this constant underlying currant of hyper vigilance, of fear, of anxiety related to this, right?

Emily Cerda:

There is. There is and children, they can’t say, “I’m having an anaphylactic reaction.” They’ll say, “My throat is a little scratchy,” or, “It feels like there’s something caught in my throat.” There’s a number of different … “My skin is itchy. My chest feels tight.” Yes. You have to be hyper vigilant as a parent and sometimes you err on the side of caution for sure. Yeah, it is something that really, really takes a lot of attention.

Dr. Nicole:

I think especially in younger children or children who struggle with communication, even as they get older, it really does become important for the adults around them, parents, other caregivers to be really watchful of any kind of change in behavior, in anything because oftentimes what people think of as an allergic reaction is, oh, the person … Maybe the child might break out in these hives around their mouth or it might be something obvious but it isn’t always something that’s immediately obvious, right?

Emily Cerda:

No, it’s not always immediately obvious and sometimes it could be as simple as a stomach ache or if a child vomits. That seems like maybe they’re sick. That can be a really big indicator that they’re starting to go down something that could have a very poor outcome. Yeah. The vigilance, it’s hard to balance that vigilance with also giving the children the freedom to try new foods and you can’t be over their back all the time and pass that anxiety necessarily onto them, so finding the way to educate them on this without making them anxious becomes a really big challenge.

Dr. Nicole:

I think that gets into something I wanted to talk about, which is as kids get older and they’re living with food allergies, there are things that need to be addressed differently. When they’re little and we have more control and they’re home with us all the time, that’s one thing. As they get older and they’re out in school settings on their home, they’re going to friends’ houses, sports practices, all of these things, it opens up more possibilities for issues and so I think that education piece becomes important.

You, I know, are living this with your son right now who is a pre-teen in middle school and so I’d really love to spend a little bit of time talking about this because we see stories in the media now about these really unfortunate tragic things that happen, particularly even around bullying and food allergies or pre-teens and teens being at somebody’s house and wanting to fit in and thinking, “I can just have a little bit of what everybody else is having,” and then that ending in a tragic outcome. These are real issues and I’m curious to hear your perspective on the kinds of concerns that come up as kids with multiple food allergies start getting older and how we can support them with that.

Emily Cerda:

Sure. I think that it’s a huge issue and we start, like you said, with this education that it’s really very much within the family and within our extended families. As kids age, you have to bring that out into the community, into the school community, into your regular community. If they’re eating in restaurants locally, obviously there has to be some advocacy and some awareness there in order for them to just do things safely. I think about sports teams and snacks and peanuts in baseball and things like that. It’s an opportunity where it starts with the parents being proactive and operating as their child’s advocate and speaking to these people and just educating them and perhaps offering alternatives to what could we us in place of the peanuts or whatever it may be.

Then I think at some point, and in the pre-teen years is a really good time, that baton gets passed from the parent to the child. As the child sees you advocating for them, ideally you’re trying to instill in them a sense of empowerment and so they then take that baton and they go on and then they can advocate for themselves. Some of the concerns that do happen are in school if they’re eating at the allergy table and they’re known as the kid with the food allergies and they do, especially when there’s a transition from an elementary school to a middle school or a middle school to a high school where perhaps they’re with a different population or a bigger population of students, they don’t want to carry that being the allergy child with them. The fear there is that they may not communicate their needs to people because they just want to feel normal.

We talk a lot about having a tight group around you and who’s going to take care of you and who are the people that you really trust with this information? They’re going to look out for you but they’re also not going to be the type who are going to tell everybody else in the school about it. Obviously having the school on board, having the school nurse, if they need any interventions like the 504, stuff like that within the school so that they can have accommodations. I know for my son, they were eating breakfast in the classroom and they were having scrambled eggs and he would come home and there’s scrambled eggs all over the desks and he was frightened to death and so we made a simple change.

We didn’t get rid of all of the food, because we understand the place of that, but we did get the eggs out of the classroom so he felt a lot safer and a lot more included. There’s this idea of the inclusion and the exclusion and a lot of times kids with especially multiple severe food allergies feel very excluded because it’s a lot easier for an adult who haven’t been educated on how to include them to say, “I need you to go to the library for a little bit while we have this cupcake for whatever in the room.” Really empowering kids to kind of stand in the space and own the condition but to do it in a way that you have to stress that they’re not the allergy kid. They’re bright kids. Maybe they’re athletic kids. Maybe they’re compassionate kids. They have so many other things going on that you can’t let the allergies define them.

Dr. Nicole:

Yeah. It’s a tough balance because on the one hand you have to be thinking about that and addressing it and on the other hand, you want them to be kids and to be seen as being kids. One of the things that stood out to me as you were speaking there is the importance of the adults at home or particularly at school modeling good awareness and inclusiveness and unfortunately … I would say most of the time now in my patient population, when there are significant food allergies or food issues in general present, more and more it’s the case that school personnel are at least somewhat aware of the issues with that and sensitive to that and willing to get on board with a plan but we still have situations, unfortunately, where adults in school settings are very excluding themselves. Which brings up the whole discussion of why food has become such an integral part of the things that we do in classrooms.

There’s just lots of things to discuss around that but that is really problematic for kids when the adults are not modeling inclusiveness with this stuff. It really makes it that much harder for the kids.

Emily Cerda:

It really does. It really does. You can tell your child to advocate and you can advocate yourself. I think that in the end, you need to have the sense of it’s all about the safety for your child. There are times when it’s best to step off or perhaps to step up and go to a school board or go higher and try to get things better that way. I’ve actually found more success going down, so I have presented to school boards. I have tried to get district-wide policies and things like that thinking this would nip it all at once and instead of that being helpful, what’s been helpful is to go down and to talk more on the principal and school staff level and really just to appeal to a person, person to person, using language like, “I wonder how my son felt when this happened,” or, “I wonder how he feels when he’s surrounded by these foods,” or, “I wonder if he was really scared.” Really trying to appeal to them on a person to person level to act.

Dr. Nicole:

I think that’s great advice and I appreciated what you said a little bit ago, too, about the options that are available to students through things like section 504 plans, even the IEP process if they qualify as a student with special needs, to be able to have some accountability and a specific plan that everybody is aware of for how this stuff is going to be handled. I think a lot of families, unless their child is having significant learning or behavior issues as a result of their food allergies, they tend not to realize that those can be pathways, particularly the 504 plan, that is open to them for providing education, getting appropriate accommodations and things like that so I’m really glad you mentioned that.

Emily Cerda:

Yeah. Yeah. I think that it is something that it feels hard to step out into that space because you don’t want to bring more attention to this child. There is that balance but really stepping out and claiming those rights, the 504 can be as simple as asking students to wash their hands after lunch or trying to get epinephrine on the school bus which sometimes isn’t available. It can be very simple accommodations. It doesn’t have to be something that really puts a label on the child.

Dr. Nicole:

Right but it’s a nice avenue for being able to be clear about what the needs are and to have some accountability on the back end, some way to hold schools accountable for making sure that those accommodations or modifications are followed.

Emily Cerda:

Absolutely, because without it you really don’t have any recourse, even if you just have an emergency medical plan for the child. You don’t have any recourse if that isn’t followed. The 504 really does that for you.

Dr. Nicole:

For those of you who are listening who aren’t familiar with, a section 504 plan is part of the Americans with Disabilities Act and it provides an avenue for students who may have a diagnosed medical or other type of condition that requires some accommodations but does not rise to the level of qualifying them as a special education student. The IEP process is for students who actually qualify as a student with a disability for the purpose of their schooling but the section 504 plan is for kids who have a medical diagnosis, for example, of severe food allergies who may need accommodations for safety in the school setting like making sure that desks are cleaned after food is served or making sure that hands are washed or that there is a separate table for them to eat at. That is a pathway for that, so just to be clear so that you know what to advocate for.

Emily, I want to jump into talking about the practical realities of raising and feeding a kiddo with all of these kinds of food allergies in the context of a busy family setting because I think it’s one of the most stressful things that parents deal with. It’s like, okay. As you said, you were given this whole long list of things without much strategy behind it and you were told, “Make sure he doesn’t eat these”. And then you went home and had to try to figure out how to feed this child but also how to feed your family. It’s a challenging thing, so I’d love to have you dive into things that you have found helpful for that.

Emily Cerda:

Sure. I think that the initial overwhelm was all about finding foods to replace, foods that we had previously eaten. I’m not talking about that in terms of nutrition. I’m talking about that really in terms of ease of preparation, so that is immediately where I went. That pathway really led me to reading ingredient lists in the grocery store, double checking on my phone to see what the ingredients were and if this was safe and obviously with a long list like that, that was really overwhelming. I am not proud to say that I cried in my grocery store aisles many times during the first few weeks.

Dr. Nicole:

Girl, I would’ve been right there with you like, “What am I going to feed all of us?”

Emily Cerda:

I know and you hold your breath when a child that age says they’re hungry again.

Dr. Nicole:

Right.

Emily Cerda:

Right? That happens.

Dr. Nicole:

Yeah.

Emily Cerda:

I really had to step back and consider that we are not going to find this perfect cracker to replace the other cracker he had previously been eating but instead I could simplify, so I really dialed back and I went into the produce section and the protein section and started to create food that now we call whole food. What’s the protein we’re going to eat tonight? Can we grill a chicken breast with some seasoning on it that’s pretty basic until I could get my wits about me as to what would be safe? Can we pick a vegetable to go with it? Then how about a whole grain that’s going to fit into his list? It really became … I want to say that we weren’t eating the standard American diet necessarily before this. We were eating pretty well but we all have these convenience foods that, in a busy family setting, you just have to go to.

My strategy of simplifying sounds like it would take a lot more time to do on a nightly basis but what I started to do was to cook more than what we were going to eat in a day so that there would be those leftovers, so maybe there were a couple extra leftover chicken breasts that we could cut up and when he did say he was hungry, we could put it on top of a little salad or find other ways to use the stuff that we had already cooked. Over the course of a week, it really, really helped, cutting vegetables that were safe and having them in the refrigerator just to grab and go or having cut fruits to grab and grow. Then eventually we did find some more of the convenience type foods that were safe but that’s such an individualized process and sometimes you end up calling companies to make sure with cross-contamination and all that kind of stuff. Yeah. Simplifying and cooking too much is what I would say would be the best strategies right off the bat.

Dr. Nicole:

Yeah. It makes so much sense and more of a focus, at least initially, on the whole foods as opposed to the processed foods because the more processed things are, even if they’re organic processes foods, there’s still ingredients that you need to watch for. One of the things that you’d really helped me become aware of, because you do amazing posts on your social media and I follow those and one of the things that has been helpful that you’ve brought to my awareness is how often companies change ingredients and how much you have to watch for that because something that may have been okay for a really long time now isn’t and I think it was recently you posted about these tortilla wraps that you and your son had found that had been a staple for you guys for your meal planning and stuff for years and then all of the sudden, you go and buy them one day and it’s like, “Oh my gosh. They changed the ingredients and now we can’t have these anymore.”

Emily Cerda:

Right. I would say that that is also part of this empowerment of raising a child with multiple food allergies. My son is in the aisles reading these ingredients with me and in cases like that he’s actually better at it than I am. He went to get the tortillas and he reads the back of it even though he’s picked those up 20 times before. He still flipped it over and read the ingredients and found that they contain egg now or something, or pea protein. Pea protein is being put everywhere so yeah. He’s starting to catch those things. He’s also being empowered to know these ingredients so that I can feel like, as he gets a little bit older and he needs to make these decisions on his own, he’s going to be able to do it for himself.

Dr. Nicole:

Yeah. So important. I think that the tips of doing batch cooking, cooking more than you need, drilling down and focusing more at least initially on whole foods, the proteins, the produce, the things that don’t have added ingredients that you know are on your child’s list of safe foods and the reality is that that often does involve kind of re-calibrating your child’s preferences and palate for things, particularly for a child who has been eating the standard American diet, a lot of processed chemical-heavy, ingredient-heavy kinds of foods, switching to more of a whole foods diet because of allergies, there’s a process with that. It doesn’t just happen overnight.

Emily Cerda:

No, it does not happen overnight and a lot of times, for younger clients, what we’ll do is start with this idea of the bento box where there is a lot of small containers of different foods, so there’s different textures. There’s different colors and start to introduce foods that way. Usually kids are pretty good about that. There may be one thing they ignore all the time but with repetition, they’re going to eat. I think it’s important to think about also the age of the first diagnosis.

Something that I see a lot is when kids say are six years old like my son was and is diagnosed, parents can get really anxious about is my child eating enough to support the growth and development, which makes a lot of sense. Some of these ages also line up with a variable eating pattern where kids are kind of self-selecting not to eat as much when they’re not growing and to eat more when they are growing. So really educating parents as to what that looks like developmentally for the child, as far as eating behavior goes, and not worrying so much that, “Oh no, my child isn’t clearing his plate every time or maybe there’s a problem here or there and they’re not going to get enough.”

Dr. Nicole:

It’s a great point and the other thing that came to mind that I see that can happen in these situations is when a kid needs to do a major overhaul with their food, sometimes it’s easy to get locked into just providing the same things over and over and that can be problematic, too, especially depending on the age or other issues a child may be having because what can happen is …

First of all, when they’re getting just the same things over and over, while that may be safe from their food allergy perspective, they’re getting a very limited range of nutrients then in those same foods but also there’s an issue that we see often in kids who come in for feeding therapy which is they do something called do a food jag where they eat the same things over and over and then one day it’s like nope, they drop it from their diet never to return. I think it’s really important for families in these situations to be conscientious about continuing to expose to a variety of things, even if the child’s not eating it right away, to try to keep more things in rotation and prevent these food jags.

Emily Cerda:

Oh, absolutely. If you think about all the restrictions that a family may have, think of my son’s 17 restrictions now, I want him eating as wide a variety that he can that’s safe to get all of that nutrient profile and also the textures and just to maintain his interest in food and a good relationship with food, honestly.

Dr. Nicole:

Yeah, absolutely. I’m curious, are there any websites, apps, things that you have found helpful? We’re talking about being in the grocery store. I know there’s lots of things that exist. I’m curious if there’s any particular ones that you have found that have been helpful to you.

Emily Cerda:

As far as finding ingredients, I really haven’t found much. We have a lot of apps that we like to kind of check out restaurants beforehand to see if a restaurant is safe. I know Allergy Eats is one that we use a fair amount and they will kind of rate the restaurant based on the allergens that they say that they’re safe from. You can go back and put your own user rating in there so a lot of people with allergies have kind of compiled this database of user reviews.

Dr. Nicole:

Right and that’s Allergy Eats.

Emily Cerda:

Allergy Eats.

Dr. Nicole:

Nice. That’s fantastic, just for those kinds of things are helpful to people I think.

Emily Cerda:

Absolutely.

Dr. Nicole:

Before we wind down here, I do think it’s important to touch on an overall approach for this population of kids because so often the focus is on just what foods they can or can’t eat but you and I really have a firm belief that taking an integrative approach to healing and overall health for these kids is a really important thing. I’d love to have you talk about why you’re passionate about more of an integrative medicine or an integrative approach to this population.

Emily Cerda:

Sure. I think it’s a huge … First of all, the population has so many different components to it. We are talking about the nutrition and the development. We’re also talking about stress handling and building resilience, and this goes for the families as well as for the children as they age because I was that overwhelmed mom. Oftentimes you need to treat the entire family in these situations. Really I think about when I got that list of foods to avoid and nothing else. There was no referral. I did ask for a referral but the practitioner was not prepared to handle that many restrictions and couldn’t refer me to somebody who could.

There is this huge gap there where we need to start focusing, yes, educating about avoidance and how important that is for safety but re-framing to what can I eat and that simple shift opens up a lot to families. That is not the feeling when you walk out with a list like that but re-framing would be wonderful. You need to look at empowering. You need to look at the stress handling. As kids age, how are they coping with this? Are they building skills? For example, are you teaching basic kitchen skills that … Okay, if your sister’s wheat bread touches this cutting board, we need to make sure that we’re putting that cutting board to be washed and we’re pulling out a different cutting board before we put your wheat-free bread on there. There’s a lot of basic things that we can do and have them not feel this sense of doom really when they leave with a diagnosis like this. It’s just totally overwhelming.

Dr. Nicole:

How about for parents who are saying, “Okay, I get the avoidance issue. I need to feed them this way but what are ways to strengthen my child’s system,” right? I look at that as being part of an integrative approach. If a child is having these severe reactions to foods, there’s something in their body and their immune system that has kind of gone wonky and is causing this reactivity. What are some of the things that you think are helpful for parents to think about or to explore with practitioners related to that?

Emily Cerda:

Right. I would first think about inflammation. If you’re having an allergic reaction or multiple, anything that’s underlying, you’re going to have this underlying inflammation that’s going on and so resolving that inflammation and sometimes it is with the food avoidance and sometimes it takes a little bit more if there’s nutrient needs or anything like that to kind of cut that inflammation.

Then really to look at gut health, so we throw around the term leaky gut a fair amount but the idea is that the intestinal barrier should be a barrier and sometimes this inflammation over time has really caused it to be compromised. If these large proteins are escaping that barrier and getting out into the blood stream and causing a loss of tolerance to these foods, then we really want to first cut down on the inflammation and then really to look at strengthening the gut barrier again. Something I will say is that if we’re talking about these IGE, these true food allergies, we’re not looking to reintroduce foods. That is between the parents and the allergist. We can help to reduce inflammation and try to smooth things out in the gut and replace nutrients but all of that reintroduction might be something that happens with food sensitivities but not with food allergy.

Dr. Nicole:

Yeah, absolutely. Great point. So many important things that you have shared both as a support to people who currently are dealing with this and also as food for thought for people who are dealing with a child with challenges and maybe haven’t explored whether this is an issue or have sensed that it is but haven’t known where to turn. Such a wealth of information. I want to make sure that we share with people where they can go online to learn more about you and your work.

Emily Cerda:

Sure. I’m at ThriveInsideNutrition.com. You can find me on Facebook, Thrive Inside Nutrition, or on Instagram at @ThriveInside. I’m pretty active on all of those and you can email me. You can find that right through my site.

Dr. Nicole:

Awesome and I highly recommend that you add Emily, Thrive Inside Nutrition, on your Facebook feed, on your Instagram feed. I really enjoy seeing all the things that she shares and you keep it real, which I really appreciate and I think that’s so important for families so definitely go check her out there. Emily, thank you so much for taking the time to share your wisdom and your experience with us today. We really appreciate it.

Emily Cerda:

Thanks, Nicole.

Dr. Nicole:

Thanks to all of you for listening to this episode. We’ll see you next time on the Better Behavior Show.