food allergy & intolerance
Food allergy and food intolerance
are often confused as they
may have some symptoms in
common. In either case, it is
important to seek medical
advice if you suspect a child has
food related health problems.
Unnecessary food restrictions
are not only inconvenient, they
may lead to an inadequate
intake of essential nutrients
affecting growth and
development of a child. Similarly,
children with food related health
problems need to feel that the
foods they eat are safe for them.
What to do
Strict avoidance of all allergenic food is required, and care
Food allergies are caused by an abnormal immune response to
must be taken to avoid “cross contamination”, as some food
foods (like allergy to bee stings or cat hair), and usually only
allergies can be life threatening. Families need to inform
involve one or two foods. Infants and children with a family
Careproviders and complete the Modified Diet Form.
history of allergy (eg eczema, hay fever, asthma) may be more
susceptible to food allergy, and symptoms are easy to recognise
Preparation, cooking and serving utensils that are not separated
and usually occur within minutes to one hour after eating the
or washed thoroughly after use can result in the next dish
containing the allergen. Make sure all utensils are clean for
each step of food preparation – eg use separate knives for
Local swelling, itch and burning around the mouth and throat
each spread. During meal times, all children will need to
are common symptoms and may be followed by nausea,
be closely supervised to ensure there is no sharing of the
vomiting, tummy ache and diarrhoea. Eczema may also flare
up, or become chronic if the food allergy is unrecognised.
You may also need to be careful in the use of non-food
The most common problem foods are milk, eggs, wheat and
activities such as play, art and drama. For example, a child
soy protein – and children usually grow out of the allergy by
with an egg allergy could react to egg cartons, eggshells
around 4-5 years. Allergies to peanut or fish are less common
or egg paints.
and are usually lifelong. These reactions are to the protein part
of a food and are easy to diagnose. Children will react to the
same type of food every time.
Food intolerance occurs when chemicals in food (which can be
either naturally occurring or artificial) irritate the body, similar to
the side effects of some drugs. Food intolerance is fairly uncommon
and of those people affected most are adults. Food intolerance is
extremely rare in children in children under 5 years of age. When
people have food intolerance they will react to a ‘group’ of foods
as the chemical can occur in more than one food type. This is
unlike food allergy, where one type of food will be the problem.
Symptoms vary widely and may include:
• hives, mouth ulcers, stomach pain
• irritability, restlessness
• flu-like aches and pains, tiredness, being “run-down”
Symptoms can take up to 3 days before they express themselves.
In especially sensitive people, food chemicals (natural or artificial)
may build up over days or weeks and cause a chronic or recurrent
symptom. For a correct and safe diagnosis and treatment,
an allergist is best qualified to identify food intolerance. Unnecessary
food restrictions are inconvenient and can lead to inadequate
Managing food intolerance can be very tricky, as reactions may
be delayed, many different foods may contain the same problem
food chemical and it may depend on how much of the
All relevant families and children in care should be told about
problem foods were eaten. An elimination diet and challenge
the allergic child’s special dietary situation. If necessary, other
is usually necessary to confirm a diagnosis, and you will need
families can be asked not to pack certain foods or ingredients
to seek help from a dietitian to ensure the diet remains
in children’s lunchboxes.
It is also important to ensure the child with the food allergy
If you suspect food intolerance but are not sure what to do,
is supported and included. Children in care can be involved
seek help from your Paediatrition, GP, or a dietitian. If a food
with relevant stories (eg books, puppets etc) to illustrate that
intolerance is diagnosed families need to inform Careproviders
we are individuals and have different needs.
and complete the Modified Diet Form.
of South Australia
Department of Education
AUSTRALIAN GOVERNMENT DEPARTMENT
and Children’s Services
OF HEALTH AND AGEING
Accredited Practising Dietitians,
Family Day Care
A D E L A I D E • A U S T R A L I A
Noarlunga Health Services
The Healthy Food Choice in Family Day Care policy is based on specific needs and views expressed by FDC Careproviders and staff, relating to promoting healthy food choices to
children in their care and their families. It was developed and refined in consultation with Careproviders, FDC staff and families, during a 3-year project run jointly through Family
Day Care, Noarlunga Health Services and Flinders University, funded through the National Child Nutrition Program, Australian Government Department of Health and Ageing.