Multiple and severe allergies

Managing multiple or severe food allergies can be challenging and requires a lot of patience, organisation and planning. A dietitian with allergy experience can help with advice on foods to avoid and to help make sure your baby is getting all the nutrients they need from the foods they can have.

Cooking for children with multiple or severe food allergies

The more allergies your little one has, or the more severely they react to allergens, the more complicated providing meals for them may be. Here are some tips from allergy dietitian Tanya Wright to help you:

• Be confident in adapting recipes
• Plan meals and snacks in advance
• When eating away from home it is easier to 'make and take'
• Cook in bulk and freeze, making sure to label clearly
• Supermarkets can provide free-from lists to help you source ingredients
• Try Asian aisles in supermarkets or Asian shops for ingredients such as alternative flours
• Always read food labels

If you're about to start weaning a baby with cow's milk allergy, download our Parent’s guide to cow’s milk allergy for recipe ideas.

Reading food labels

Always read food labels to look for the presence of allergens you need to avoid, even if you think you know the product from previous use. Companies often change recipes or move production to different factories so ingredients and warning information can change.

In the EU, food labels emphasise the major allergens that are present within the ingredients list.

Cross contamination of foods

Cross contamination at home can occur when food is prepared or served on surfaces that have been exposed to other foods containing an allergen. It is therefore particularly important to always use different utensils and pans when preparing food for your child with severe allergies.

Manufacturers may label their products to warn of the risk of cross-contamination.

Anaphylaxis

Anaphylaxis, or anaphylactic shock, is a severe symptom of an allergy and can be life threatening. With any allergy this is a concern, but it is a particular worry when a child has multiple food allergies or experiences severe reactions as the chances of it occurring may be increased. In cow's milk allergy, anaphylaxis is a severe symptom associated with IgE-mediated allergy. Not every child with allergies will experience an anaphylactic shock but it is important that you understand what it is and how to manage it so that you can recognise and respond quickly and calmly if it does occur.

Anaphylaxis usually occurs suddenly after exposure to the allergen and quickly gets worse. Symptoms include:

• Swelling of the tongue or throat
• Difficulty in swallowing or speaking
• Wheezing, persistent cough or severe asthma
• Dizziness, collapse of loss of consciousness (floppiness in babies)
• Fast heartbeat
• Clammy skin
• Itchy, raised rash
• Feeling or being sick
• Stomach pain

If you suspect anaphylaxis you should call for an ambulance immediately.

If your doctor thinks your child is at risk of anaphylaxis they may prescribe adrenaline auto-injector pens. You will be trained on how to use them so that you can administer the adrenaline in the event of an anaphylactic shock.

Amino acid-based formulas

If your little one has severe cow’s milk allergy or multiple allergies your healthcare professional may have recommended an amino acid-based formula such as Nutramigen PURAMINO. Amino acid-based formulas are based on amino acids (the building blocks that form proteins). This means that there is no cow’s milk protein for your baby’s body to react to.