Tips

I have included my Tips section from Dairy-free, Egg-free, Kid Pleasing Recipes & Tips. I hope they can supplement any medical advice or other informational materials that you peruse. I am not a doctor. These tips do not include any specific medical issues, just wisdom from a mother who has been in your shoes!

TIPS

I must admit that I am a bit of a natural worrywart. Couple that with having to be on constant food patrol and I do spend an inordinate amount of time obsessing about nutrition for my two small boys. It seems that “other” mothers can have their bases covered if their child drinks two glasses of milk and a couple of smears of peanut butter a day. We parents of food-allergic children have to have a more substantial and organized, militant approach to guaranteeing nutrition success. I am not a nutritionist and I know that vitamin enriched foods are not quite as powerful as whole foods, but hey--every little bit helps. Here are my tips, my game plan if you will, to assure myself of nutritional victory.

1) VITAMINS Figure out what kind of vitamin your kids like best and stick with it, no matter what the cost. Finding a dairy-free selection is a somewhat perilous journey, but doable. My boys LOVE the Gummy Vites by L’ll Critters. They are in gummy bear form and taste like the real thing. I get them at Costco here. They may cost a bit more, but I’m positive that they take their vitamins each and every day.

2) JUICE The only juice I have in the house is calcium fortified orange juice. They get great vitamins and the extra calcium and I let them drink it with snacks. I only allow water or milk with meals though--they need to fill up on good drinks.

3) SOYMILK--our gift from God. I always try to get the “PLUS” versions of the milk to get all the extra vitamins, protein and calcium. I was surprised that my boys actually like the plain flavor better than the vanilla. But whatever gets them to drink it, I go for it: hot cocoa, chocolate milk, with a straw, with mini marshmallows, whatever encourages them to drink more milk. Hershey's Chocolate Syrup is safe! I keep an eagle’s eye on the sale ads each week for soymilk deals and really stock up when there is a sale, especially when I have corresponding coupons. The best thing about soymilk is the incredible shelf life. Refrigerated soymilks are good--but I wouldn’t say they score stellar taste points above the shelf variety. Of course, I stock up when they are on sale, but to tell you the truth, my boys don’t really notice the difference. You also run the risk of spoilage with the refrigerated selections. My goal is to experience Evan outgrowing his dairy allergy BEFORE some of my shelf soymilk expires! It is very handy to have both plain and vanilla soymilk on hand for your baking and cooking needs. Scalloped potatoes just don’t taste as good when made with vanilla soymilk! We have been drinking a new version of soymilk lately: unsweetened; the boys actually love it!

4) SNACKS We snack on the different options I have listed in the “Snack section” and mostly on dairy-free, nut-free, vitamin enriched cereals. I buy a few different kinds of safe cereal and mix them up in a snack bowl with raisins, mini marshmallows, homemade granola, nut-free pretzels, etc. Again--the kids are getting extra vitamins and calcium from the enriched cereals. I carry these snack cups with me wherever we go, in addition to safe crackers and/or homemade treats. It is always better to be over-prepared instead of ending up somewhere with no treat and no available easy alternatives. Also, I have learned to carry a secret, extra special treat (lollipop or fruit leather in our case) for those few, inevitable times when Evan sees something that he wants and can’t have. Nothing calms a screaming toddler like a special treat that no one else can have. We are also huge fruit eaters. I enjoy surprising them with out of season fruits and they gobble them up like crazy. They also really go for Hummus or an eggplant dip with “safe” crackers.

5) FOOD ALTERNATIVES I want to rave about my favorite tofu products. Tofutti is a wonderful brand with Sour Supreme sour cream alternative, and Better than Cream Cheese cream cheese alternative. They taste and feel like the real thing! Evan’s favorite lunch is “meat roll-ups” safe bologna rolled up with Tofutti Better than Cream Cheese inside. I.M. Healthy has both a crunchy and creamy Soy Nut Butter that is fabulous. Silk brand or Wholesoy yogurts are the best for taste and texture; Evan is a true fan. There are several soybean margarines available. I mostly use Shedd’s Willow Run. I am not so impressed with soy cheese selections. Be sure you check the ingredients. It is my experience that ONLY the cheeses marked VEGAN are dairy-free. Most of the cheeses labeled as “soy” have casein as one of the top ingredients. Your local Food Coop, Fred Meyer Nutrition Center, or good grocery store should carry these products and more. Molly Katzen’s Moosewood Cookbook has several egg-less mayonnaise recipes using tofu. I haven’t tried them all and haven’t quite found one that the boys really love yet--but it is worth the try.

6) FOOD PREP IDEAS Stock up on mushrooms when they are in season and devote a few hours to making your own jumbo size Cream of Mushroom soup using soy margarine and soymilk (see Soups). Divvy up the batch into useable substitution portions; pour them into large, freezer zip lock bags and wha la! Freeze them flat in your freezer for optimum room and enjoy the convenience. Who needs mushroom soup in a can? Use for all of your favorite recipes calling for this soup.

Definitely make a double batch of your favorite meal and freeze half. You WILL have many evenings when you don’t have the time or energy to cook. If you prepare ahead, you’ll always be covered.

Use your bread machine! Homemade bread is a slice of heaven. It is guaranteed safe and so much healthier for you and your family.

Don’t skimp on the Vanilla extract. Get the real stuff and use it! I always add just a touch more than what is called for, because I’ve found that using Vanilla gives the baked goods some extra “oomph,” especially in waffles and pancakes.

Like any mother, I secretly add minced vegetables to anything that I can and add wheat bran, wheat germ, and/or flax seed (freshly ground) to almost all of my baked goods. My new goal is to replace at least half of my regular flour with whole-wheat flour in my baking recipes AND to eat vegetarian once a week.

7) SAFE PLACES I have learned to be very selective about the places I am willing to bring Evan. I am worried about him picking up some interesting snack (read: Goldfish crackers) and plopping it into his mouth before I can stop him. I’ve barely taken my eyes off that child his entire babyhood, toddler hood, and racing into childhood. It is exhausting. So I pick and choose where we go. The library is definitely IN. I do find discarded snacks now and then, but generally it is clean. We are really lucky because our library is wonderful and has many reading group activities.

We also have participated in a “More Than One” Baby-N-Me class at the local technical college. I hand out a sheet at the beginning of each session describing Evan’s allergies, with “Signifying milk, egg, and nut proteins” lists, as well as snack ideas. They have been great and supportive. It helps that they are a “nut-free” institution, so they are particularly aware of the food allergy issue.

Woods--we live in a great place and spend many an afternoon hiking and exploring in the woods around our house. It is enough for now. I encourage it as a healthy and brain broadening activity. If you add a homemade Popsicle, it doubles the pleasure and raises your stature to one of supreme loved mommy.

Beaches--need I explain further? What child would choose a tunnel play place over a beach? Is there anything better than sandy beaches for summer digging fun and rocky beaches for crab hunting and beach combing? Of course, keep an ever-vigilant eye out for littered snacks.

I have two kids--and things are definitely better now that they are older. But for a while I had to put on hold activities that got way beyond my control. We attended free gym time for a while. My older son would get into confrontations and I would have to divert my attention to him, leaving Evan vulnerable in that snack littered environment. So we quit going to that until the boys were older. Then Leighton handled himself better while Evan just wanted to battle over toys instead of searching for floor food.

Anything with tunnels is out--it is too hard to supervise. And all of those places: fast food restaurants, tube play places, children’s museums, etc. usually serve food--which of course can end up in those tunnels where you cannot watch your child.

Friends’ houses--here we go: you soon learn who your friends are by their valiant housekeeping efforts yet you will still feel the stomach knots when your vulnerable child goes down to the playroom where food is not allowed. Because you never know--maybe just for one occasion they had buttered popcorn down there. There is nothing more uncomfortable than picking up some crumbs off the floor of someone else’s house-especially in front of them. I usually talk my way to the room with my child, so I can supervise him nonstop. You pick your supportive friends and choose when to visit and when to insist with good cheer that they come visit you.

Playgrounds are the biggest food pigsties around, according to my hypercritical observations. I do believe that caregivers carelessly discard leftover snacks thinking that birds will come along and eat all the bits and pieces that are littered around. These people do not realize that this offensive action can spell disaster for an allergic, curious child. We ONLY go to playgrounds with my husband, or a close, understanding friend, where we can divide and conquer. This situation calls for extreme diligence and is truthfully very stressful for me.

8) RECOMMENDED BOOKS AND SUPPORT SYSTEMS

It is a lonely thing to have a child with a life threatening food allergy. Acquaintances and family members disregard your life-and-death reality as being some “fad, hippy, and granola mommy thing.” I have seen the eye rolling. I have been told to, “Stop this nonsense.” I have kept my manners after ANOTHER family inquiry as to what Evan is allergic to, after politely declining the chocolate candy AGAIN. People don’t have as much interest in your child as you do. Okay--I accept that, but it sure doesn’t make for much of a social life.

First step contact:

I turned to FAAN (The Food Allergy & Anaphylaxis Network: 10400 Eaton Place, Suite 107, Fairfax, VA 22030-2208, 1-800-929-4040, or online at:

www.foodallergy.org

for support. They were far away and did not know me, but I counted on them. I felt camaraderie with the parents who wrote tales and tips. I highly recommend them as a perfect starting place. They have vast amounts of information, recipes, cookbooks, and are a source of comfort to know that there are many, many parents out there in exactly the same boat as we are. They provide an excellent newsletter.

Books:

The Parent’s Guide to Food Allergies: Clear and Complete Advice From the Experts on Raising Your Food-Allergic Child by Marianne S. Barber This book came into my life when we met the new Allergy Doctor in town: Dr. Maryanne Bartoszel Scott, who is a co-writer of the book. I highly recommend this clear and complete book on food allergies. The book is chock full of guidance and information. I WISH I HAD THIS GUIDE WHEN EVAN WAS FIRST DIAGNOSED! It covers the basics such as tips to organize your pantry, ideas on how to handle Halloween, a detailed nutrient and ingredient lists, and even a discussion about marital tension. She also includes some great recipes. It is a “must have!”

Bakin’ Without Eggs: Delicious Egg-Free Recipes from the Heart and Kitchen of a Food-Allergic Family by Rosemarie Emro There are quite a few adaptable recipes in this cookbook, although there is a heavy reliance on dairy products (cake mixes, sour cream, buttermilk, etc.) The recipes that I have adapted from this collection and added to my repertoire have excellent texture and taste!

Moosewood Cookbook by Mollie Katzen, 1992 edition This cookbook has always been one of my favorites. Katzen includes many egg-free and dairy -free or -optional recipes. I really enjoy vegetarian dishes and am working on getting my kids to love them too, albeit slowly.

The internet is a wonderful tool to find support groups for parents of children with food allergies. I have compiled an incredible list of valuable links on my LINKS page on my website. Please visit and connect to good support, information, recipes, and help:

9) WARNINGS Always check the ingredients label EVERY time. Ingredients can and do change. Just recently, TWO of our stand by, reliable foods suddenly included warnings about being processed on equipment with peanuts. Thank goodness there was not an allergic reaction.

Also--don’t forget to check your VITAMINS ingredients label--I have noticed several that have dairy protein.

Don’t forget that cat and dog food (and corresponding pet treats!) often have dairy and egg ingredients. Move the pet food so it is completely inaccessible to your child and don’t let them give the animals any treats that are dangerous.

Organic does not mean “pure.” Often organic foods include nut, dairy and/or egg proteins in their ingredients too.

Be watchful about prepared broths—often they include egg and/or dairy proteins. Better yet, always prepare your own with “safe” bouillon.

Beware of soy ice creams! The companies that make them are all pretty small outfits and most often include one or more (I’m sure delicious) ice cream varieties featuring nuts. Therefore, you must treat that safe looking vanilla flavor as one made on equipment with nuts, regardless of a lack of warning on the label.

I have discovered that sorbets and whole-fruit Popsicles are run on the same lines as regular ice cream and ice cream bars, so beware of both dairy and nut contamination. I have concluded that purchased frozen concoctions are just too risky. I make the homemade variety of Popsicles, and honestly the kids love them just as much.

Remember that dairy, egg, tree-nut, and peanut proteins pass through breast milk. If your child has a severe food allergy, you too must avoid all offending allergen proteins.

Your child exhibits a propensity to food allergies. Therefore he or she could very probably develop an allergy to tree nuts and/or peanuts as well (if they are not already diagnosed with one or both). You should scrutinize ingredient lists for these proteins as well and avoid all chance of ingestion.

Note: water chestnuts are actually a legume and coconuts are actually technically a fruit. A person allergic to tree nuts can safely ingest both.

Beware that the MMR vaccine, routinely given to children on their one-year check-up doctor’s visit, is developed using egg protein. Avoid a reaction by delaying this vaccination until your child (hopefully, most likely) outgrows his or her allergy.

Be aware that flour is sometimes made in factories where other nut flours are also processed, such as almond flour. Call the company and make sure that you are baking with “safe” ingredients. I use Gold Medal’s unbleached, all-purpose flour and Stone-Buhr’s whole-wheat flour.

Avoid buying bulk foods. Bulk food processing lines are used for all of the bulk food items, including the nut granolas. Treat bulk food items as made on equipment with nuts.

Purchase packaged deli meats for optimum safety. As a former Deli counter service person, I can tell you that at times the slicer is not thoroughly cleaned between cuts of cheese and meat. Treat deli-counter meat as processed on equipment with dairy.

10) LABELING AND CONTACT INFORMATION: Be sure to really think about food product lines. Labeling is not up to full speed yet and while many companies are voluntarily including the “made on equipment with nuts” warning, this is not a legal requirement (yet!). At this point in time, consumers must anticipate products that could be made on shared equipment with nuts (such as bread and ice cream/sorbet) and avoid them for the sake of our food allergic children. It is a given that store bakeries share all of the equipment and so those delicious walnut brownies and peanut butter cookies that they make do contaminate the bowls and baking trays. Treat all store baking products as “made on equipment with nuts.”

Don’t hesitate to track down and call a company and ask them about ingredient information or equipment practices. This can be a frustrating experience, as some companies are seemingly impossible to contact. Be patient and put on your research hats! Use Internet sites as a starting point; often the company states their direct phone number somewhere in the “Contact Us” section. Here is a starting list of manufacturer's phone numbers:

General Mills (800)328-1144

Kraft (800)847-1997

Pepperidge Farms (888)737-7374

Nabisco (800)622-4726

Frito-Lay (800)352-4477

Wonder Bread (800)761-5502

Fantastic Foods (800)288-1089

Sun Luck (206)624-4011

Fred Meyer/Kroger no longer guarantees allergen information

11) PARTY PLANNING I love planning birthday parties and wholly believe that they should be home affairs anyway. I fill the house with safe treats (lollipops and an unregulated potato chip bowl are our favorites), decorations, games, homemade piñata with safe candy, pop, and a big, tailored cake. Thank goodness my husband is a part-time artist and is a whiz with the cake icing. We have successfully created the following themed birthday cakes: Thomas the Tank Engine on a big round cake, R2-D2 on a sheet cake, Bionicle figures on a large frosted sheet cake, a “Scout Walker” figure from Star Wars out of a few sheet cakes with some carving and icing detail, as well as a snake-shaped cake, a great rocket-shaped cake, and a pirate ship made out of layered, frosted cake sheet sections with homemade apple leather sails. See Family Fun Magazine’s website for other birthday part suggestions, ideas and inspiration: www.familyfun.com.

For a tailored, shaped cake, figure out a good (and “doable”) shape. Prepare a couple of sheet cakes from a recipe (see Easy Chocolate Cake in the Dessert section), taking care to ensure equal thickness. Cool completely. Prepare a big cardboard cake platter by folding some foil on a large piece of cardboard. Lay down wax or parchment paper around the outer edges of the cake. Cut out shape(s) and assemble on the paper on the platter. Prepare a thin frosting. Use this frosting to glue the various pieces together and to frost a “crumb layer.” Let harden. Prepare a regular consistency frosting and frost the cake completely. Add detail using frosting and a tip. Finally, remove the wax paper from around the sides with the accompanying, inevitable mess.

Serve slices of birthday cake without ice cream or substitutes WITHOUT apologies.

Prepare a yummy fruit punch using Sprite or 7-Up pop, with frozen balls of fruit juice (use your ice tray).

Plan some fun games and give them “safe” candy for prizes.

Relive your childhood and purchase or make your own piñatas! Fill them with allowable candy and be the star of the party. We made the best “TIE Fighter” piñata for our son’s Star Wars themed party. We Paper Mached a balloon with toilet paper rolls attached on either side to cardboard cutout wings. Then we painted the whole thing gray, and then later added great detail with black acrylic paint. (TIP: don’t go too crazy with the Paper Mache, or else the kids won’t be able to break through the tough layer.).

Love your birthday child up and down and enjoy the fun with the whole invited gang!

12)WEIGHT GAIN IDEAS

I have some ideas to encourage weight gain in your young children. Purchase and use the soymilk "plus" versions. I know that WestSoy and Pacific Soy both have “plus” versions. Make every calorie count. Instead of crackers for snack, offer meat "worms," or fortified cereal, or add big smears of soy nut butter or soy cream cheese on the crackers. Instead of serving your child juice--make fruit smoothies, using soy yogurt, bananas and “plus” soymilk. Freeze any leftover food--perhaps in individual. portions (use small Ziploc bags within a large gallon freezer bag)—to offer a quick reheat for snack time, etc. We usually have two lunches (early and late)--in response to my boys being hungry---if I call it lunch, I prepare something worthy/hearty for maximum nutrition and they are happy with “real” food instead of a lighter snack. Add soy cream cheese and/or vegan cheese to sandwiches, etc. Add mashed tofu to all foods you can think of--tofu really has no taste—so you can “hide” it in many foods and it has great nutritional value. You could add it to any main dish sauce, snack breads or muffins, etc. Use the buttermilk substitute that I have in the substitute section of the book at every opportunity, for instance when a baking recipe calls for regular soymilk.

If try these tips and your child still doesn’t seem to gaining weight, please see your doctor and/or allergist as soon as possible. He/she may have some additional ideas and can also give you a referral to see a nutritionist or dietician. I recommend you see a dietician or nutritionist. Your insurance company should pay for it as well. Feeding children is hard enough without the additional factor of food allergies and mothers can use all of the advice and help that they can get. I wish you ease and success in feeding your vulnerable children!

13)SOY ALLERGY INFORMATION

I have gotten many questions regarding using soy ingredients in my cookbook and want to address this issue here for your information.

First of all, let me say that I have great empathy for you in your situation. I realize how lucky I am to be able to heavily rely on soy products in place of dairy in our diet. I sincerely hope that all, or most of the food allergies you are dealing with, will be outgrown soon and the memory of this experience will dim.

My cookbook is based on recipes that do NOT use any dairy protein, egg protein, or any nuts/ingredients manufactured on lines that make nut products. I do use soy margarine, shortening, and soy milk in my ingredients, especially for baking recipes. That said, I think that substituting rice milk in place of the soy milk would not pose any problems. So that leaves the issue of shortening and margarine.

Shortening: there is a new trend in the health conscious world to use

3/4C Olive oil for each 1 C shortening called for in baking recipes

OR use dairy-free AND soy-free margarine in substitution.

Margarine: I have done some online research about soy-free and dairy-free margarine products or substitutions and found the following information. I do not claim an expertise in soy allergies or soy avoidance, but hopefully can pass this information on to you for your benefit. Please note that this is for your information only--I have NOT thoroughly checked with the companies for allergen information (I highly recommend you to do so).

Coconut oil: You can substitute coconut oil for margarine in baking. Coconut oil is in a solid form until it heats up. It does make things a little softer than normal so you need to experiment on the amounts. Usually just cut the coconut oil down slightly than what the recipe calls for with margarine/butter.

Migdal margarine

Smart Squeeze liquid spread--it works just as well as any other stick margarine. It is made by Smart Beat. The bottle says not for frying or baking but it works fine for baking. It does NOT work for frying - things stick to the pan.

So is Dairy-free, Egg-free, Kid Pleasing Recipes & Tips for your family? My cookbook does have many, many main dish recipes. I suggest that you visit my Table of Contents page and determine if you are willing to use substitutions. And you might get some great main dish ideas that you can use for dinner tonight.

I also suggest that you visit FAAN (on my LINKS page). They offer cookbooks that are very well organized. They use a "key" at the top of each recipe to alert you to the allergens that that particular recipe avoids.

14) SCHOOL Along came the day when Evan insisted upon a school experience. He was not to be denied preschool. I was very protective of my sweet, vulnerable boy, but I also wanted him to be “normal,” alive, and independent. So I researched all of the local preschools until one met my safety requirements and quality demands.

I searched and found an excellent preschool that was familiar with food allergies, was trained yearly in the use of an epi-pen (the teacher was very on top of this before she met us), was affiliated with the National Association for the Education of Young Children, and allowed only prepackaged snacks with clear labeling. They were receptive to my worries and very welcoming to my child. I prepared a “Snack letter” at the beginning of the year, with a list with all possible dairy-free and nut-free snack options (Evan had outgrown his egg allergy by then). I also kept “Safe” snacks in the cupboard in case Evan couldn’t have the snack brought in for the day. I scrutinized the ingredient lists on the snacks every single morning. He thrived at that wonderful preschool and I was so happy to find somewhere I felt comfortable leaving him.

Evan is now in first grade and I am navigating the public school maze. It is LAW: Public schools are mandated to provide a SAFE environment for every student with a disability. A child with a life threatening food allergy is considered to have a disability at school. Schools are mandated to provide a SAFE LUNCH for such students. I am only asking for a safe lunch table and classroom for my food allergic child—I am not asking for a safe lunch to be provided. Therefore—I am not asking too much of my principal and school and nurse to ensure a safe environment for my child!

School policies are usually in place to deal with food allergies that state: “Keep the students safe.” But every school district interprets that statement differently AND roles are not clearly defined. The Spokane School District (WA) has a very detailed policy that clearly spells out each district employee’s role. That policy is available online and is a great example. This detailed policy was created and enacted after a peanut allergy death on a field trip. By law the state cannot mandate a “Peanut-free” school—because then you’d have to be “free” of everything that could be a problem for students, such as strawberries, dairy, etc. Schools must provide lunch—so you can’t remove food from schools.

Food allergic students should not eat the school lunches. Recently two anaphylaxis reactions occurred in schools on the same day, as a result of the food service provider changing distributors of the chicken nuggets without notifying the schools and food allergic kids. There are too many things that can go wrong (contamination, etc) with school lunches!

Schools are more focused on their response to an event and not as focused on the pro-active part of avoiding the accident in the first place. It is up to us parents to gently educate and promote good healthy food policies. We have filled out the 504 plan. This form spells out the medical response plan and legal seriousness of the situation. I passed out a Contact Letter (with a picture) at the beginning of the year to his teacher, lunch ladies, playground duties, and secretaries. I listed the symptoms that would occur if Evan came into contact with dairy and also what it would look like if he ingested dairy. Contact letters should be available in Spanish as well. Snack wasn’t an option in half-day Kindergarten, but it is in First Grade. Messy snacks are confined to one table and hands and table are wiped down afterwards, with wipes that I provide. There have been no problems so far. I am unable to persuade the teacher to discontinue snack time.

My son’s school does not have a peanut free table in the cafeteria. The tables have “two-seater” benches and Evan sits on one alone, to distance himself from spraying yogurt tubes. I have trained him to eat completely over his lunchbox and to leave anything if it falls on the table or floor and thus becomes contaminated.

Ultimately, our children ARE the last line of defense against a reaction to food allergies. We have to thoroughly train our children about avoiding allergens and what do to if there is contact. Evan is well trained and knowledgeable about his food allergy. I make sure that all school personnel are prepared in case there is accidental ingestion. I do not want an immature mistake to be a fatal mistake. Evan is a happy, rough and tumble, charismatic school boy who just happens to have a serious food allergy. He is asserting his independence now, unfurling his closely cropped wings.

Do you have any further questions about my cookbook? E-mail me: mailto:tkingma@pair.com