Unfortunately, there is no quick and easy test available for determining whether or not your child has a food chemical intolerance. It is not possible to predict which food chemical they may be intolerant to based on their symptoms. Given that reactions can often be the result of intakes over a period of time, it is near impossible to correctly identify the culprit once they start to experience a reaction.
An elimination of all possible triggers is necessary for determining which food chemical your child may be intolerant to. The elimination phase of the RPAH Elimination diet can last from 2-6 weeks.
Undertaking an elimination diet with a child can be difficult. They often do not understand the reason behind why they are no longer able to eat some of their favourite foods.
The RPAH diet is a restrictive diet which is likely to see a dramatic change to the foods that your child is allowed to eat. If you have a fussy eater who already has a fairly restricted diet, then placing them on an elimination diet places them at an increased risk of dietary inadequacy for a whole range of vitamins and minerals.
Depending on the degree of fussy eating and the severity of food intolerance symptoms, it may be necessary to first tackle the fussy eating before embarking on the elimination phase of the RPAH diet. These two factors – fussiness and symptoms – will also determine which approach to the diet is most appropriate for your child: simple, moderate or strict. Your practitioner will discuss this with you further.
Getting Them on Board
Some children interpret an elimination diet as a form of punishment – after all they are no longer allowed to eat some of their favourite foods. As a result they typically resent being placed on an elimination diet, and are likely to try to sneak in foods when you aren’t looking. It is important that you talk to your child and explain to them the reasons for placing them on the diet. Do this in a positive manner and try to get them to understand the importance of sticking with the elimination diet.
Make sure that they also understand that this is just for a short time – once we know which food chemical is responsible we can move towards liberalising the diet as much as possible so that they can still enjoy a wide variety of foods while remaining symptom free.
To help motivate them it is a good idea to use incentives, that is, reward them for participating. What works best as a motivator depends on the age of the child. Younger children will likely respond well to a sticker chart and/or an activity-based reward (e.g. a trip to their favourite playground at the end of the week). Older children/teens may respond well working towards a goal. For example, at the end of the elimination period they get a larger reward – something they’ve been wanting for a while.
It is also helpful to stick to family meals so that the child does not feel singled out. All family members should eat the same low food chemical family dinner, as well as any other meals or snacks that are eaten together. Everyone else can enjoy their typical foods away from the home (e.g. in lunchboxes, at work etc).
Preparing for the Elimination Diet
The RPAH elimination diet can take 2-6 weeks, followed by up to 8 weeks of challenges. It is important that before you begin you are certain that you are able to commit to the timeframe – this will ensure the shortest amount of time possible on the diet. Every break from the elimination diet simply makes the process longer.
Check your child’s schedule and try to plan for a time when implementation will be easiest – make note of any upcoming excursions or social events. If symptoms aren’t too severe it may be better to wait for school holiday periods.
Meal planning is essential when undertaking an elimination diet. The RPAH Elimination Diet Handbook has some handy meal plans starting on page 101. You may also want to consider purchasing Friendly Food (available from most bookstores) for recipe ideas.
Have a list of ready-to-go snack options for your child. Some good options are:
- Pretzels (if including wheat – check ingredients)
- Fresh peeled pear or tinned pear in syrup, drained
- Homemade ANZAC biscuits without coconut (if including wheat and dairy)
- Rice cakes with Hank’s pear jam
- Woolworths Free From Gluten Milk Arrowroot Biscuit
If there are any special occasions or if your child is invited to a birthday party, consider sending them with a low food chemical special treat so that they don’t have to completely go without.
This could be the Pear and Carob muffins recipe from page 65 of The RPAH Elimination Diet Handbook (if you aren’t eliminating wheat and dairy then these can be made using regular self-raising flour and cow’s milk).
Need some help investigating your child’s food chemical intolerances? Our Paediatric Dietitian Michelle Bulman can help!