The Dietitian's Role in Food Allergy Management
When your child is first diagnosed with food allergies, what is the first thing you do? You think, "What will I feed my child? How will I make sure I provide foods that are nutritious but won’t trigger an allergic reaction?"
A dietitian may be the first person who comes to mind to answer this question. Perhaps your allergist recommended a dietitian to help you plan an allergen-free diet.
How a Dietitian Can Help Your Child
During a visit with a dietitian, your will discuss your child's normal intake. Also, you will discuss symptoms that have occurred with the ingestion of suspected foods. You should compare the nutritional needs of your child with current intake. This will help to determine if more nutrition-dense foods or supplements are necessary. You should outline a meal plan. The nutritionist should provide you with food/symptom diaries and a list of foods to avoid. He/she should give you suggestions for meals including which foods to use. Make sure to schedule a follow-up visit. The follow-up visit allows you to discuss progress, as well as concerns. You may also need to make an alternate plan for suggestions that did not work.
Finding a Dietitian Who Specializes in Food Allergy
Can a dietitian really help you? Maybe — maybe not.
There are doctors who have specialties. In a similar way, there are dietitians who specialize in certain areas of nutrition. You would not take your child to a general practitioner to test, diagnose and treat your child's allergies. For the same reason, you will want to find a dietitian who specializes in food allergy or pediatric nutrition.
A registered dietitian (RD) is a food and nutrition professional. Registered dietitians meet certain academic and professional requirements. The Academy of Nutrition and Dietetics sets these requirements. Registered dietitians have a bachelor’s degree in nutrition from an accredited college or university. Their coursework is approved by the Commission on Accreditation for Dietetics Education.
Most registered dietitians also complete an approved practice program or internship. RDs also pass a national examination administered by the Commission on Dietetic Registration. They have to finish their professional educational requirements to maintain the registration.
But, does this prepare a dietitian to help you with your child's allergies? Not necessarily.
Many dietitians choose a field of practice they find interesting. Food allergy is not a topic covered well in the educational and practice training of most dietitians. So, dietitians who want to specialize in food allergy must study on their own. They also need to gain experience working in a setting where allergy is a specialty. Sometimes they work in a pediatric hospital. They learn from allergists. They also make an effort to attend conferences and seminars that address food allergy.
When choosing a dietitian consider the following:
- Where did the dietitian train?
- How many food allergy patients has the dietitian worked with?
- Does the dietitian work with the allergist to order tests or conduct food challenges? Is the dietitian involved in educating patients about food allergy?
- How did the dietitian gain knowledge in food allergy beyond the bachelor’s degree and internship?
- What professional memberships are held? Examples include:
- Pediatric Nutrition Practice Group
- American Academy of Allergy, Asthma and Immunology
- American College of Allergy, Asthma and Immunology
If the dietitian has not had food allergy experience, keep searching for one who does. The Academy of Nutrition and Dietetics (www.eatright.org) lists registered dietitians by specialty and location.
Deb Indorato, RD, LDN, has served as nutrition advisor on the medical advisory team of Kids With Food Allergies since we began in 2005. She has a special interest in food allergies and consults with medical practices and businesses to educate staff on food allergies. She provides food allergy education for individuals and groups. She is also an allied health member of American Academy of Allergy Asthma and Immunology, and has served on its Adverse Reactions to Foods Committee.
Reviewed by medical advisors September 2014.