Food Allergy Resources

Is Your Dietitian the Right Fit?

March 2007

By Debra Indorato, R.D., L.D.N

As soon as your child is diagnosed with food allergies,what is the first thing you do? You think, "What will I feed my child and 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 for help in planning your child's allergen-free diet. But, can one really help? Maybe — maybe not.

Just as there are doctors who have specialties, 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 would want to find a dietitian who specializes in food allergy or pediatric nutrition.

A registered dietitian is a food and nutrition professional who has met certain academic and professional requirements as outlined by the American Dietetic Association. Registered dietitians must earn a bachelor’s degree in nutrition from an accredited college or university with coursework approved by the Commission on Accreditation for Dietetics Education. They should also complete an approved practice program or internship, pass a national examination administered by the Commission on Dietetic Registration and finish professional educational requirements in order to maintain the registration. Does this prepare a dietitian to help you with your child's allergies? Not necessarily.

After completing all of the necessary requirements for registration, many dietitians choose a field of practice they find interesting. Food allergy is not a topic regularly covered in the educational and practice training of most dietitians. Therefore, any dietitian who wants to specialize in food allergy must study on their own and work in a setting where allergy is a specialty. Many allergists are willing to have a dietitian work with them to help parents choose nutritional foods and supplements while avoiding their children’s trigger foods. These dietitians learn from allergists, as well as make an effort to attend conferences and seminars specifically addressing food allergy.

Those who are experts in food allergy have studied that subject and worked in pediatric hospitals and medical practices guided by allergists who focus on nutrition and food allergy.

As a registered dietitian, it is disheartening to hear parents say, "My child's doctor referred me to a dietitian but she really didn’t help us." When I was at the Kids With Food Allergies booth at a recent conference, many physicians said they did not know where to refer their patients for nutritional guidance for food allergies. This can be frustrating for physicians and parents.

When choosing a dietitian consider the following:

• Where did the dietitian train?


• How many food allergy patients has the dietitian worked with?


• Has the dietitian been involved in the diagnostic aspect of food allergy, including testing and food challenges in addition to educating patients?


• How did the dietitian gain knowledge in food allergy beyond the bachelor’s degree and internship?


• What professional memberships are held (Pediatric Nutrition Practice Group, American Academy of Allergy, Asthma and Immunology, American Association of Allergy, Asthma and Immunology)?


• If the dietitian has not had food allergy experience, then find one who does.

During a visit with a dietitian, your child's normal intake should be discussed along with symptoms that have occurred with the ingestion of suspected or positive test foods. The nutritional needs of your child should be compared with current intake to determine if more nutritionally dense foods or if supplements are necessary. A meal plan should be outlined, food/symptom diaries provided, lists of foods to avoid and suggestions for meals and foods to use provided. A follow-up visit should be scheduled for you to discuss progress, as well as concerns, and determine an alternate plan for suggestions that did not work.

The American Dietetic Association (www.eatright.org) has a network of registered dietitians listed by specialty and location.