How to Ensure Children with Food Allergies Are Getting the Nutrients They Need to Grow and Thrive

By: Kerry Lett, MPH, RDN, LDN, CLC

Food allergies in the United States are on the rise (1). As many as 32 million Americans, including 6 million children, have food allergies (2,3,4). That means that 11% of adults and 8% of children have at least one food allergy (2,3,4). However, among the children that have food allergies, 40% of them are allergic to multiple foods (4).

How Do Food Allergies Affect Growth & Development?

While science has made great strides in recent years, avoidance of all known food allergies is still the recommended treatment for those with food allergies. However, restricting intake of food, especially multiple foods and food groups for those multiple food allergies, starts to bring up concerns of whether or not that individual can get the nutrients they need. This is especially true for children, who are rapidly growing and developing and, therefore, relying even more so on their diet to give them the nutrients they need.

Research has found that children with food allergies are at an increased risk of inadequate nutrient intake, which can lead to poor growth and vitamin & mineral deficiencies (5,6,7). One study found that children with multiple food allergies were significantly shorter than children without food allergies (5). In extreme cases, research studies have also reported that allergen elimination diets have caused children to develop rickets or Kwashiorkor (a severe form of malnutrition) (5,6).

How Can I Ensure My Child Is Getting the Nutrients They Need?

Luckily, research also tells us that if children with food allergies find appropriate ways to replace the nutrients they are missing, they can still continue to grow and thrive (5,6). So how can you make sure your child is replacing the nutrients they are missing out on due to food allergies? The first step is to think about what your child may be losing by not consuming their specific food allergen(s).

Below is a list of the big 9 food allergies and the nutrients they are best sources of:

• Dairy/Cow’s Milk: protein, calcium, iodine, phosphorus, selenium, zinc, and vitamins A, B2, B5, B9, B12, D, & K

• Eggs: protein, iodine, and vitamins A, B2, B5, B7, B9, B12, D, & K

• Soy: protein, calcium, magnesium, potassium, and vitamins B1, B6, B9, & K

• Wheat: fiber, copper, magnesium, manganese, iron, selenium, zinc, and vitamins B1, B2, B5, & B9

• Peanuts & Tree Nuts (varies by nut): protein, copper, magnesium, manganese, phosphorus, selenium, zinc, and vitamins B3, B7, B9, & E

• Fish & Shellfish (varies by fish/shellfish): protein, omega-3 fatty acids, copper, iodine, and vitamins B1, B3, B5, B6, B7, B12, & D

• Sesame Seed: protein, fiber, calcium, magnesium, manganese, zinc, and vitamins B1 & B6

Once you have figured out what your child’s food allergens are good sources of, it is important to find safe alternatives to replace these nutrients. Luckily, most nutrients come from a wide variety of sources, so you can hopefully find a safe source of each nutrient to serve your child.

Below is a list of the most common nutrients present in food allergies with sources:

• Protein: beans, edamame (soy), dairy products, eggs, fish, lentils, meat, nuts, nut butters, seeds, seed butters, seitan (wheat), tempeh (soy), & tofu (soy)

• Calcium: dairy products, green leafy vegetables (other than spinach), & fish eaten with bones (such as sardines)

• Copper: dark chocolate (70% or greater cacao), seeds, shellfish, nuts, and whole grains

• Iodine: dairy products, eggs, fish, seaweed, & shellfish

• Iron: beans, fortified breakfast cereal, meat, & seafood

• Magnesium: beans, green leafy vegetables (such as spinach), nuts, seeds, and whole grains

• Manganese: leafy vegetables, legumes, nuts, rice, some seafood (such as clams, oysters, & mussels), and whole grains

• Selenium: Brazil nuts, dairy products, grains (such as pasta & rice), meat, & seafood

• Zinc: beans, dairy products, fortified breakfast cereal, meat, nuts, some seafood (such as oysters, crab, & lobster), & whole grains

• Vitamin B1: fish, meat, & whole grains

• Vitamin B2: eggs, dairy products, green vegetables (such as spinach), and meat

• Vitamin B5: avocado, dairy products, eggs, fish, meat, seeds, some vegetables (such as broccoli, mushrooms, & potatoes), and whole grains

• Vitamin B6: fish, fortified breakfast cereal, meat, non-citrus fruit, and starchy vegetables (such as potatoes)

• Vitamin B7: eggs, fish, meats, nuts, seeds, & sweet potatoes

• Vitamin B9: beans, dairy products, eggs, fruit, grains (such as rice & bread), green leafy vegetables (such as asparagus & spinach), meat, & seafood

• Vitamin B12: dairy products, eggs, fish, fortified breakfast cereal, meat, and nutritional yeast

Should My Child Take a Multivitamin?

I believe that most children do not need a multivitamin. This is because most children are able to get the nutrients they need from food alone, even children with food allergies. However, if your child has multiple food allergies or is experiencing other factors that are impacting their food intake, such as picky eating or other diseases, and you are not able to find suitable replacements for the nutrients they are missing out on, then talk to your child’s pediatrician or registered dietitian about whether or not they would benefit from a multivitamin.

When Should I Seek Professional Help?

Since childhood is a time of rapid growth and development, it is important that your child is getting all of the nutrients they need. However, this can be hard! This is especially true if your child has multiple food allergies or is experiencing other factors that are impacting their food intake, such as picky eating. If you are struggling to figure out how make sure your child is getting the nutrients they need to grow or if you child is having issues with growth or weight, then it is important to seek professional help from your pediatrician and a registered dietitian with training in food allergies. It is also perfectly okay to seek professional help even if you just have questions about how to manage your children food allergies or want to triple check your child is getting everything they need to thrive. Healthcare professionals, such as myself, are always here to support you and your family!

Kerry Lett, MPH, RDN, LDN,CLC is the pediatric & maternal registered dietitian and owner of Milestones Pediatric & Maternal Nutrition in Cary, NC. Kerry is passionate about helping growing families navigate life and achieve all of their milestones along the way. Schedule an appointment today.

Last medically reviewed on May 17, 2023