Can Your Child Still Eat without Fears?
In Skin Diet: Eczema are Not Just about Visible Symptoms, we learn about food-eczema connection and how eczema can improve by avoiding foods triggers from an inside-out approach towards holistic management in The Unlikely ‘Everyday’ Suspects of Eczema Triggers.
The Next Step: Starting an Elimination Diet
Removing Potential Food Triggers
An elimination diet is a systematic approach where you remove the problem foods or allergens for your child for a period of time (usually 21 days or a month) and then re-introducing them back one by one at a later stage; monitoring any reactions for symptoms. You will find a lot of parents using this elimination diet for eczema and finding it works so well and literally calling it the ‘best eczema diet’. That is because it addresses the uniqueness and individual needs and intolerance that interferes with your child’s quality of life and skin conditions.
Before eliminating a food or any trigger, you would have already used our Foods & Symptoms Journal to track and identify your child’s trigger (refer A Parent’s Practical Tips to Identify Eczema Triggers). Or you may also have taken any allergy or related tests for the same purpose (refer Testing Eczema Triggers: What Tests are Reliable?).
The next step is to confirm that with an elimination diet once you have identified the possible culprits. Completely remove the suspected food from your child’s meal for at least 21 days.
Removing many foods or nutritious foods such as staple food from your child’s diet can deprive them of good nutrition or putting her health in jeopardy. If you are not well versed in nutrition in children, it is best to work with a nutritionist when planning your elimination diet so that equally nutritious food alternatives can be substituted. More often than you might believe, the foods that your child eat the most for so long can be the ones that she is building up a reaction against over time. Because these foods are so much a part of a daily routine, you probably never think that they can be her source of problem before.
Now, eliminating these foods will be a learning process for you. You will learn to be understand and read labels; and find substitute ingredients for your child’s diet.
Eating Again: Re-Introduction of A Food
Re-introducing food is a very important step in a well-planned elimination diet. Follow several basic rules described below to ensure that it is done properly and correctly:
1. After 21 days of food avoidance, you are ready to add it back slowly, one at a time.
2. Re-introduce only 1 pure food at a time on Day 1. Why pure food? That’s because if you are testing wheat intolerance, testing complex food like bread as your yardstick for wheat will not provide a conclusive result because bread contains many other ingredients such as wheat, vegetable oil, butter, yeast, egg, etc.
3. Monitor any reactions for the next 2 days. Keep a journal of your observations.
4. Continue to consume the same food for 3 days if no negative reactions are observed.
5. Move on to the next food on Day 4. Repeat Steps 3 to Steps 5 above.
6. If a reaction is seen, you’ve found a sensitivity. It also means that you need to keep it off your child’s diet throughout the elimination diet.
7. If she does not react negatively, it can be continued as part of her diet during the rest of the elimination diet.
Rotation Diet: Eating on Rotation
We have also found that Rotation Diet can come in handy in event that your child is just having food insensitivity rather than food allergy.
Basically, the idea of a rotation diet is that your child does not eat the same food more often than once every three or four days. By diversifying foods and foods in the same group, we are able to allow enough transit time for the body to clear off effects of the foods before we eat them again.
Some basic rules about eating on rotation are:
Rule 1 – Do not eat the same food more often than every 4th day.
Say, if you eat rice on Day 1 (corresponding to Monday), you cannot eat rice again until the next Day 1 (corresponding to Thursday or Friday) in that rotation cycle, with three or four days in between.
Rule 2 – The simpler you eat, the better.
Eat as whole, pure and organic as possible. Refined or processed foods are often inflammatory, high in Omega-6 fatty acids and do not retain any nutrition.
Rule 3 – Within a rotation, food families are also rotated.
Foods in the same botanical food families tend to share common chemicals allergens and may react similarly. E.g. oat, rice, spelt and millet belong to the same food ‘Grass’ family. In other word, if you also decide to rotate the same food family, it is not okay to eat, for instance, Oat on Day 1, Rice on Day 2, Spelt on Day 3.
A final word: Sustainability and planning are very important in undertaking elimination diet if you wish to see results. Because diet is so much a lifestyle, you cannot simply just change a diet without planning what you can substitute with. Planning helps you prepare both yourself and your child for a transition and a lifestyle change, making the process easier for the family as a whole.
In the articles – Feeding Babies and Eczema: Eczema Milk? and Milk Alternatives for Babies with Eczema, we will navigate parents’ common concerns about how breastfeeding affects infant or baby’s eczema. Is breastfeeding to be blame? And when breastfeeding is not an option, what alternative milk substitutes there are for babies with eczema.