Vegan Is Love Cooks Up Controversy

If you're a regular here, you know that I've tried to make you aware of dozens of books that could be helpful to anyone who wants to control or eliminate the dairy in their dairy. That covers a huge range, from the basics of lactose intolerance to books on keeping kosher to non-dairy cookbooks to almost anything vegan. I've been doing this forever, since the 1990s in fact, when I added the Milk-Free Bookstore section to my website. (Remember websites? Apparently I don't, given how little updating I've done of mine lately. Most of the information there remains good, though. And just browsing through the titles should give you an understanding of the incredible range of materials out there waiting to be used.)

So I'm a friend to vegans. Always have been. Except, of course, for the nutty fringes, like PETA. Or Jenny McCarthy. I hate all nutty fringes, of all descriptions and varieties.

What am I to make of what one child psychologist called "the most disturbing children’s book I’ve ever seen"?

The book in question is Vegan Is Love: Having Heart and Taking Action by Ruby Roth

Book Description

Publication Date: April 24, 2012 | Age Level: 7 and up | Grade Level: 2 and up

In Vegan Is Love, author-illustrator Ruby Roth introduces young readers to veganism as a lifestyle of compassion and action. Broadening the scope of her popular first book That’s Why We Don’t Eat Animals, Roth illustrates how our daily choices ripple out locally and globally, conveying what we can do to protect animals, the environment, and people across the world. Roth explores the many opportunities we have to make ethical decisions: refusing products tested on or made from animals; avoiding sea parks, circuses, animal races, and zoos; choosing to buy organic food; and more. Roth's message is direct but sensitive, bringing into sharp focus what it means to "put our love into action." Featuring empowering back-of-the-book resources on action children can take themselves, this is the next step for adults and kids alike to create a more sustainable and compassionate world.

What makes the book controversial? Alyssa Giocobbe's blog, which is also where I found the child psychologist's quote, said the book:

explores complex themes like animal cruelty, big agriculture, and world hunger, and while the message is not overly heavy-handed, Roth doesn't dance around the idea that she believes eating meat will destroy the Earth and everyone we love, and soon — a heady concept for a kid, for sure.

It's unquestionably true that meat takes a larger toll on the environment than plants per unit, although it's not absolutely clear what the net result would be if we had to put many more acres under cultivation in order to go to an all-plant diet. I continue to eat meat myself, without guilt, although I try to keep portions to no more than 4 ounces at a meal. The gigantic servings that are the norm at restaurants and many homes are a waste and a recipe for obesity and health issues.

As an adult, I can make these choices for myself. Children cannot. I've listed many books that give parents help in putting and keeping their children on vegetarian or vegan diets. You can do this safely and healthily for a child, but you need to be even more vigilant than normal. As Giacobbe wrote:

John Bagnulo, PhD, MPH, who teaches nutrition in Kripalu Healthy Living programs, says that kids can be very healthy as vegans, but it's important to remember that it's not as simple as "just eat plants." For example, a vegan diet for children that is mostly grain, flour, and fruit juice is much more unhealthy than one that's mostly fruits and vegetables with, say, small amounts of fish, he says. "So many vegetarian and vegan parents embark on this journey with the misconception that kids have the same nutritional needs as adults," says John. "Nothing could be further from reality. Kids' brains are developing so fast and there is clear evidence that high-quality essential fatty acids, like those found in oily fish, are a factor in brain development. You can also get these nutrients in raw walnuts, raw pumpkin seeds, freshly ground flax seeds, and power-packed specific greens such as purslane." But getting them is essential. B12 and zinc are also critical.

This is a New Age-oriented site with heavy amounts of woo making these cautions. I'm quoting it in the hopes that the words coming from her have more of an impact than a warning from an old-fashioned carnivore like me. No matter how you raise your child, do your research. And keep away from the nutty fringes.

Ian's Natural Foods - Dairy and Gluten-Free Kid's Meals

Ian's Natural Foods has an allergen-free line of kid's foods that are all "made without wheat, gluten, casein, milk, eggs or nuts".

Three of the meals are of special interest to dairy-free families as true alternatives to normally dairy-laden products.

Mac & No Cheese - WF/GF Recipe

Kids with food allergies can now enjoy another American classic - macaroni and cheese! Ian’s combined brown rice pasta with a rich ’no cheese’ sauce to create a delicious macaroni and cheese dish made without wheat, gluten, milk, casein, eggs, nuts or soy.

Mac & Meat Sauce - WF/GF Recipe

Tender brown rice pasta, ground chicken and flavorful marinara sauce are combined to create the perfect Italian-style dinner for kids with food allergies! Ian’s WF/GF Recipe Mac & Meat Sauce is made without wheat, gluten, milk, casein, eggs, nuts or soy.

French Bread Pizza - WF/GF Recipe

Ian’s French Bread Pizza is a great-tasting meal for anyone with allergies! Don’t limit yourself to homemade pizza; enjoy the taste of thick, hearty wheat and gluten-free French bread with a zesty Italian sauce, plus nutritious dairy and casein-free mozzarella cheese. French Bread Pizza is made without wheat, gluten, milk, casein, nuts or eggs. Contains soy.

Ian's Natural Foods, Inc.
360 Merrimack Street
Building 9, Suite 320
Lawrence, MA 01843

Phone: 800.54.FOODS (36637)
Fax: 978.989.0602

Two Books for Dairy-Allergic Kids

Cody the Allergic Cow is one of a series of books about children with various food allergies, along with Chad the Allergic Chipmunk (nut allergies) and Allie the Allergic Elephant (peanut allergies), all written by Nicole Smith and illustrated by Maggie Nichols.

Reviews
Cody the Allergic Cow is a cleverly written book that will help those of us in public education support one more sector of our population. Through such enlightened awareness students, teachers and parents will serve as a catalyst for more inclusiveness and normalization. --Lew Davis, Principal, Foothills Elementary School

Cody through its delightful illustrations, lets a child learn about milk allergy, understand responsible behavior, and know that kids can be allergic to milk yet still have fun. Kids with milk allergy are special, just like Cody! --Lynda Mitchell, Mother of milk-allergic child, Food allergy support group facilitator

Thank you, Nicole and Maggie, for another child friendly, informative book on food allergies. I'm delighted to have another one of your books and will recommend Cody the Allergic Cow for the little ones in my practice with milk or other food allergies. --Bonnie Baswell, M. D. Allergist, Colorado Springs, CO

Product Description
Cody the Allergic Cow helps children learn about milk allergies and how to recognize an allergic reaction. Cody explains milk allergies in a way that parents, teachers, and children themselves can talk about allergies and understand them better. Written by the author of Allie the Allergic Elephant, Cody is her next book discussing severe food allergies.

Allergic Child Publishing Group
26 pages
List price: $12.95

Another option is The No Biggie Bunch Dairy-Free Dino-Licious Dig, written by Heather Mehra and Kerry McManama and illustrated by Michael Kline.

Product Description
Grab your shovels! Join Davis and Natalie as they scour the backyard for dinosaur parts and bone up on allergen-free snacking. You never know what they might dig up! The No Biggie BunchTM is a new book series for Kids Creatively Coping with Food Allergies. Their stories are meant to act as springboards for conversation among children, parents, teachers, friends and family members.

The other books about the No Biggie Bunch are Trade-or-Treat Halloween, Peanut-Free Tea for Three, and Sports-Tastic Birthday Party, all by the same creative team.

Parent Perks, Inc.
32 pages
List price: $14.99

Food Bank Feeds Lactose Intolerant Toddlers

Rich Miller of WFIE reported on an innovative plan to feed needy children. And that includes the lactose intolerant ones.

The Tri State Food Bank lends a hand in feeding pre-schoolers.

It's called the piggy back backpack program. Twenty back packs will be provided for pre-schoolers to take home over the weekends. The packs contain enough food for two breakfast meals and two dinners.

The $2500 grant for the program was written by USI [University of Southern Indiana in Evansville] students and the funds came from the university. They will provide food for the toddlers for a year.

"If a child at this age doesn't receive the proper nutrition it can affect their I.Q," said USI student Mindy Prien. "It can just affect their ability to learn. It is hard to concentrate on your lessons and learning when you're hungry."

Backpacks for lactose intolerant children will also be provided as part of the program.

Nutrition for Vegetarian Children

Emily Sohn in the Los Angeles Times gave a number of good tips for ensuring that children who want to be vegetarians continue to get a full complement of the vitamins, minerals, and esential dietary components.

Some of the major points:

Protein needs range from 13 grams for toddlers to 34 grams for middle-school students and about 50 grams for teenagers. However, most Americans get too much protein, including vegetarians.

Dairy products and eggs are complete proteins that, like meat, contain all essential amino acids. These foods also provide calcium and vitamin D, essential for healthy muscles and bone development, especially during growth spurts and adolescence. One large egg contains 5 grams of protein, a cup of milk has 8 grams, and a cup of yogurt has 11 grams.

To get complete proteins from plant-based sources, you need to combine foods such as beans, rice, corn, nuts and tofu, but dietitians no longer believe that you need to eat those foods at the same meal. Eating a variety of foods throughout the day works just as well.

Vitamin B-12 is one of the nutrients that vegetarians most commonly miss. Essential for making DNA and maintaining healthy nerve and red blood cells, it is plentiful in seafood and beef and is found in lesser amounts in milk and yogurt. Vegans can get it from fortified cereals or supplements. Doctors often recommend B-12 supplements for breast-feeding mothers who are vegan.

Iron, which is abundant in meat, is present in a harder-to-absorb form in beans, tofu, spinach and raisins. Absorption is enhanced by consuming a source of vitamin C at the same time as a vegetarian source of iron, says Ruth Frenchman, a registered dietitian in Burbank and spokeswoman for the American Dietetic Assn. (Pair a cup of orange juice with a peanut butter sandwich, for example.) ...

Calcium and vitamin D are found in leafy greens and fortified soy milk or juice. Make sure to look at the labels on dairy-free versions of milk and yogurt and on organic cereals because they're not always fortified with added nutrients.

Fat: A baby's brain needs enough fat to develop properly. The American Academy of Pediatrics recommends full-fat versions of milk, yogurt and other foods until age 2.

Halloween Allergy Anxiety

Which would be a bigger surprise to you? That 80% of mothers with allergic children "say Halloween causes a great deal of anxiety"? Or that 20% of mothers don't?

The survey, conducted by the MomCentral.com website, also found that 20% of moms get so hyper about the holiday that they are thinking about having their children give up trick-or-treating entirely.

Why? Probably because they are uncertain about how much they know and about what to do. As the survey found:

•61 percent of children have been prescribed an epinephrine auto-injector; however, only 23 percent of them carry it with them at all times.

•One in five moms is unsure how they feel about their school's emergency plans in place to deal with a severe allergic reaction.

•While many moms feel they have good information on food allergies, they also expressed a clear desire for more: 78 percent of survey respondents say they would benefit from additional information on food allergies and how best to prepare for and treat allergy-related medical emergencies.

I've mentioned before that children and teenagers tend not to carry their auto-injectors with them. This is one of those parenting challenges that no outsider can solve. Getting your kids to carry reminders that they are different is a constant battle.

By now you may be guessing that I'm quoting from a press release that is related to injectors. You are quite correct. This one is by the maker of EpiPens.

Unlike all too many press releases, fortunately, they tone down the hype and focus on helpful advice.

Tips for an Allergy-friendly Halloween

For parents of children with food allergies, monitoring Halloween candy is just one way to avoid an accidental allergic reaction. Stacy DeBroff from Mom Central offers additional tips for enjoying an allergy-free holiday:

•Find Allergy-Free Activities: With a little research, you can find many festive activities right in your own backyard. Take the family pumpkin picking, on a hayride or for a scavenger hunt.

•Bring the Fun to Your Child: Consider hosting your own costume party for your child's friends. Invite everyone over for pumpkin carving, bobbing for apples, spooky stories, a scavenger hunt and other Halloween-themed games. This way, your child can still have fun and you can control all the goodies that are being passed out.

For those children who do go trick-or-treating, the American Academy of Allergy, Asthma, and Immunology (AAAAI) offers these helpful tips:

•Never Go Alone: Always accompany younger children trick-or-treating and have older children go out with friends.

•Inform Others: Make sure all the adults and friends in your group know about your child's food allergies and what to do in an emergency.

•Pack Medication: While out for Halloween, make sure you or your child is carrying an epinephrine auto-injector. Make sure your child's friends or other adults know how to administer this medication.

•Provide Safe Snacks: Provide your close neighbors and even your child's teacher at school with safe treats or even non-food items like stickers that can be given to your child.

•Check the Goodies: Carefully read labels or check the candy company's Web site to make sure the product doesn't contain something that can cause an allergic reaction. It's important to remember that the ingredients of 'fun size' candy bars may differ from the regular-size bars.

•When in Doubt, Throw It Out: If you can't find information on a treat's ingredients or are simply not sure if it's safe, then throw the candy away or stick it in a treat jar that is out of the reach of the child.

•Avoid Snacking: Eating dinner before trick-or-treating might curb your child's urge to sneak goodies from the bag.

Lactose-Free Milk May Help Diarrhea in Children

The British newspaper The Guardian published a health article in conjunction with the BMJ Group, the BMJ standing for nothing less than the British Medical Journal. That means the advice came with footnotes referencing the actual medical journal articles that backed up the words. Excuse me while I fan myself from the palpitations. Stuff this wonderful doesn't come across every day.

The article answered a question that most parents have to deal with at some point in their youngsters' early lives, What treatments work for diarrhoea in children?

One treatment that might work, though they hedge the answer within an inch of its life, is substituting lactose-free milk for regular milk.

There has been a lot of debate about whether babies with diarrhoea should be given formula milk that is lactose-free while they recover. Lactose-free formula milk does not have cow's milk in it. The theory is that the part of the gut that helps to digest lactose is damaged in diarrhoea so that lactose-free formula milk might be easier to digest. But lactose-free formula milk is usually recommended only in children who have had diarrhoea for a long time.

There have been some studies but the results haven't given us a clear answer about whether formula milk that is lactose-free is better than standard formula milk.

One summary of the research (a systematic review) that looked at 13 studies found that diarrhoea or dehydration was more likely to get worse in babies who had normal formula milk (about 2 in 10 babies) compared to those who had lactose-free formula milk (about 1 in 10 babies).[6] Babies on lactose-free milk got better faster (after about three and a half days) compared to those on normal formula milk (about four days).

Out of five other studies, three found that diarrhoea stopped more quickly in babies who were given lactose-free formula milk.[7] [8] [9] In the two other studies the special formula milk made no difference.[10] [11]

There don't seem to be any side effects from using lactose-free formula milk.

6. Brown KH, Peerson JM, Fontaine O. Use of nonhuman milks in the dietary management of young children with acute diarrhea: a meta-analysis of clinical trials. Pediatrics. 1994; 93: 17-27.

7. Allen UD, McLeod K, Wang EE. Cow's milk versus soy-based formula in mild and moderate diarrhea: a randomized, controlled trial. Acta Paediatrica. 1994; 83: 183-187.

8. Fayad IM, Hashem M, Husseine A, et al. Comparison of soy-based formulas with lactose and with sucrose in the treatment of acute diarrhoea in infants. Archives of Pediatrics and Adolescent Medicine. 1999; 153: 675-680.

9. Wall CR, Webster J, Quirk P, et al. The nutritional management of acute diarrhea in young infants: effect of carbohydrate ingested. Journal of Pediatric Gastroenterology and Nutrition. 1994; 19: 170-174.

10. Clemente YF, Tapia CC, Comino AL, et al. Lactose-free formula versus adapted formula in acute infantile diarrhea. Anales Espanola Pediatria. 1993; 39: 309-312.

11. Lozano JM, Cespedes JA. Lactose vs. lactose free regimen in children with acute diarrhoea: a randomized controlled trial. Archivos Latinoamericanos de Nutricion. 1994; 44: 6-11.

You should also note that:

Rehydration drinks (also called oral rehydration solutions) contain a mix of salts and sugar to help your body replace fluids and salts lost through diarrhoea. They do not stop the diarrhoea. But they can prevent your child getting dehydrated.

This is the safest treatment and it should be tried first.

Constipation Not Linked to Dairy Allergy in Children

The Doctor NDTV site reported on a new study on chronic constipation.

The prevalence of allergies among children with chronic constipation is not significantly different from that of the general population and an allergy to cow's milk does not seem to be involved.

In several studies, chronic constipation in children has been reported as a clinical manifestation of cow's milk allergy. Allergic proctitis - an allergic reaction causing inflammation of the rectum, which can be accompanied by a frequent urge to defecate, bloody stools and other symptoms - has been suspected, but the response to eliminating cow's milk protein from the diet has been variable.

They took this from an article in the December 2008 issue of Archives of Disease in Childhood. D. Simone et al. 93(12):1044-1047, December 2008.

Prevalence of atopy in children with chronic constipation.

Abstract
Objectives: To evaluate the prevalence of chronic constipation (CC) in unselected children, its association with atopy and the efficacy of a cow's milk protein (CMP) elimination diet on refractory constipation.

Study design: The study was conducted by six primary care paediatricians, serving a population of 5113 children aged from birth through to 12 years; only 2068 children were 6 months to 6 years. During a 3-month period, prevalence of CC was determined for the entire study population, ages 0-12 years. In the second part of the study, all patients aged 6 months to 6 years with CC, and age- and sex-matched controls, were evaluated for atopy and its association with CC. A questionnaire was completed including personal and family history of atopy and bowel-movement characteristics. Patients were tested for atopy by specific serum IgE and/or skin-prick tests. Constipated patients, refractory to osmotic laxatives, underwent a 4-week CMP elimination diet.

Results: 91 (1.8%) children had CC, and 69 (3.3%) of the 6 months to 6 years age group fell into the atopy study age range. All 69 constipated children (mean age 34.9 (18.0) months) and 69 controls completed the questionnaire. Twelve of the 69 constipated children (17.3%) and 13 out of the 69 control children (18.8%) had a diagnosis of atopy. Eleven out of 69 (15.9%) constipated children were refractory to constipation treatment, and three (27.3%) of these had atopy. The 4-week trial of dietary elimination did not result in improvement in any of these 11 children.

Conclusions: In our study group, prevalence of atopy among children with CC is similar to that in the general population. The level of refraction of CC does not seem to be related to cow's milk allergy.

Gradual Doses of Protein Can Reduce Allergies

Another study has been released with the intriguing finding that exposing children to extremely tiny amounts of milk protein and then gradually increasing the amounts given can result in a better toleration of the protein.

The study, "A randomized, double-blind, placebo-controlled study of milk oral immunotherapy for cow's milk allergy," by Justin M. Skripak et al. appeared in The Journal of Allergy and Clinical Immunology, 28 October 2008 DOI: 10.1016/j.jaci.2008.09.030

Johns Hopkins Medical Institutions (2008, October 31). Drinking Milk To Ease Milk Allergy? Oral Immunotherapy Study Shows Promise -- But Do Not Try This At Home. ScienceDaily. Retrieved November 5, 2008, from http://www.sciencedaily.com­ /releases/2008/10/081030192851.htm

Giving children with milk allergies increasingly higher doses of milk over time may ease, and even help them completely overcome, their allergic reactions, according to the results of a study led by the Johns Hopkins Children's Center and conducted jointly with Duke University.

Despite the small number of patients in the trial – 19 – the findings are illuminating and encouraging, investigators say, because this is the first-ever double-blinded and placebo-controlled study of milk immunotherapy.

...

Researchers followed allergic reactions over four months among 19 children with severe and persistent milk allergy, 6 to 17 years of age. Of the 19 patients, 12 received progressively higher doses of milk protein, and seven received placebo. At the beginning of the study, the children were able to tolerate on average only 40 mg (.04 ounces or a quarter of a teaspoon) of milk.

At the end of the four-month study, both groups were given milk powder as a "challenge" to see what dose would cause reaction after the treatment. The children who had been receiving increasingly higher doses of milk protein over a few months were able to tolerate a median dose of 5, 140 mg (over 5 ounces) of milk without having any allergic reaction or with mild symptoms, such as mouth itching and minor abdominal discomfort. Those who had been getting the placebo remained unable to tolerate doses higher than the 40 mg of milk powder without having an allergic reaction. In the group receiving milk protein, the lowest tolerance dose was 2, 540 mg (2.5 ounces) and the highest was 8,140 mg (8 ounces). Lab tests showed the children who regularly drank or ate milk had more antibodies to milk in their blood, yet were able to better tolerate milk than those who took the placebo. Researchers say, tolerance in children treated with milk continued to build over time, and recommend that these children continue to consume milk daily.

Beverages in School Lunch Program Must Have Milk's Nutritional Value

Last week I informed you that "The United States Department of Agriculture (USDA) announced [that] parents or legal guardians may request, in writing, soymilk as an alternative to cow's milk for children receiving National School Lunch and Breakfast Program meals."

That came from a press release put out by the Soyfoods Association of North America. Not surprisingly, they selectively quoted the announcement and left out the parts now about soymilk.

The International Dairy Foods Association was a little slower on the draw, but it sent out its own press release yesterday.

It also has good news for parents of lactose intolerant children.

[The] USDA also made statements that supported lactose-free milk as the beverage of choice for lactose intolerant children, although it was not included as part of the regulations. Lactose-free milk already is allowed in the school meal programs, and documentation is not required for a student to receive lactose-free milk instead of regular milk. USDA indicated that "there is no need to offer a fortified milk substitute to a student whose medical or special dietary need is lactose intolerance."

What the regulations actually say is that any other beverages served in the program must be the same nutritional value as milk:

Beverages that could substitute for fluid milk, such as soy beverage or fruit juice, will be required to be nutritionally equivalent to whole milk with regard to calcium, protein, vitamin A, vitamin D, magnesium, phosphorous, potassium, riboflavin and vitamin B-12 content. Currently there are no soy beverages that provide all of these nutrients at the same level as milk.

Note the sly dig at the soyfoods people.

I still can't find the source of this information on the USDA.gov website. The page on the National School Lunch Program hasn't be updated since July. I'll try to find the original ruling and see what other important tidbits it might have for people who don't have a side in this fight.

Parents Can Now Ask Schools to Serve Soymilk

A press release from the Soyfoods Association of North America alerted parents to new rules from the U.S. Department of Agriculture (USDA).

The United States Department of Agriculture (USDA) announced parents or legal guardians may request, in writing, soymilk as an alternative to cow's milk for children receiving National School Lunch and Breakfast Program meals. This change caters to the growing diversity of participants in the School Nutrition Programs and allows children with lactose intolerance, dairy allergies or cultural diet restrictions to have an alternative source of calcium at school mealtime.

...

Recognizing the need for alternative calcium sources and low-calorie nutrient sources, USDA has included fortified soymilk in food supplement programs such as the Women, Infant, and Children Supplemental Food Packages and now the National School Lunch and Breakfast Program. The USDA Food Pyramid for Young Children also identifies soymilk as an alternative to dairy milk. The Institute of Medicine report, Nutrition Standards for Foods in Schools, recommends fortified soymilk be offered as a source of calcium for school children of all ages.

Vomiting in Infants with Lactose Intolerance

The history of lactose intolerance (LI) is odd in almost every way.

The condition was first recognized in the 1950s, in babies who were born without the ability to digest lactose, a condition now called congenital lactose intolerance. This is an extremely rare, not even one-in-a-million births, event.

So naturally doctors were rocked to the tips of their stethoscopes when they found that not only was LI fairly common, it is the natural condition of all mankind (and all other mammals), occurring in about 70% of all humans alive today.

When studies and surveys were conducted on almost every ethnic group and national population on earth in the 1970s, an interesting side fact emerged. The populations with the smallest overall percentage of LI - which turned out to be, not surprisingly, the northern Europeans whose doctors had never discovered the problem - also were the populations in which the onset of LI occurred at the latest age. In fact, the condition was called adult-onset lactose intolerance for a while to distinguish it from congenital lactose intolerance.

But with time and investigation, researchers finally realized that in those populations in which almost everyone had the normal version of the gene, the one that turned off lactase production sometime after weaning, most children became LI before adulthood.

And then came another surprising finding. Almost any ailment that impacted the gastrointestinal system could temporarily knock out the lactase making ability, since that happens at vulnerable places on the inside of the small intestine. This became known as temporary lactose intolerance.

Today, three types of LI are recognized, and the names have more or less stabilized at congenital LI, secondary (rather than temporary) LI, and primary (rather than adult-onset) LI. The last two can occur at any age.

Even babies, who aren't supposed to be LI at any time - that interferes with breastfeeding, since human milk has the highest lactose content of any mammal's milk - can get secondary LI. They can, and do. A lot. Any ordinary "stomach flu" - which is really a gastrointestinal ailment not located in the stomach - can stop lactase production for weeks until the intestines heal.

One other oddity. Even though vomiting is so rare a symptom of primary LI that most people, even me, tell anyone who vomits that LI isn't the cause, babies with secondary LI can and do vomit as a symptom. (Here's one of the first medical journal articles to report this, Severe lactose intolerance with lactosuria and vomiting, by A. Hosková, et al., Arch Dis Child. 1980 April; 55(4): 304–305.)

This tends to confuse everyone. You can search - as I did, which is why I'm writing this - and finds lots of non-academic sites on the net which will tell you flatly that vomiting is never a symptom. Or that babies who vomit must be allergic to milk rather than LI. I don't know for sure which is more common, but my first thought with a baby who was never bothered by milk but now vomits because of it would definitely be secondary LI.

Talk to your pediatrician and check this out if this happens to your child.

Vegan Mac 'n' "Cheese" for Kids

Jennie Geisler has a home cooking column in the Erie Times-News newspaper and a two-year-old son with a dairy allergy. That's a recipe for non-dairy dishes to appear regularly in her column. ("That's a recipe," get it? Newspaper columns and headlines are full of these cheapest of all puns. Why oh why oh why? I thank Geisler for writing straight.)

Anyway, she borrows a recipe, Macaroni and 'Cheese' from V Cuisine: The Art of New Vegan Cooking, by Angeline Linardis. Not only is is dairy-free, but cheese-free. Soy milk makes the milky substitute.

Geisler adds a couple of cooking notes that are relevant.

The recipe called for either carrots or red bell peppers as the puree base for the "cheese" sauce. I went ahead and used both. I chopped them up, put them in a big cereal bowl, covered it with plastic wrap, and steamed them in the microwave for 5 minutes or so. Then I poured them into the blender, splashed them with soy milk and gave it a good whirl. That and a few seasonings, and we were ready to rock.

Nutritional yeast is a flaky yellowish substance that's different from regular yeast in that it will not help in leavening. It adds nutrition and flavor to whatever contains it. You can find nutritional yeast at the Whole Foods Cooperative, 1341 W. 26th St., in bulk. All you need is a quarter cup.


Nutritional yeast is also known as brewer's yeast. You can add it to any baked good at a proportion of 1 to 3 teaspoons per cup of flour. It offers protein, fiber and potassium to anything that contains it. The yeast is included here, according to the cookbook, because it has a fermented taste that suggests the flavor of real cheese.

Answers to Questions from Readers, part 14

Q. Can lactose intolerance in children cause behavioral problems in children if left undetected?

Only two small possible problems. Truly undetected LI may result in your child's having what is politely called "anal leakage." Once you know about LI, however, you should be able to avoid this by either keeping your child away from large amounts of milk or by making sure you keep lactase pills available at all times. If children do stay away from milk, there is always the "different child" syndrome, in which they dislike not being like everybody else. This is usually not a major problem; children with milk allergies, who must be many times more cautious about milk than anyone with LI, soon learn how to cope.

Q. It seems that I can't digest anything high in carbohydrates without extreme LI symptoms. Is there lactose in spaghetti? potatoes? biscuits? bread? cake?

There can be - and most likely is - lactose in biscuits, breads, and cake, (although definitely not in spaghetti and potatoes unless it's added in cooking) but that's probably totally besides the point. Lactose and most other carbohydrates share one trait in common: they must be broken down into simpler sugars by digestive enzymes. Usually the lactase enzyme that digests lactose is the only one missing, but that does not have to be the case. And in fact the inability to digest carbohydrates may be an indication of a more serious underlying problem. I would advise you to talk to your doctor about this and see if testing needs to be done.

Q. Is "Lecithin" a lactose milk product? It seems as if it is derived from a Latin root word for milk, and therefore I am afraid to eat anything containing it without taking a lactase tablet.

My dictionary shows it as coming from the Greek for egg yolk, which is quite correct. It has nothing to do with milk.

Q. I keep seeing ingredients like malted barley, malted this and malted that. I used to drink malts and malted milk when I was young. Is there any kind of milk in "malt"?

The only milk in malted milk is in the milk. Any malt by itself should be milk-free. And "malted" barley or any grain merely means sprouted grain.

Caution Needed When Changing Child's Diet

Here's the kind of anecdotal story I run across or have emailed to me on a regular basis.

Everyone kept reassuring Nikki Sharp that her daughter had merely entered the terrible 2s a bit early.

Kylee was Sharp's first baby, but Sharp had been around toddlers before, and the fits she was seeing from the 18-month-old were out of the normal range.

"She'd wake up from naps and scream uncontrollably for an hour," said Sharp, 29.

And that's not all. "She couldn't focus," Sharp said. "Other toddlers could sit and watch at least half of 'Sesame Street,' but she was all over the place. I couldn't even sit her down to teach her anything."

That's when her husband, Ian, told her about some reading he'd done that indicated diet might affect children's behavior.

They pulled all things dairy. No milk, no yogurt, no cheese. They read labels to make sure they didn't give Kylee anything with casein, a milk protein commonly used in the food industry.

"Within 24 hours, we had a brand-new kid," Sharp said.

Now 23 months old, Kylee can focus. She's now able to concentrate, her learning abilities increased dramatically and her speech improved. The tantrums ended.

Sounds wonderful, doesn't it?

And it may be the cure for your child as well. But as the rest of that Associated Press story shows, it may not be quite that simple. At the very least you have to approach the change in a knowing and thoughtful manner.

On the positive side is a pediatrician who has long advocated for dietary change.

Doris Rapp, a pediatric allergist based in Scottsdale and an author of eight books exploring hidden allergies and environmental toxicity, recommends that parents try a diet to eliminate foods that commonly cause sensitivities, as well as buy an air purifier to reduce toxic airborne chemicals, dust, mold and pollen.

"The pity is that they've put kids on drugs when in many cases, there's a fast, simple, easy and inexpensive answer," Rapp said.

Rapp, whose 1989 appearance on Phil Donahue's show is posted on YouTube, wrote about these issues in her 1992 book, Is This Your Child? The first customer review of the book on Amazon.com tells the story of a woman who read the book, eliminated dairy products from her son's diet, and reported that within 48 hours, the boy's increasingly evident symptoms of listlessness and depression lifted.

Rapp's book is available on the Kids & Parenting page in my Milk-Free Bookstore.


Is this good science or merely anecdotal evidence? Hard to say for sure.

[S]tudies are conflicting and varied. For each that indicates a link, another detects nothing. And critics argue that focusing on diet could prevent kids from getting the medication and other therapies they may legitimately need.

Michael Daines, a pediatric allergist at University Medical Center [in Tuscon], whose practice is skewed heavily toward food allergies, acknowledged that blaming diet for behavior remains controversial because there is little research to back it up.

...

"My standard advice for families who want to do diet modification is that it's OK as long as they're avoiding one or two things," he said. "If they start avoiding more than one or two things, the problem is that they can put their child at risk for nutritional deficiencies."

Secondly, he encourages families to get input from developmental pediatricians, who can have a more detached analysis of behavioral changes, and get comments from teachers and school officials who frequently interact with their child.

"Parents of children with autism and behavioral problems are desperate to find ways to help their children out, so they're easily convinced," Daines said. "Parents need to make sure what they think they're seeing is what they're actually seeing."

That last paragraph is crucial. Parents need to find someone who is objective enough to look past their desperation and ensure that any "help" given to their children is truly help. A succession of false "cures" can make a bad situation worse.

The number of children who cannot properly be diagnosed with milk protein allergies yet can benefit from the removal of dairy in the diet is small. Yet the difference for those few children can be dramatic. All I can hope is that the right children find this right solution.