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Should my daughter avoid dairy and wheat?

The question

Food sensitivities run in my family. My 5-year-old daughter doesn't appear to have any problems with food so far, but should I steer her clear of wheat and dairy just to be safe?

The answer

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It is important to differentiate between food allergies and food sensitivities. Allergies are caused by your immune system overreacting, and can be severe enough to cause problems such as a closed airway or a rapid drop in blood pressure. Sensitivities are far less dramatic and often non-specific to one food item.

First, the family history you mention should be double-checked, since many food sensitivities are over-diagnosed.

One can diagnose dairy allergies with a skin test, a challenge test or a blood test. If your child has had no specific signs such as eczema, wheezing, a tight chest, hives, diarrhea or vomiting when challenged by dairy, I would be reassured.

Some patients say that they get mucous in their airways from milk, or that their child gets frequent upper respiratory or ear infections from dairy. There is not enough objective data to support such claims. However, I suggest an elimination of all dairy and then a challenge with one dairy product at a time.

Lactose intolerance is often over diagnosed as well. Lactose is the sugar in milk - as opposed to the protein which is the focus in true allergies. Lactose may be associated with gas, cramps, abdominal pains and loose bowel movements. Children who get a severe form of viral diarrhea may have a temporary lactose intolerance when recovering from the infection.

The role of probiotic drops in improving food sensitivities remains blurry at this time, but trying them out can't hurt. You can get probiotics from a health food store. Make sure it is a good quality.

Send pediatrician Peter Nieman your questions at He will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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