Food Allergy Management and Prevention
Support Tool for Infants and Toddlers
Non IgE Mediated

These sections contain the same information as in the PDF handouts throughout this section, but are formatted for easier placement within EMR systems to place in after visit patient handouts.

Pediatric Gastroenterologist

We have put in a referral for a pediatric gastroenterologist. A pediatric gastroenterologist is a medical doctor who specializes in managing issues related to the GI tract, including the esophagus, stomach, small and large intestine, liver as well as the pancreas. Gastroenterologists perform many procedures like endoscopy and colonoscopy and treat many diseases, such as Crohns disease, celiac disease, ulcerative colitis, irritable bowel syndrome to name a select few. Non IgE mediated food allergies, such as eosinophilic esophagitis and food protein enterocolitis, are often co-managed by the gastroenterologist with the allergist for optimal results. In addition to this they work closely with a patient’s pediatrician in order to create the best care plan for a patient’s needs.

To find a pediatric gastroenterologist in your area you can use this search engine found at the North American Society for Pediatric Gastroenterologist, Hepatology, and Nutrition.

Label Reading for Food Allergens

Read Every Label, Every Time

The 8 Major Allergens Are:

Milk or Dairy
Tree nuts (almonds, hazelnuts, walnuts, pecans etc.)
Fish (cod, bass, salmon, tuna etc.)
Crustacean shellfish (lobster, shrimp, crab, etc.)

Note:  While the 8 major allergens are responsible for the majority of allergic reactions, ALL allergens must be taken seriously.

The Food and Drug Administration (FDA) enforces the Food Allergen Labeling and Consumer Protection Act (FALCPA) labeling law. FALCPA applies to all domestic and imported packaged foods and the 8 major allergens, which must be written in clear, plain language and labeled when in flavorings, colorings or other additives.

Note: FALCPA only applies to the 8 major allergens!

The allergens below are not included in the major 8 allergens and therefore are not included in the labeling law:

The following items are not regulated by the FDA or the labeling law:

Major 8 Allergens Can be Listed in 1 of 2 Way

Be aware that allergens may be written in plain language in the body of a products ingredient list.



A “Contains” statement:

Remember “contains” statements only apply to the 8 MAJOR allergens and companies can choose to not use them.

Advisory or Precautionary Statements

Note: For children with celiac disease or gluten sensitivities, it may be best to look for “gluten-free products” because labeling can be inconsistent. Wheat is one of the major eight allergens, but other sources of gluten such as barley, rye and oat are not.

Cross Contact

What is Cross Contact?

Cross contact is the unplanned presence of food allergens. It occurs when an allergen protein is unintentionally transferred to an allergen free food or object. Cross contact can be invisible to the eye and can come from many places. Even small amounts of an allergen can cause an allergic reaction.

This means that your child can accidently be exposed to an allergen through:

Objects (Utensils, cooking surfaces, highchairs, pacifiers, sponges, bib, apron, etc.)

Food (Steam, splatter, accidental contamination, frying oil)

Saliva (People, pets, binky, Sophie the Giraffe, musical instrument, etc.)

Who needs to know about allergen cross contact?

Any caregiver for your child. Babysitters, siblings, grandparents, extended family, friends, teachers, etc. Routine teaching of all caregivers about sources of cross contact and prevention of exposure is essential.

Children explore their environments with their hands and often put them, or other objects in their mouths.

Younger children are more likely to put their hands in their mouths and noses; therefore, caregivers should have increased awareness and wash their children’s hands often Avoid sharing of food, utensils, water bottles and anything else that may go in their mouth, such as musical instruments.

Cross Contamination vs Cross Contact

Cross contamination occurs when microorganisms such as bacteria contaminate food and result in a food borne illness. Unlike cross contact, the risks of cross contamination may be eliminated with proper cooking techniques, whereas proper cooking does not reduce or eliminate the chances of a food allergy reaction.

Tips for Preventing Cross Contact When Serving and Preparing Food




Keep it simple, limit multiple ingredient dishes, cook from scratch.