This article was originally written & published for Child Guide Magazine, which provides excellent resources and activities for families. The January 2014 issue can be found in it’s entirety HERE.
You are what you eat. How many times have you heard that? As adults, we certainly have considered this when considering our own food intake, but what about our children?
One local family has been considering every bite of what enters their son’s mouth. Finn Csordas is 2 ½ years old, who is affectionate, silly, and quite the charmer to his 3 older adoring sisters, but this was not always the case. Shortly after his birth, his parents, Jennifer & Alex, noticed how frequently Finn was fussy. His original pediatrician initially felt this was simply colic, but as Finn grew older, his parents’ concerns also grew. Finn spit up more frequently than other babies. He had frequent hives in many places on his body that the family was told were eczema patches. He was fussy more than he was content and could not find a way to self-soothe or to be soothed by his parents. More concerning, Finn seemed “spaced out,” and had significant delays in social, language, and motor skills that became more noticeable the older he became. The most alarming observation though, was head banging. It started at night when Finn would bang his head against his crib to fall asleep but progressed to banging throughout the night, and then even during the day, while playing. Finn would find the corner of the wall and bang his head until a bald spot appeared and didn’t seem concerned by the discomfort.
Jennifer & Alex persisted in their belief that these symptoms had to be more than eczema or colic – but their journey wasn’t an easy one. After switching pediatricians, they began a search for what was going on with Finn. He started medication for acid reflux, which helped somewhat with spitting up, but not with other symptoms. Because he did have a history of reoccurring ear infections, he had tubes placed in his ears. Shortly after this procedure, he did start to walk, but the communication and social skills continued to become more delayed and the head banging intensified. The Csordas’ worked with a team of early interventionists from West Virginia Birth To Three, including speech, physical, and occupational therapists that offered strategies from sensory integration and balance activities to teaching basic imitation skills during play as a basis for eventual language development. A developmental specialist with experience in behavior observed Finn and worked on providing self soothing options and deterring techniques for the head banging. A service coordinator helped link the family to specialists to help find a solution. When sensory strategies weren’t very successful, an MRI of Finn’s brain revealed no concerns, and he passed a detailed screening for Autism at Children’s National Medical Center, the team called on a registered dietician through the West Virginia Birth To Three Program.
Finn was evaluated by a gastroenterologist to determine if he had an allergic inflammatory condition of the esophagus called Eosinophilic Esophagitis (EE). When it was clear that he did not, a final referral to a pediatric allergist was made. After blood testing and 3 days of extended patch testing, the Csordas’ finally got their answer – Finn is allergic to soy, wheat, dairy, oats, and has a significant phenol intolerance (Phenol is a chemical found in many natural foods and in common artificial preservatives).
While some of their larger fears were put to rest, Jennifer & Alex had a whole new world to learn about. Finding foods that were safe for Finn and that he would actually eat while maintaining the required calories and nutrients for his age is no easy task, but was one that they took on without reservation. Jennifer shares, “To be completely honest, I wasn’t sure that I believed all the diet changes would help, I prayed that they would, but deep down I was skeptical. To think a handful of goldfish crackers or a couple grapes could cause him to struggle for days and completely alter the course of the entire family is something I would have never thought possible, had I not lived it! “
After 2 weeks of eliminating the foods Finn was allergic to, there was a dramatic change in his demeanor and development. His mother recalls, “We had food journals and had to document everything he ate, all his skin reactions, behaviors, and try to make sense of all the parallels. About two weeks after we had changed his diet, he went from having about 5 words to over 70 words, and no longer needed weekly speech therapy!” Within 5 months of changing his diet, Finn has made over a years worth of progress with development. He is walking, running, and climbing, talking in complete sentences, initiating social greetings, and is most importantly – he is a happy 2 ½ year old. While his speech is still slightly behind for his age and the head banging still remains in smaller amounts (it is likely more a learned behavior, which was originally caused by the allergic reactions), Jennifer and Alex are thrilled that they can finally get to know the little boy he actually is and not the one who could only react to pain & discomfort.
Finn is not alone in his diagnosis of food allergies. According to a study by the Center for Disease Control, food allergies increased 50% from 1997-2011. And while the number of people who have a food allergy is growing, there is no clear answer as to why. And while many “traditional” allergic symptoms, such as facial swelling and hives, are well known and well recognized, those such as the ones that Finn experienced are often misdiagnosed as something other than a food allergy or intolerance.
Georgeann Freimuth, MS, RD, LDN, is the Registered Dietician who spearheaded solving Finn’s developmental puzzle. Freimuth, a Licensed Dietician Nutritionist and a part time professor at Shepherd University, works with children and families through the West Virginia Birth To Three Program and privately through consultations. She sees more and more children having behavioral and developmental consequences from what they eat. When people question the relationship between the two, Freimuth jokes, “Think there’s not a gut to brain connection? Come have a glass of wine with me!” In all seriousness, the connection of nutrition’s affect on the body should not be ignored. Freimuth says, “The gut to brain connection should not be overlooked when dealing with a child who is sensitive to emotion anger, anxiety or who has behavioral concerns. This is important because the brain and the gastrointestinal system are intimately connected. Certain foods and food intolerances or allergies can adversely affect a child’s behavior and attentiveness, while certain nutritional deficiencies can cause aggressiveness disorders and behavioral disorders as well as subtle and occasionally dramatic effects on the child’s behavior.”
Some food allergies are severe with defined noticeable reactions, like Finn’s, but others can be subtler. Either way, nutrition should be included in the complete list of possibilities when assessing a child’s well being. Freimuth says, “Food allergies or food intolerances can affect the nervous system causing the brain to have alterations in brain chemistry which then can affect a child’s behavior. Understanding if a child has food allergies and/or food intolerances along with nutritional imbalances could be helpful when trying to help a child’s behavior or development.” Often elimination diets (where certain foods are removed one by one) are suggested to determine what is the potentially offensive food. However she cautions, “It is recommended if a parent wants to try a trial and elimination diet at home to see if their child’s diet is related to their behavior they should consult a Registered Dietitian. The caution used with trial and elimination diets are sudden nutritional deficiencies when certain food groups are removed.”
Jennifer Csordas agrees. “Before we knew all Finn was allergic too, it was like having a toddler with colic. He was always unhappy and no matter what we did, we couldn’t change that. Now he smiles all the time, laughs and plays, things that I took for granted when my girls did them. It takes a lot of planning and can be a challenge at times keeping up with his diet, but to know he isn’t in pain is a huge blessing. “
While eliminating aversive foods can be helpful in some cases, increasing particular nutrients and minerals that are lower than typical are necessary in others. For example, in some cases, increasing zinc levels can improve symptoms associated with ADHD.
As the trend for extremely busy families continues in America, so will the market for convenience foods, which are often full of too many ingredients to count and enough preservatives to frighten any parent. While it does take pre-planning and self-packaging on the part of parents, ensuring children have whole foods (ones your great grandmother would recognize. Yes to the apple. No to the bright orange cheese puff) is a great place to start. Remember that whether your child has a diagnosed condition or developmental concerns or not – foods that we all eat certainly affect us in some way. The effect of nutrition on an individual is certainly more far reaching than allergies alone. An individual can have developmental or behavioral concerns from intolerances to certain foods or reactions to the chemicals and preservatives found in many foods children are fed, or from low levels of essential vitamins and nutrients. Freimuth advises, “Intolerances to foods, food additives or looking into food allergies may have a crucial role in your child’s behavior. Behavior and cognition in children and adolescents can be influenced by what they eat and their nutritional statuses.”
While nutrition is not the culprit for all developmental or behavioral concerns, it certainly is a possibility. If you have concerns about the role nutrition is playing with your child, speak to your Pediatrician or a Registered Dietician who specializes in pediatric care. Prepare for the conversation by logging 3 days worth of everything your child eats to share specific intake (including medications) and list frequently observed behaviors or developmental concerns for discussion. Each parent may have individual standards for what they are able and comfortable to provide their child to eat, but all parents wish for happiness and health for their child. Let’s help our children live out “You are what you eat.” We can do this first by remembering that what they put in their bellies has a huge impact on their brains. We can also start with small changes to provide nutrition that helps them to be happy and healthy for many years.
Georgeann Freimuth is dedicated to helping families learn more about the gut to brain connection and how it could be affecting their child. She can be reached at: firstname.lastname@example.org The author thanks her and the Csordas family for their contributions to this article.
Nicole Sergent, MPT is a Pediatric Physical Therapist & co-author of 1-2-3 Just Play With Me. Her favorite processed food is a Reese Cup, but she feels happier & knows she is smarter when she eats her many favorite non-processed foods – especially nectarines & brussel sprouts!