Cindy Nguyen has been at Children’s National since November 2010. She sees patients with food allergies and anaphylaxis and specializes in all allergic and immunologic diseases including atopic dermatitis, asthma, and eosinophilic esophagitis. Dr. Nguyen sees patients at Children’s Sheikh Zayed Campus in DC on Mondays and Fridays and at the Northern Virginia Regional Outpatient Center on Wednesdays and Thursdays.
Anna Sprunger, PA-C
Anna Sprunger, PA-C, sees immediate and delayed food allergies, eczema, allergic rhinitis, asthma, urticaria/angiodema, and contact dermatitis. She specializes in pediatric allergic disorders and has an interest in food allergies and eosinophilic esophagitis. Anna sees patients at the Northern Virginia Regional Outpatient Center.
A food allergy is a response by the immune system when it mistakenly recognizes a certain food as dangerous. The immune system of someone with a food allergy produces immunoglobulin E, an antibody, to fight the food allergen. As a result, when the person is exposed to that food, IgE binds to it and causes the release of a number of chemicals, including histamine. This leads to an allergic reaction. The most common food allergies are peanuts, tree nuts, milk, eggs, fish, shellfish, wheat, and soy. There are almost three million children in the United States with food allergies.
Signs and Symptoms of Food Allergies
An allergic reaction can happen with any number of symptoms. These symptoms occur within minutes of eating the triggering food. Contact your pediatrician if you notice the following:
Skin: hives, eczema, redness, and swelling of the face or extremities, and itching and swelling of the tongue, lips, mouth, and throat
Stomach: nausea, abdominal pain, vomiting, and diarrhea
Breathing: runny nose, sneezing, coughing, wheezing, and trouble breathing
Cardiovascular system: a drop in blood pressure, fainting, and dizziness
A severe allergic reaction, known as anaphylaxis, usually happens suddenly and can include a number of symptoms. Seek medical care immediately if you notice the following:
Trouble breathing
Low blood pressure
Weak pulse
Swelling of the lips, tongue, and/or throat
Severe vomiting
How to Manage Food Allergies
The primary and most effective way to treat food allergies is to avoid any foods or drinks containing the allergen. Below are some additional tips:
Develop an emergency action plan including children, parents, and school officials in the planning process. Be sure to let other caregivers know your child has a food allergy.
Read the labels on packaged foods. By law, any food produced in the United States after 2006 must clearly list the ingredients derived from any of the eight major food allergens.
Avoid cross-contamination by using utensils and pans that have been thoroughly washed with soap and water. If cooking several foods at the same time, cook the allergen-free meal first, then keep it covered and away from any splatter caused by other foods that are cooking.
To effectively clean in a food allergy environment, surfaces must be washed with soap and water. To be safe, buy an extra cutting board to be used for allergy-free foods only, or use a disposable plate.
When dining out, present a chef card to the waiter. Chef cards list the foods and related ingredients your child is allergic to.
Exercise does not have to mean going to a gym or participating in an organized sport. You can incorporate exercise and activity into your family’s daily life in other ways. Here are some indoor and outdoor activity ideas for you to do as a family.
Outdoor Activities
Play tag: freeze tag, television tag, flashlight tag, etc.
Play kickball with a large, soft ball
Have a track meet: skip, hop, run, and sprint
Explore a new park or back road on foot or bicycle
Walk the dog
Play frisbee
Take a walk after dinner instead of turning on the television
Hike a local trail
Invite neighbors to a game of “capture the flag”
Take a swimming trip to a nearby lake or river
Play “Simon Says” or “Red Rover”
Make a hopscotch or four square grid on the sidewalk with chalk
Jump rope
Play hackey-sack
Play a team sport such as football, softball, or volleyball
Go rollerblading or biking around the neighborhood
Have a squirt gun battle on a hot day
Make an obstacle course and see who navigates it fastest
Indoor Activities
Dance to music
Build forts out of blankets and chairs
Follow homemade maps to locations around the house
Stretch
Make a band. Play instruments made from kitchen items using pots and pans as drums, rice in plastic bottles as maracas, etc.
Act out favorite books or stories
Make an indoor bowling alley with homemade pins (made from empty milk jugs, juice bottles, or cereal boxes) and a small rubber ball
Play basketball with toys when cleaning up (shoot toys into a toy “basket”)
Do scavenger hunts in which family members compete against one another on teams
Create your own fitness test with jumping jacks, jogging in place, push-ups, and sit-ups
Children's National Medical Center's Strong Tradition of Research
Research at Children’s National is conducted through Children’s Research Institute (CRI), the academic arm of Children’s National Medical Center. The Institute conducts and promotes research and education programs within Children’s that lead to improved understanding, prevention, treatment, and care of childhood diseases.
The institute is divided into five specialty research centers:
Research at Children’s National is highly collaborative and multidisciplinary. In 2009, the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children’s National Medical Center was launched to redefine what is possible in surgery through innovative, integrated research. By combining research and clinical work in this area with the groundbreaking translational research underway at Children’s Research Institute, Children’s National is developing knowledge, tools, and procedures that will benefit children in the Washington region, across the country, and around the world.
Breakfast does not have to be composed of so-called breakfast foods. Soup, sandwiches, or leftovers make great choices for breakfast. Also, it is important to remember that not all foods packaged as breakfast food are the best source of fuel for children’s bodies to start off the day. Some choices are better than others. For example:
Plain oatmeal mixed with chopped apples and low fat milk contains whole grains, fiber, vitamins, and protein. Whole grains and fruit have fiber which helps keep us feeling full longer. They also contain carbohydrates, which is the most efficient source of energy for our bodies.
Protein foods like low fat dairy foods, nuts, and lean meats can be added to breakfast and may help satisfy your child’s hunger longer.
A good breakfast can be anything your child or teen will eat that has some nutritional value, including leftover pizza, a glass of milk (even low fat, low sugar chocolate milk is fine), a piece of fruit with yogurt, or a peanut butter and jelly sandwich made with whole wheat bread.
Eating high-sugar foods such as doughnuts may make your child feel sleepy and may increase his or her hunger sooner than healthier foods.
Learning and Hunger
A hungry child may perform poorly in the classroom. Breakfast is the fuel that will help get your child’s brain through the morning. Children can become cranky and irritable when they are hungry. Without energy, they may be less alert and attentive to classroom activities. That’s why teachers often remind children to eat breakfast before taking a long morning test.
Healthy Weight
Some teenagers believe that they can control their weight by skipping breakfast. This is not true. Eating breakfast helps to control weight because it gets the body’s metabolism moving- it’s a jump start to the day. Also, teens are less likely to overeat later in the day when they eat breakfast. When you wait too long before eating, it can be almost impossible to control the amount of food consumed, resulting in excessive caloric intake.
Make sure your children eat breakfast. It only takes a few minutes to prepare and eat, but having this meal, or even just a glass of milk or piece of fruit, will be beneficial to them all day.
Depending on your child’s type of food allergy, substituting certain foods may be necessary. The Food Allergy and Anaphylaxis Network (FAAN) suggests the following simple substitutions:
Milk
Substitute in equal amounts, with water or fruit juice. (For example, substitute 1 cup milk with 1 cup water.)
Eggs
These substitutes work well when baking from scratch and substituting 1 to 3 eggs. For each egg, substitute one of the following in recipes:
1 ½ tablespoon water, 1 ½ tablespoon oil, 1 teaspoon baking powder
1 packet gelatin, 2 tablespoon warm water. Do not mix until ready to use.
Wheat
When baking with wheat-free flours, a combination of flours usually works best. Experiment with different blends to find one that will give you the texture you are trying to achieve. Try substituting 1 cup wheat flour with one of the following:
7⁄8 cup rice flour
5/8 cup potato starch flour
1 cup soy flour plus ¼ cup potato starch flour
1 cup corn flour
Turkey Pasta Toss (Dairy-, egg-, and gluten-free)
Preparation time: 20 minutes
Ingredients:
1 medium onion, chopped (¾ to 1 cup)
1 pound ground turkey
3 stalks celery, thinly sliced at an angle
3 medium carrots, thinly sliced
1 large clove garlic, minced
2 tablespoons safflower oil
12 ounces gluten-free egg-free pasta
Instructions:
Cook the pasta according to the directions on the box.
While the pasta is boiling, cook the onions in 1 to 2 tablespoons of oil in a large skillet.
Add the ground turkey and sauté into small pieces until well cooked.
Add the celery and carrot slices and cook on low heat until desired softness.
When the pasta is done, drain and add it to the skillet.
Darlene Mansoor, MD
A food allergy is a response by the immune system when it mistakenly recognizes a certain food as dangerous. The immune system of someone with a food allergy produces immunoglobulin E, an antibody, to fight the food allergen. As a result, when the person is exposed to that food, IgE binds to it and causes the release of a number of chemicals, including histamine. This leads to an allergic reaction. The most common food allergies are peanuts, tree nuts, milk, eggs, fish, shellfish, wheat, and soy. There are almost three million children in the United States with food allergies. 
Research at Children’s National is conducted through Children’s Research Institute (CRI), the academic arm of Children’s National Medical Center. The Institute conducts and promotes research and education programs within Children’s that lead to improved understanding, prevention, treatment, and care of childhood diseases. 
Breakfast does not have to be composed of so-called breakfast foods. Soup, sandwiches, or leftovers make great choices for breakfast. Also, it is important to remember that not all foods packaged as breakfast food are the best source of fuel for children’s bodies to start off the day. Some choices are better than others. For example:
Turkey Pasta Toss (Dairy-, egg-, and gluten-free) 
