5 Misconceptions about Food Allergy Dietitians
This post was inspired by a recent reading from my FARE Certificate of Training in Pediatric Food Allergy course. This 9-month program will finish in May 2023 and provides training on up-to-date and evidence-based nutrition care for children with food allergies.
It’s amazing what comments people say about dietitians in food allergy Facebook groups:
“…not worth the time or money in my opinion.”
“…the nutritionist shamed me for the alternative milk I got.”
“…a quick google search was the same info I got from her…”
To be honest, these comments are gut-wrenching. But at the same time, I can appreciate where these parents are coming from.
I made the decision to pivot my newly established private practice after struggling to find a “local” dietitian to help me navigate food allergies after my youngest son had his third allergic reaction in just three months.
Because honestly, dietitians that truly specialize in food allergies are few and far between. Nutrition care for multiple food allergies is not covered in depth at most undergraduate dietetics programs or supervised practice experiences. In fact, most clinical dietitians - both adult and pediatric - do not have much experience helping patients navigate life after a new food allergy diagnosis.
In the 10+ years that I have worked as a dietitian, the prevalence of food allergies has increased in the United States. In 2008, it was reported that 1 in 25 children had a food allergy; today that statistic has increased to 1 in 13 children.
As a result, we are seeing significant advancements in prevention guidelines, labeling laws, and prospective treatment options for food allergies. It is difficult for the average clinical or pediatric dietitian to stay up-to-date on all these changes unless they specialize or focus the majority of their practice on food allergies.
What is a food allergy dietitian?
A food allergy dietitian can work with patients and their families to create an individualized avoidance strategy to help 1) avoid trigger foods and 2) find suitable alternatives that provide adequate nutrition in both the short-term and long-term. This becomes especially important with children, who need optimal growth and oral motor skill development.
In fact, working with a food allergy dietitian can improve the growth and nutrition status of young children with food allergies.
So the question is not “should I see a dietitian for food allergies?” but instead, “how do I find an allergy specialist dietitian?”
Because we need more dietitians that specialize in food allergy in the United States. The hard truth is that in some parts of our country, it can be hard to find a dietitian with extensive food allergy training. But this is starting to change.
Food Allergy Research and Education (FARE) is trying to help educate dietitians through their initiative to provide a 9-month, intensive Certificate of Training in Pediatric Food Allergy Nutrition course. On their website, FARE offers a list of registered dietitians who are accepting new patients and hold a FARE Pediatric Food Allergy Certificate. Many Midwest states - including Iowa, Nebraska, and Illinois - are not currently represented.
Which is why I am currently enrolled in the 2022-2023 cohort.
I know how overwhelming it is as a generalist dietitian to receive a referral for food allergies. Because I was that dietitian, earlier in my career. And I know how frustrating it is as a food allergy parent to try and sort out what is actually evidence-based, up-to-date nutrition guidance using Google. Because I’ve been there as well.
So today I’m sharing five misconceptions about food allergy dietitians and how I can help patients and parents confidently navigate a new food allergy diagnosis.
5 Misconceptions about Food Allergy Dietitians
Misconception #1: “[The dietitian] was wrong on a number of things (saying they were safe when they were not) and just gave me a list of products.”
Food allergy dietitians have been trained to provide a patient-specific approach as part of the individualized food allergy consultation. We do not just provide a list of foods to avoid and sample meal plans with a calorie allotment. Instead, a food allergy dietitian should be well versed in teaching how to identify foods that are safe and working with the individual family to find appropriate substitutions for both optimal nutrition and quality of life (aka food enjoyment).
We have a firm understanding of food labeling laws and can help families understand cross contact risk beyond reading a food package. Food allergy dietitians also understand cross-reactivity and can help the allergist prioritize which foods to possibly challenge based on nutritional benefit.
Misconception #2: The dietitian will just shame me for my food choices.
A food allergy dietitian has been trained to provide patient-specific care to meet each patient or family’s specific needs. One of our goals is to help prevent unnecessary over-restriction, but we also understand that each family may have additional food values or priorities beyond avoiding known allergens.
It is also important to understand that not every provider-patient relationship will be a perfect fit. I offer a free 15-minute Discovery Call for prospective families that have concerns about my approach or flexibility with their food-related values. Just like physicians have different bedside manors, dietitians can vary in their practice styles and philosophies.
Misconception #3: The dietitian won’t come up with reasonable, safe food choices and won’t understand my child’s picky eating.
Food allergy dietitians include overall nutrition, feeding behaviors, and risk for malnutrition as part of the individualized patient assessments. And while we may not have an immediate answer to a safe food question, we have plenty of resources and strategies to help families find reasonable, safe food choices that meet their specific needs and budget.
We are also willing to try different strategies with individuals that are picky eaters in order to improve their overall nutrition. In fact, food allergy dietitians have worked with enough families to appreciate how crippling food anxiety can be for those with allergies. I have three picky eaters myself, with different sensitivities to changes in tastes and textures. And I have experienced the impact that a food allergy can have on existing picky eating in children.
Misconception #4: A quick google search will provide the same information as a dietitian.
Google is a fantastic tool that can lead us to quality resources like FARE, Kids with Food Allergies, FAACT. Chances are, you can use a google search to find the same information that you would get from any healthcare provider, not just dietitians.
But a google search will also come up with many outdated, misleading, and incorrect information about food allergy nutrition. The value of working with an allergy specialist dietitian is evident in our clinical experience and educational training. We speed up the process of sifting through information to provide the most valid, up-to-date information that Google has to offer while sharing our expertise to immediately answer any questions or concerns specific to your food allergens.
Misconception #5: “[A dietitian is] not worth the time or money….”
Each family has their own time:cost threshold. There is also a learning curve when it comes to navigating any food-related chronic disease. Even as a dietitian, it took me a good six months before I felt like I was confidently managing my child’s food allergies. And I had access to trainings and resources beyond what is available to the average food allergy family.
So I completely believe that working with an allergy specialist dietitian would have significantly shortened my learning curve in caring for my food allergy child. But as I said before, the key to this misconception is finding a dietitian that truly specializes in food allergy nutrition. Bonus points for finding one that also takes insurance and is in network with your benefits plan.
How to find an allergy specialist dietitian:
At the time of this writing, the only advancing training program for food allergy dietitians in the United States is FARE’s Certificate of Training in Pediatric Food Allergy. I can personally vouch for how intensive and in-depth this 9-month course really is.
To search for a FARE-trained dietitian in your state, you can use this list of Registered Dietitians holding a FARE Pediatric Food Allergy Certificate who are accepting patients. You will see that less than half of the states are represented on this list. The nine-month program runs from September to May, so this list should be updated annually in the summer.
If your state is not represented, here are some additional ways to search for a food allergy dietitian:
Check if your allergy clinic has a dietitian on staff
Ask your allergist for a referral or list of recommended dietitians they work with
Find a nutrition expert through the Academy of Nutrition and Dietetics with food allergy listed as a specialty.
Once you find a name (or list of names), then it is important to do some additional research to see if that dietitian would be a good fit for your family. Check out their website, learn about their additional training or certifications, and skim their blog (if they have one). You can also read reviews on Google or ask other food allergy families for their feedback.
For example:
I am currently enrolled in the FARE Pediatric Food Allergy course, in addition to 20+ hours of continuing education in food allergy nutrition over the past two years.
I am licensed to work with patients in the states of Iowa, Nebraska, and Illinois. You can learn about what insurance plans I am in network with and how to verify your insurance benefits here.
I offer an allergy-friendly recipe index and blog about Small Steps for Joyful Eating with Food Allergies on my website.
To learn more about me and the services I offer, you can check out my bio, listen to my podcast, read my book, and review the topics that are included with my food allergy education and counseling. A new food allergy diagnosis is overwhelming - you shouldn’t have to navigate it on your own!
