Lisa Forbes, M.D., Assistant Professor of Immunology Allergy and Rheumatology at Texas Children’s Hospital, Clinical Director for the Center for Human Immunobiology, and of course, a passionate DEFINE client, saw one of our posts on Ear Infections and Food Allergies in Small Children, by DEFINE’s Lori Hudson, D.C., R.N. and wanted to add to the conversation. We can’t thank Lisa enough for her contribution! Read her guest post below!


Hello Definers!

If you are reading this you are probably as obsessed with the Define mind, body, soul connection as I am!  I look to Henry, Erin and team as thought leaders in fitness nutrition and the mind body connection.  So, as thought leader in the world of Allergy and Immunology, I wanted to add some information to Lori’s recent blog post about food allergy and ear infections.

Let’s start with a little bit about the immune system and the gut.  So, about 50% of your immune system is in your gastrointestinal tract.  The maturing infant and toddler immune system is sensitive to all sorts of changes.  The young system is learning how to tolerate all sorts of foreign entities including food.  What we now know, is that the immune system needs to consistently see these foreign entities to create long term tolerance and/or memory.  For example, if the kiddo tolerates milk and it’s eliminated from the diet for more than 3-6 months without the consult of a physician, the little one could develop an intolerance to milk as the gut will have not seen it in a while.    Lori is spot on with the most common foods that cause food allergy.  But, don’t fear the foods.  The fats and protein in milk is so important for brain development.  The good carbs are an important source of minerals and caloric intake even if they have gluten.  Peanut butter is a great alternative to protein for the veggie families or those picky kids.  The only indication to hold off on the big six most common foods that cause allergy, is a first degree relative with food allergy or a reaction in the child themselves.

Ok, now onto the ear infection and food allergy question.  Yes, we have a growing epidemic of food allergies in this country with up to 1 in 13 children having them.  And, yes, kiddos with food allergy can present with respiratory, skin, gut, and cardiovascular symptoms.   Yes, respiratory symptoms can be congestion and increase inflammation in the upper respiratory tract.  However, only about 5% of kiddos with food allergy present with congestion and only about 25-35% of eczema in an infant is related to a food. Food allergy is suspected in eczema only when the situation is tough to treat with common creams. That means, the majority of eczema and congestion/ear infections are due to other environmental, anatomic, or genetic factors.

So, my message is the following.  Please don’t start eliminating foods at the onset of chronic congestion or skin changes without the consult of your pediatrician or an allergist.   It’s a good thought, but usually not the most common reason.  Remember what worked for one kiddo might not apply to your little one, so I wanted you to have more info to arm yourself to make the best decision possible for you special little someone!

We are so lucky in Houston to have one of the country’s leading experts in food allergy in our backyard at Texas Children’s Hospital.  Dr. Carla Davis is embarking on some cutting edge research to help us further sort out all these issues.

See you in class!!


Lisa Forbes, MD

Assistant Professor

Immunology Allergy and Rheumatology

Texas Children’s Hospital

Center for Human Immunobiology, Clinical Director