Gurdev (Dave) Judge MD, an Allergist
Board Certified in Allergy, Asthma and Immunology
Board Certified in Pediatrics
Allergy Doctor, Specializing in Pediatrics and Adult

Cary Office: (919) 859-5966
North Raleigh: (919) 870-6440
Wake Forest: (919) 562-7195
Accepting New Patients

Gurdev (Dave) Judge MD, an Allergist

Board Certified in Allergy, Asthma and Immunology
Board Certified in Pediatrics
Allergy Doctor, Specializing in Pediatrics and Adult
Cary Office: (919) 859-5966
North Raleigh: (919) 870-6440
Wake Forest: (919) 562-7195
Accepting New Patients
Request an Appointment

Dr. Judge an Allergist, was Trained at Duke University Medical Center as a Allergy Doctor,
Practicing in Cary, Raleigh & Wake Forest
FAQs - Food Allergy

Food Allergies

Is goat milk a safe alternative to cow milk?

Goat's milk protein is similar to cow's milk protein and may, therefore, cause a reaction in milk-allergic individuals. It is not a safe alternative.

 
What formulas are recommended for children with milk allergy?

Extensively hydrolyzed, casein-based formulas are often recommended. These formulas contain protein that has been extensively broken down so it is different than milk protein and not as likely to cause an allergic reaction. Examples of casein-hydrolysate formulas are Alimentum® and Nutramigen®. If the child is not allergic to soy, the doctor may recommend a soy-based formula.

 
When should a child stop using formula?

When to wean from a milk-free formula to a milk substitute (such as rice milk or soy milk) will vary depending on the child's current diet. A milk-free formula is an excellent source of necessary nutrients, so many doctors recommend continuing its use well past the age of one year for children on restricted diets due to food allergy. Discuss your options with your doctor or dietitian to be sure that the child's nutritional requirements are all being met.

 
Can an MMR Vaccine be given to an individual with an egg allergy?

The recommendations of the American Academy of Pediatrics (AAP) acknowledge that the MMR vaccine can be safely administered to all patients with egg allergy. The AAP recommendations have been based, in part, on scientific evidence supporting the routine use of one-dose administration of the MMR vaccine to egg-allergic patients. This includes those patients with a history of severe, generalized anaphylactic reactions to egg.

 
I've heard the flu vaccine contains egg, is this true?

Yes, influenza vaccines usually contain a small amount of egg protein.

 
Is flu shot safe for an individual with an egg allergy?

Influenza vaccines are grown on egg embryos and may contain a small amount of egg protein. If you or your child is allergic to eggs, speak to your doctor before receiving a flu shot.

 
Can peanut allergy be outgrown?

Although once considered to be a lifelong allergy, recent studies indicate that up to 20% of children diagnosed with peanut allergy outgrow it.

 
Can alternative nut butters (i.e., cashew nut butter) be substituted for peanut butter?

Many nut butters are produced on equipment used to process peanut butter, therefore making it somewhat of a risky alternative. Additionally, many experts recommend peanut-allergic patients avoid tree nuts as well.

 
Should coconut be avoided by someone with a tree nut allergy?

Discuss this with your doctor. Coconut, the seed of a drupaceous fruit, has typically not been restricted in the diets of people with tree nut allergy. However, in October of 2006, the FDA began identifying coconut as a tree nut. The available medical literature contains documentation of a small number of allergic reactions to coconut; most occurred in people who were not allergic to other tree nuts. Ask your doctor if you need to avoid coconut.

 
Is nut safe?

The water chestnut is not a nut; it is an edible portion of a plant root known as a "corm." It is safe for someone who is allergic to tree nuts.

 
Should carrageenan be avoided by a fish-allergic individual?

Carrageenan is not fish. Carrageenan, or "Irish moss," is a red marine algae. This food product is used in a wide variety of foods, particularly dairy foods, as an emulsifier, stabilizer, and thickener. It appears safe for most individuals with food allergies. Carrageenan is not related to fish and does not need to be avoided by those with food allergies.

 
Should iodine be avoided by a fish-allergic individual?

Allergy to iodine, allergy to radiocontrast material (used in some radiographic procedures), and allergy to fish or shellfish are not related. If you have an allergy to fish, you do not need to worry about cross reactions with radiocontrast material or iodine.

Food Intolerances

Food intolerances differ from a food allergy, as the immune system is not involved when a person is intolerant to a food. Two common intolerances, lactose intolerance and Celiac disease are discussed here.

  • Lactose Intolerance

    Lactose intolerance occurs when an individual's small intestine does not produce enough of the lactase enzyme. Therefore, affected individuals are not able to digest lactose, a type of sugar found in dairy products. The symptoms of lactose intolerance typically occur within 30 minutes to 2 hours after ingesting dairy products. Large doses of dairy may cause increased symptoms.

  • Celiac Disease

    An adverse reaction to gluten is known as celiac disease or "celiac sprue". This disease requires a lifelong restriction of gluten, which is found in wheat, rye, and barley, and perhaps oats. These grains and their by-products must be strictly avoided by people with celiac disease. Celiac disease causes damage to the lining of the small intestine, which prevents the proper absorption of nutrients in foods. This is turn can cause a person with Celiac disease to become malnourished. Celiac disease can cause many symptoms, including bloating and gas, diarrhea, constipation, headaches, itchy skin rash, and pale mouth sores, to name a few. The symptoms may vary amongst affected individuals.