How to Keep A Food & Symptom Journal

More frequently than I’d like to see, new parents post on the FPIES message boards.

It’s almost always the same basic introduction message: “My child was just diagnosed. I feel completely overwhelmed! What do I do now?!”

Every single time, the first piece of advice given is to start a food and symptom journal. 

We’ve kept one on both our kiddos for over 4 years now, and I have to say that food and symptom tracking is invaluable data for any parent tasked with keeping a food allergic/intolerant child safe.

However, many folks new to the food allergy/food intolerance world have asked – both on the boards and specifically to me – how exactly they are supposed to keep a food and symptom journal! It seems so overwhelming at first. They wonder what they’re supposed to write down, what format it should be in, and how detailed they need to be.

Today I’m going to clear the air on the subject, and share with you exactly how to keep a food and symptom journal.

Ready?

The best, most perfect food and symptom journal is the one that works for you. 

The end.

(Just kidding.)

Seriously, though…when it comes to keeping track of your child’s food intake and symptoms, the only thing that matters is what makes sense for you, and therefore, what you will actually use to collect the data. The actual format or method is immaterial. 

It’s sort of like a calendar. Some people are totally techno-phobic and must have a paper calendar system, while others are technophiles and keep everything logged into some app or program.

Both are perfectly fine. It’s all about figuring out what works best for you.

Keep in mind that you may not be the only person responsible for keeping records on your child. Your spouse, parents, or baby-sitters may also need to use the food and symptom journal. Consider accessibility to all responsible parties when making your choice.

Here are some suggestions to get you started. I haven’t used all of them, but am recommending ones that I’ve either used myself or heard other FPIES parents report highly about.

Tech Food & Symptom Journals

• Google Calendar. Lots of FPIES families report using Google Calendar for their food and symptom journal. It’s apparently very easy to set Google calendar up to record specific symptoms and food intake. I’ve never used it so I can’t tell you how to do it, but this has always earned a “thumbs up” rating from other FPIES parents. One big plus to this is that it can be accessed online, so you can easily pull the data and organize it in the  middle of a doctors appointment.
• Apps. There are a few smartphone apps out there that can help you keep track of food intake and symptoms. One that is recommended is mySymptoms Food and Symptoms Tracker. This one looks promising to me! I use my phone for almost everything; however, for us it wouldn’t be practical since I travel for work and my parents watch the kids when I’m gone. If I didn’t travel, though, I would probably give this a try. It has many of the same benefits as Google Calendar, but all conveniently located in one app.
• Spreadsheets. For some very tech savvy people, they’ve created their own spreadsheets and databases to record food intake and symptoms. Honestly, I do not know how they did it, but the ones who have done so are very happy with the results! If you’re especially talented in this field, you could consider doing this.

Paper & Pen Food & Symptom Journals

• Worksheets. You can find food & symptom journal templates at both the IAFFPE and the FPIES Foundation. Look them over, see if one seems to fit your thinking and record keeping style, print them out and give them a shot. OR…
• Spiral notebook. Just a blank spiral or composition notebook that you fill with the data you find pertinent. This is the method I use for most things.

If you go the old-fashioned, blank notebook method, I’ll share how I use ours and you can use that as a starting point for your own methodology.

Since I have two kids to keep track of, I use two facing pages per day. One side is Jed, the other is Zac.

I write the date in the upper left hand corner, then the kiddos name at the top of each page.

After that, it’s just a timeline! Here’s a sample of one of Zac’s baseline day entries:

7:30 a.m. – woke up
7:40 a.m. – wet diaper
8:00 a.m. – ate b/q/e/c breakfast bake, drank 2 glasses gm
9:30 a.m. – poopy diaper – perfect!
10:00 a.m. – snacked on q/e/c/a cookies – 16, drank 1 glass gm
11:45 a.m. – napped, woke at 1:25 p.m.
1:30 p.m. – wet diaper
1:45 p.m. – ate q/e/c/a cookies – 5
3:00 p.m. – ate b/a/gm popsicles – 3
5:30 p.m. – poopy diaper – perfect!
6:00 p.m. – ate chicken – 1/2 c. (4 oz.), quinoa – 1 c., drank 1 glass gm
7:00 p.m. – ate dried cucumber slices – 13
8:15 p.m. – asleep

Then at the bottom I write anything pertinent about the day. Example: “Today was a great day! Didn’t fight me for naps, behaved well, perfect poops, think we’re ready to start our next food trial!”

For us, this makes sense. B=banana, GM=goat milk, A=apricot, E=egg, Q=quinoa. Since he has such a limited diet and I often adjust the recipes as I make them, this is all I need to know.

Of course, things look very different on accidental ingestion days, or on food trial days.

Then his log might more resemble this:

7:30 a.m. – woke up
7:40 a.m. – wet diaper
8:00 a.m. – ate b/q/e/c breakfast bake, drank 2 glasses gm
9:30 a.m. – poopy diaper – very good, but a little mucousy; good color and consistency
10:00 a.m. – snacked on q/e/c/a cookies – 16, drank 1 glass gm
11:45 a.m. – napped, woke at 1:25 p.m.
1:30 p.m. – wet diaper
1:45 p.m. – ate q/e/c/a cookies – 5
3:00 p.m. – ate b/a/gm popsicles – 3
**4:00 p.m. – ate a bite of one of Jed’s rice crackers – GRRR!**
5:30 p.m. – poopy diaper – perfect! (miracle!)
6:00 p.m. – ate broccoli – 3 stalks (approx. 1/3 c.), chicken – 1/2 c. (4 oz.), drank 1 glass gm
7:00 p.m. – ate dried cucumber slices – 13
9:35 p.m. – asleep – fought sleep pretty hard; fussed and thrashed over an hour but finally calmed and went to sleep

My notes under that day might read: “Day 3 of broccoli and it has been going pretty well. Some mucous in the poop. Reaction? Body adjusting? Don’t know yet. Stinker grabbed a broken bit of cracker off the floor while Jed was eating. I HATE ACCIDENTAL INGESTIONS! But things have been going well enough that we decided to keep going and just observe for now. Hopefully it won’t be enough to cause a reaction to confuse the food trial. Concerned about fighting sleep at night. Not normal for him. Will watch to see what he does overnight and tomorrow. Hopefully it’s just the rice cracker and nothing more.”

__________

All this is fictional, but fairly accurate for a typical food and symptom entry for Zac.

I don’t write down nursing on the paper log, simply because I don’t often have the notebook with me when I actually nurse him. Every nursing session is recorded in an app I have on my phone.

Since I’m the only one who nurses him, that works well for us. Everything other than nursing is recorded in the notebook, so anyone can write down the other data there.

Using the app for nursing makes it easy for me to cross-check nursing session numbers and length of time, since the phone keeps an accurate time-log of how long he actually nurses.

During food trials, I’ll sometimes even grab the number of nursing sessions and total time nursed from the app and write in in the food journal book. (He normally nurses 3.5-4 hours per day; if he nurses for 7 or 8 hours on a food trial day, that is concerning, since that could be a sign of comfort nursing.)

I’ll often write something like “Broccoli: Day 3” at the top of the page, too, to make it easier to flip through the book to find food trial data.

I usually include any activities we do, such as going to the park, playing in the sandbox, or coloring with beeswax crayons…just in case. Such things can prove useful when you have an unexplained reaction.

If he’s especially cranky or fussy, I note that in my comments – unless there’s a specific tantrum he has, which would get noted in the timeline. This often helps me determine if he’s having a reaction or doing a typical baby thing like teething.

As you can see, there are lots of options for keeping track of food intake and reaction symptoms. You may decide, like us, to use a combination of record keeping for reasons that best suit your purposes. 

Whatever way you go, though, be as detailed as you need to be. Write down everything you can think of at first. Quantity of food, any unusual behavior or potential reaction signs you see, any activities that are atypical for you, and times and dates are vital. Anything else, like my daily summary, is icing on the data keeping cake.

If you have any tips or questions about food and symptom journals, please share them! I’m sure this isn’t a comprehensive list, and I’ll be happy to include anything that you can think of or fill in any blanks I may have left.

How do you prefer to keep your food journal?