Allergy Baby: February 2012

This week I realised that we are fast approaching the 1 year land mark birthday. Where did that year go? He has completely uncurled. The baby stage is gone. He is shuffling on his bottom from room to room, exploring the world. Fighting for his toys, demanding his sibling toys and full of cuddles and kisses.

But in the background he lives with allergies, where his body doesnt like dairy, egg, soya, tree nuts and some fruits. The MMR vaccine concerns me as evidence in literature shows there is a trace of egg protein. Some reseach states the vaccine is cultured in egg but the egg trace is so low it is safe in the use of children with egg allergies.

Professor John Warner, Chair of the BSACI Paediatric Allergy Group and Professor of Paediatrics at St. Marys Hospital, London said "Egg-allergic children who have not had problems with other vaccinations can safely be given the MMR in primary care. Specialist asssessment is only required if any previous vaccinations have resulted in severe allergic reation (including any breathing problems or collapse)" http://www.politics.co.uk/opinion-formers/royal-college-of-physicians/article/rcp-new-recommendations-for-mmr-vaccine-in-egg-allergic-chil
In addition the British Society for Allergy and Clinical Immunology guideines for the management of egg allergy agrees that all children with egg allergies should receive the MMR. They explain that large number of studies of egg-allergic children show there is no increased risk of severe allergic reactions to the vaccines. Children who have documented anaphylaxis to the vaccine itsself should be assessed by an allergist. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2222.2010.03557.x/pdf

So I understand why my allergist is not concerned about Thomas recieving the MMR in primary care.

On http://www.patient.co.uk/doctor/Measles-Mumps-and-Rubella-%28MMR%29-Immunisation.htm it advices that if a child is allergic to egg. Immunisation under supervision by a paediatrician is advisable.

So what if he does react? What then? These are factors I have to consider in my decision making process
1. The closest A&E is 1 hour in ambulance
2. Majority of ambulance technicians are not paramedics.
3. Primary Care is not set up for such emergencies.
4. Very importantly the GP is not happy to administer the MMR to Thomas.
5. Experienced mothers to egg allergic children say that even though their children did not react to the MMR they would have certainly considered paederiatic supervision if they were aware that there is a trace of egg in the MMR.
6. A medical colleague suggested single dose of the MMR.

Even though the research is clear that the MMR is safe to administer to egg allergic children. I have to consider the huge flashing factor here is my GP is not happy to administer the MMR to Thomas. My instinct tells me to take all precautions and go with the safe, security of the hospital environment.

On the introduction of this blog I write "Questioning is the door to knowledge". You are your child's advocate. You need to develop your knowledge make informed discussions. I am writing this piece to show you;
How I reached MY decision.
How I problem solve.

This decision is not right for each individual child. You as the parent need to write down the pros and cons and come to your own decision. You need to research! Ask for support and advice! Question!

So I have asked my GP to organise that Thomas has his MMR in a hospital environment under the supervision of the paediatrics.

I will keep you posted but need to organise a dairy, soya and egg free birthday party first!

This is not medical advice!

Wednesday 29 February 2012

WHO | Formulas containing hydrolysed protein for prevention of allergy and food intolerance in infants

Tuesday 28 February 2012

Food Safety Authority

We are our childrens advocates; so therefore we need to arm ourselves with information. This summaries the labelling legistration in Ireland...

http://www.fsai.ie/faq/allergens.html#legislation

Monday 27 February 2012

Reflux, Asthma and Ezcema are warning signs for Intolerances and Allergies

"Arching back means reflux, Knees to the tummy means colic" Wise words from my GP a mother of 4 boys. Both of my older children were diagnosed with silent reflux and were successfully treated with Gaviscon. At home all the cots are elevated at the head, sleep apnea mats under the mattress and Gaviscon in the medicine cupboard. After each feed I would sit them in a bouncer for 30 minutes before bed. I watched out for the signs and symptoms; discomfort after feed, arching back, crackling upper airway, strong acidic smell from spit/vomit, unable to lie down after feeding.

So when Thomas was born I asked for him to be prescribed Gaviscon. All 3 children were breastfed. I found that with each individual child there were different triggers that would exacerbate their reflux for example citrus juice, broccoli, olives or sparkling water. In addition to Thomas reflux, if I ate dairy products e.g soft cheese, cheese cake, ice cream it would reflect on Thomas' skin. His face would flare up and become itchy. He was also showing signs of asthma. So I cut out all of the foods that increased reflux and now I was cutting out dairy. Much to my disappointment, I had to stop breast feeding I couldn't control his symptoms.

Recently I read that if your baby has reflux, asthma and eczema they are high risk of presenting with allergies. In addition it is recommended that if your baby reacts to dairy whilst been breastfed, he/she chances of being allergic to dairy is high. I wish I had explored this area of research before offering him milk formula. He reacted to milk formula. Initially, it was a mild rash but a typical allergic reaction starting on the chest and moving up to his face. My GP recommended soya milk so off we went with our soya milk but he couldn't keep it down without two sachets of Gaviscon. He appeared lethargic and groggy. His first major reaction was to porridge with fortified milk. Which I have described on my http://allergybab.blogspot.com/. We saw an Immunology Specialist and she stopped the soya. Because if you baby is allergic to the protein in milk they are likely to be allergic the protein in soya. Thomas was commenced on amino acids hypo allergic formula. Within 3 days he was a different child, he started to roll and move and interact more.

All children were different, Thomas was more complicated than the other two children. Initially, he had reflux but quickly presented with eczema and asthma. So if you have a baby with any one or more of the above look at their feed. I wish I had put it all together. I started a blog http://allergybab.blogspot.com/ to help mums who are in the middle of that haze of confusion. I am also on twitter at #IrishAllergyMum. On the blog I look at allergies, intolerance and sensitivities. I would love to help mums by sharing my experiences, problem solving and provide advice on emergency action plans, food diary and dairy and soya free recipes for babies.

This was a guest blog for baby eureka who focus on reflux recovery www.babyeureka.com

Delay in Milk Allergy Diagnosis

This makes a very interesting read..http://news.bbc.co.uk/2/hi/health/6157490.stm
Education and awareness in the diagnosis of milk allergies needs to heightened. My son first is a classic milk allergy case, presenting eith ezcema, reflux and asthma whilst breast feeding. I spoke to my GP in relation to cutting out dairy in my diet ti control his skin condition. Thomas was also commenced on Soya Milk which did not improve his condition. After seeing a allergist who stopped his soya milk he was a different child after 3 days and has not looked back.

Friday 24 February 2012

Allergy Proofing a Party

If a parent informs you that their child has an allergy don't stress out! With some common sense and logic you can safely allergy proof your party. Talk to the parents ask them about the allergy.
1 What is the allergy?
2. How does it affect the child?
3. What foods they can and cant have?
4. At the party show the parent the food and drinks being served and ensure that they are happy. With severe allergies the parent may supply their own food.
5. Ask the parent to stay if you are concerned or nervous.
6. Does the child require adrenaline and if they do where is it? And do they have an action plan?
7. In my opinion, if a child requires adrenaline and you are not happy to medicate ( very reasonable fear) ask the parent to stay.

I can promise you the parent will be delighted and relieved if you show that you are interested. Go tohttp://allergybab.blogspot.com/ for more advice on a common sense approach to allergy proofing a party.

Wednesday 22 February 2012

Afraid of introducing fish to your allergy baby!

Ohhhh how I put off the introduction of fish... As fish is one of the top 8 allergens I was very nervous about introducing fish. If you baby is allergic to fish I would recommend do not introduce fish without medical supervision. Avoidance is the best treatment. However, I followed these steps:
1. His blood results were negative to fish allergies. So speak to you Immunologist about you babys blood results.
2. If you are introducing a new food, pick lunch time or morning time.
3. Inform your partner or friend so you have support if needed.
4. Ensure you know where his/her medication are.
5.Try a small amount, they will react within a few minutes if they are going to react.
6. Observe after the meal, some times they will develop a hive rash under the chin, behind their legs. Treat as instructed by your specialist eg antihistamine. If this occurs stop feeding and treat. Follow your action plan.

On http://allergybab.blogspot.com we advice on signs and symptoms of analphlaxis and action plans.

Monday 20 February 2012

Dairy,Soya and Egg Free Pancakes

This are super fluffy delicious pancakes for finger food and one the whole family can enjoy. You can add blueberries and/or diced banana into the cold mixture.

Ingredients
150g of white flour
3 tablespoons of caster sugar
1 pinch of salt
2 1/2 teaspoons of baking powder
45mls of melted margarine*
210 mls of water/ rice milk*

1. Sift flour, baking powder, sugar and salt together in a meduim mixing bowl.
2. Melted the margarine and add to the water/rice milk and mix well.
3. Stir the wet ingredients with the dry ingredients. Until moistened dont worry if there are some lumps. However, if you are like me and tied for time put everything into the blender and blitz! You can add blue berries and banana after blitzing.
4. Cook the pancakes until they are bubbly on the top and the bottom is golden brown approx 4 mins.
5. Flip over you pancakes cook the other side.

For over 1 year you can serve with honey/maple syrup. or slice as great finger for food.

Notes *
Rice Milk is dairy and lactose free, gluten free, low in saturated fats. It is made from water and rice. It does not contain as much calcium and protein as normal cows milk but most commerical rice milk are foritified with calcium,, vitamins thiamine, B6 and B12.

Margarine- This is a tricky find in Ireland however, there are dairy free, soya free maragines on the market in large shopping stores. I rubbed the maragine on Thomas leg first to test for allergy and then used with potato or dairy free homemade bread. I will not recommend a brand as I think this is individual to the child. But you can email me for ideas.

Saturday 18 February 2012

Food allergy safety: Avoiding cross-contamination in your home

Friday 17 February 2012

Cross contamination of foods with allergenic ingredients

Video on Allergy to Milk

http://video.about.com/foodallergies/Learn-About-Dairy-Allergies.htm

Wednesday 15 February 2012

Dairy free soya free nut oil free butter

I have just rubbed pure sunflower butter on to Thomas knee to test if he will react. He hasnt so I am about to mash it into his mashed potatos wish me luck!

Tuesday 14 February 2012

Allergist and Dietician

Please ensure you are refered to an allergist and dietican. This may seem basic but allergy awareness in Ireland needs work... My son was discharged from A&E without a referal. Also no one mentioned an emergency action plan. My GP organised an emergency appointment.

Sunday 12 February 2012

If you havent done an action plan please do one now. I have customise the action plan http://www.anaphylaxisireland.ie/downloads/ManagingChronicHealthConditonsatSchool.pdf I have added relative phone numbers, directions to the house and house phone number and what to say when you get through to emergency services eg name, age, allergies - drugs given.

Allergy, Sensitivity or Intolerance

Allergy – this is a reaction produced by the body’s immune system when it encounters a normally harmless substance.

Sensitivity – this is the exaggeration of a normal side effect produced by contact with a substance. For example, the caffeine in a cup of coffee may cause extreme symptoms, such as palpitations and trembling, when it would usually only have this effect when taken in much larger doses.

Intolerance – this is where a substance, such as lactose, causes unpleasant symptoms (such as diarrhoea) for a variety of reasons, but does not involve the immune system. People with an intolerance to certain foods can typically eat a small amount without having any problems. In contrast, people with a food allergy will have a bad reaction even if they come into contact with a tiny amount of the food they are allergic to.

Step by Step Advice

This is step-to-step advice on what to do in the initial stages of diagnosis.. This list is not finished as I am still on the journey of discovery too!
1. Medical Assessment and Treatement
2. Do you need anti-histamine and steroids? Do you require an anapen or adrenaline? Get training and education on how to use the equipment for you and your partner.
3. An Emergency Action Plan. What is your plan if your child has another reaction? I used this action plan as a template. I customised it.... Drugs to administer and how much, putting in the directions to the house, phone numbers, name age and diagnosis. http://www.anaphylaxisireland.ie/downloads/ManagingChronicHealthConditonsatSchool.pdf
4. Change milk product or soya product. Thomas was prescribed neocate hypoallergenic http://www.cowsmilkallergy.ie/product/availability-of-neocate/
5. Store your medication in a safe secure area where there is no change in temperature. (like a good bottle of wine) Also you know where to find it when needed.
6. Dont leave home without your medications.
7. Carry an extra one in your car but be aware in the cold of winter or the heat of summer it can cause the adrenaline to crystalise.
8. Practise using your anapen/epipen or drawing up the medication.
9. Talk to your pharamactist, take the adrenaline out and check it against the prescribtion. I found as the administration of adrenaline was very rare they gave me the incorrect concentration. Discuss how you will draw it up, do it and check it with someone else... check and check and check again not when you in the middle of an emergency. If you have a epipen or anapen look at how to use it, you can buy practise pens. Famaliarise yourself with it.
10. Your baby is covered by the neocate for calcium and iron. But you need to find alternative ways of introducing them into the diet.
12. Avoidance is the safest form of treatement.
13. Ask for dietican involvement.
14. Start a food diary - This will help you track what the triggers are and how to avoid them. More importantly it will help you to plan a diet plan for your baby.

Allergy Baby