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!

Food Allergies in Babies

Food Allergies in Babies

In Ireland it is estimated that food allergies affect 40% of children 30 % of adults.  The prevalence, severity and complexity of the reaction are rising.  Therefore, education in allergies is vital for all parents, pre-school carers, teachers and medical staff. 

Recently I read an interesting piece suggesting that most babies are diagnosis as allergic to milk on the first night following birth when that lovely, lovely nurse tries to assist the mum in getting some well deserved sleep and gives the baby his/her night time feed using formula.

If a baby has eczema, reflux or asthma they are at higher risk at having an allergy.   

If a baby has eczema whilst being breast feed they are a high risk of being allergic to milk. 

Food allergies are far more common among children in families where other members suffer from an allergy. 

What is a food allergy?

Food allergies occur when your immune system become confused and instead of ignoring harmless food proteins.  It triggers a reaction that leads to the release of the chemical called histamine.  It caused allergy symptoms like hives, swelling and in severe cases respiratory wheezing and reduced blood pressure called anaphylaxis.   Food allergies are an allergic reaction to food or an ingredient in a food.  This is called an allergen.  Symptoms vary in severity and most reactions occur within minutes but some may take up to several hours.

How do I know if my baby has a food allergy?

An immediate reaction after the food is digested is easy to spot.  You would witness the following:

Swelling of lips, face and eyes.

Hives, welts, itchy skin, rash

Tingling mouth, abdominal pain, vomiting nausea

Severe Allergic Reaction (one of the following symptoms)

Difficulty/noisy breathing

Swelling of tongue

Swelling and tightness in throat

Difficulty talking and /or hoarse voice

Pale and floppy

Wheeze or persistent cough

Condition steadily worsening.

You need to get help urgently phone 999or 911.  Seek urgent medical attention. 

However, some reactions take longer and may present as

Eczema

Reflux

Poor growth

Swelling in the small bowel

Constipation and/or diarrhoea

Raising knees to the chest with tummy pain

Frequent distress and crying.

If you have a baby with any of the above symptoms you need the help of an experienced Doctor. 

What is the next step if you suspect a delayed allergic reaction? 

Keep a Food Diary document if the baby experiences any of the above symptoms and when.  This way, with the help of an allergist you may be able to identify the trigger. 

The weaning process is very important in the diagnosis of an allergy, sensitivity or intolerance.  (See home page) 

Try each food individually for 4 attempts documenting any of the above symptoms

Get referred to an immunologist/allergist.

Get referred to a dietician.

Signs and Symptoms of an anaphylaxis reaction

Swelling of lips, face and eyes.

Hives, welts, itchy skin, rash

Tingling mouth, abdominal pain, vomiting nausea

Severe Allergic Reaction (one of the following symptoms)

Difficulty/noisy breathing

Swelling of tongue

Swelling and tightness in throat

Difficulty talking and /or hoarse voice

Pale and floppy

Wheeze or persistent cough

Condition steadily worsening.

What is the next step if your baby experiences an anaphylaxis reaction?

Seek urgent medical attention immediately.  Phone 999 or 911.  

Get treated at the Accident and Emergency Department

Do you need Adrenaline? Normally if there was respiratory involvement they will recommend Adrenaline.

Get training on how to administer the Adrenaline? When to administer the Adrenaline?

How much Adrenaline? (This is assessed on weight)  In Ireland, babies under 1 years are Adrenaline is unlicensed to give via Epipen and Anapen.  So you may have to draw the medication up and administer. 


What order do you administer drugs – Antihistamine-Steroid- Adrenaline? 

Action Plan:  Draw up an Emergency Action Plan

Involve your family and friends.  Use all the support you can around you.

Ask questions.  If you don’t understand something ask and ask and ask until you understand.  People with Allergies depend on the persons around them when they have a reaction.  You are your babies advocate.  You will have to develop a very strong back bone.

Be aware as you baby has triggered to one allergen their may be more.  Be vigilant. 

Avoidance is the best treatment.   See day to day tips on Home page.

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