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allergies

Many moons ago, when Maya was a wee thing of only 18 months old, she had an allergic reaction to peanut butter, which landed us in the allergist’s office for allergy testing. The almost immediate hives that sprung up on her back in several spots made it apparent we were dealing with a nut allergic kiddo. Sure enough, after the testing window was up, the results indicated a fairly severe allergy to peanuts, cashews and pistachios. Epipen in hand we went on our way.

Here we are 3.5 years later and we found ourselves in the allergist’s office again. Our pediatrician in St. Louis recommended retesting Maya at 5. Our pediatrician here in Seattle said she would have probably recommended retesting sooner, but 5 worked, so she referred us to a great allergist here. I admit I was hopeful going into this appointment. Perhaps too hopeful.

Our appointment was first thing in the morning and this clinic deals with a lot of pediatric patients so they were well equipped for my two kiddos to be running through their halls. The staff was wonderful, the receptionist got us checked in super fast and the nurse has us back in the office 20 minutes before our scheduled appointment! The nurse was great and super friendly with Maya, which helped calm her nerves a little. After a brief once over by the nurse the doctor came in. She was super sweet and very informative. We went over Maya’s history at length, including everything I could remember from her previous appointment, many moons ago. She went over in great detail what they are looking for in retests, specifically what indicators they hope for that would show Maya is perhaps on her way to outgrowing this allergy and what indicators would show that she may be one of the 20% who never outgrow their food allergy.

Once our long, and very informative conversation with the doctor was over it was time for the actual testing. Maya is, shall we say, a bit over dramatic when it comes to needles, bandaids, pricks of any kind from medical professionals. I had done my best to prepare her for what to expect at this appointment but I don’t think she completely understood. She flipped out a bit when the nurse came in with a tray full of little pins! The nurse did a great job of calming her down and talking her through everything she was going to be doing. Maya laid down on the table and was super brave. She did cry the whole time, but given her history for melodrama I was very impressed. With the allergens in place on her back we began the waiting game.

The waiting game didn’t last long. Within minutes she started to develop hives in several locations including the peanut, cashew and pistachio spots. Halfway through the testing window the nurse came in to check on her and this is what her back already looked like :(

6 minutes later when the test was complete each hive was bigger and there was no question she was definitely still allergic. The nurse came in and measured each of the reaction sites. The doctor returned to go over the results. Just as I had expected from watching the hives rapidly develop on her back during the test she is still severely allergic to peanuts, cashews and pistachios, and has now added pecans and brazil nuts to the mix. Her allergy has not gotten any better over the last 3+ years, in fact it has gotten worse. Each of her reactions was worse than her previous testing plus she reacted to 2 new nuts. I was so incredibly bummed by that news.

So, what do the results mean? Well, they mean that Maya is still severely allergic to peanuts and tree nuts (more so than before). She will still require an epipen. And, she is getting closer to the likelihood that she will never outgrow this allergy. The doctor recommended retesting in 3-4 years to see where we are. There is still hope for her to outgrow this allergy, but her chances definitely took a big hit today.

Allergy suffers are always the first to know when spring has arrived.  The itchy eyes, runny nose, coughing, all around crappy feeling of seasonal allergies is never fun.  But most especially not fun for babies and toddlers who suffer from dreaded seasonal allergies.  As parents we want to make our little ones feel better.  We want to do something to make the runny nose, itchy eyes and all around yucky feeling go away, but when you have a child that suffers from seasonal allergies that isn’t always easy to do.

For the most part seasonal allergies (hay fever) do not set in for kids until they are 3 years old or older, however, some toddlers and even some babies will begin exhibiting signs of suffering from seasonal allergies much earlier than that.  A lot of the time parents don’t know if their child has allergies or is just sick with the common cold since the symptoms are so similar.  There are a few ways to tell if the stuffy, runny nose your child seems to continuously have is caused from the pollen in the air or just a common cold bug.

It is likely allergies IF:

  • The mucus is thin and clear and doesn’t change to a thicker, more yellow colored mucus.
  • The stuffy, runny nose last more than a week or so.
  • There is no fever associated with the symptoms.
  • Your child has itchy, watery eyes.
  • The symptoms are worse in the early morning hours or after an extend stint of playing outside.
  • Your child has dark circles under their eyes even when fully rested.
  • Your child is wiping at his or her eyes and nose frequently.

If you suspect that your child may be suffering seasonal allergies you should make an appointment with their doctor to get them checked out, tested and on the path to relief.  The doctor will either do the allergy testing themselves or refer you to an allergist for full testing.  The testing will determine what allergens trigger your child’s symptoms and from there the doctor can recommend a course of action to give your child some relief.

Common treatment for seasonal allergies in children include:

  • Avoiding outside play during peak pollen time, the early morning hours of about 5am – 10am.
  • Washing your child’s clothes, blankets, etc frequently.
  • Keeping your home well dusted.
  • Using the air conditioner instead of opening windows whenever pollen counts are high.
  • Getting rid of any offending plants or trees from your own yard if possible.
  • Use of an antihistamine, either over the counter or prescription, as recommended by your child’s doctor.

If you have questions or concerns about your child’s symptoms be sure to contact your child’s doctor to discuss those concerns and determine if your child is indeed suffering from seasonal allergies.

halloween candy

Before Maya was diagnosed with a peanut and tree-nut allergy I didn’t give any thought to what kids with nut allergies did on Halloween.  Trick-or-treating is a big part of Halloween and probably the part kids most look forward too.  Going around the neighborhood in their costume collecting candy from all the neighbors is what people most associate with Halloween.  However, if you have a child with a nut allergy the candy part of Halloween can become a bit scary.  A lot of what ends up in your child’s trick-or-treat bag will either contain nuts or present a cross contamination risk.  You don’t want to have to take that joy of trick-or-treating away from your child.  They go through enough in life because of their nut allergy that makes them feel different, this doesn’t need to be one of them.

Making Halloween safe for your nut allergy child doesn’t have to be difficult, it just requires a little forethought on your part and a little imagination to make your child feel special and not left out.

If you are comfortable it is perfectly safe to continue to let your child trick-or-treating with his or her brothers and sisters and friends.  Set specific ground rules and make them apply to all your children.  Such as, no one is to eat, unwrap, play with anything they get in their trick-or-treat bag until they get home and you have a chance to examine it all (this rule should apply regardless of whether your child has a nut allergy or not).  Once your child gets home take their trick-or-treat bag and go through it.  Remove all candy that contains or may contain nuts.  Many parents with nut allergy kids do an exchange, for everything they take away they replace it with something that is safe.  You could also just have a trick-or-treat bag pre-made for them them and when they come home exchange they bag they have for the new safe bag.

There is plenty of Halloween candy that is safe for nut allergy kids.  Here is a list of a few I could think of (be sure to always read the label as some manufacturers may change their processes at any time):

  • Skittles (all varieties)
  • Most jelly beans
  • Anything made by Haribo
  • Hershey Kisses (except the peanut butter and almond varieties)
  • Full size Hershey Milk Chocolate and Krackle bars
  • Milk Duds
  • Hershey Kissables (great M&M alternative)
  • Rolos
  • Many Wonka products including; nerds, bottle caps, runts, gob stoppers, pixy stix and tart n tiny.
  • Smarties (rockets for my Canadian readers ;))
  • Laffy Taffy
  • Tootsie Rolls and Tootsie Pops
  • Lifesaver Gummies
  • Whoopers (except the peanut butter variety)
  • Sweet Tarts
  • Sunmaid chocolate-covered raisins
  • Twizzlers
  • York Peppermint Patties
  • Red Vines
  • Jolly Ranchers
  • Starburst
  • Candy Corn (read label carefully)

Remember to always read the label carefully as not all varieties, particularly non-name brand versions can be manufactured in facilities that also manufacture nut products.

You will likely have to spend a bit more time in the candy aisle than most people because you’ll have to read labels carefully.  Luckily there are lots of options so you will be able to find several things to hand out for Halloween and to give to your child as an alternative.

Our plan this year, since Maya is still so young, is just to let her to a little trick-or-treating on our street and just keep what is safe.  She doesn’t need a lot of candy, so I figure what she is left with should work out just fine.  Once she is older I plan on doing the exchange with her by taking what isn’t safe and replacing it with something that is.

What tricks do you use to keep your nut allergy child safe on Halloween?

I’ve learned that having a child with a nut allergy means you have to read the labels of everything you buy a little more carefully. As you load your grocery cart you are looking for actual nuts in the ingredients list of everything you pick up as well as special label warnings such as “may contain nuts”, “produced on shared equipment with nuts”, or “produced in a facility that also processes nuts”. Since even the smallest amount of nut protein can result in an allergic reaction it is always best to steer clear of any product you either suspect may contain nuts, or you suspect may have come into contact with nuts.

Remember, there is a lot of stuff out there that is perfectly safe for your child to eat and the more you learn about nuts and nut allergies the better you will get at identifying safe and unsafe foods.

There are a few foods that are considered “high risk” for those with nut allergies. They include;

  • Baked goods: Unless you make it yourself or it has a clear label that it is safe it is probably a good idea to avoid it. Cross-contamination is very common with baked goods as there is a lot of sharing of prep surfaces, cooking surfaces and cooking utensils.
  • Candy (especially chocolate): There are a few candy manufacturers that make some of their chocolate and candies in nut free facilities, however, most are prepared on shared surfaces with nut products. Read the labels carefully. If it isn’t labeled as safe, skip it.
  • Ice Cream: Cross-contamination is very common in ice cream parlors. The same scoop is used over and over again. Even soft serve can become cross-contaminated if the same machine dispenses multiple kinds of ice cream. Do your research before allowing your child to eat ice cream while you’re out. The safest thing to do is to buy a carton of ice cream from the store so you know what the ingredients are and you know the product is safe.
  • Ethnic Foods: African and Asian cuisine often contain peanuts and tree nuts. With Mexican and Mediterranean cuisine cross-contamination is possible as some of their dishes may contain nuts. It is best to avoid these foods unless you absolutely know it is safe (ie you made it yourself or have talked to the restaurant owner and chef).
  • Sauces: Many chefs use peanuts, peanut butter, or other nuts to thicken their sauces. Read labels, talk to the restaurant manager, and know it is safe before you allow your child to consume it.

To name a few. It really comes down to doing your homework. Thankfully food labels are a lot easier to read now adays and often contain special warnings that make it so much easier to identify safe and unsafe foods. Nuts can be easy to avoid if you know what to look for.

Here are a few helpful websites:

As I mentioned last week Maya was referred to an allergist for some testing due to a possible peanut allergy. Well, we had that appointment today. I had done a little research about what to expect at the appointment on a few forums and through talking with her pediatrician (whose own daughter has a nut allergy). I was a little worried about the appointment since Maya HATES all doctors and nurses (anyone in scrubs!) and I had heard that the tests can be particularly difficult for little ones because they don’t understand what is going on and have to sit still for an extended period of time. Luckily, it wasn’t as bad as I thought it would be.

Maya started getting tense as soon as we entered the building and started crying as soon as she saw the receptionist behind the desk. Our appointment was one of the first of the day so we didn’t have to wait at all, we were taken right back into an exam room. Maya cried the whole time Dr. Allergy was in the room with us. It made it a bit difficult to talk about her medical history, family history, etc :). Every time Dr. Allergy or his nurse entered the room she would start crying and saying “all done” and “bye-bye”. Thankful she would stop crying as soon as Dr. Allergy or his nurse left the room so that made it a little easier on her and me.

The test itself wasn’t too bad, really. They used a small plastic disc with tiny pins on it. The allergens were put on the ends of the pins and then the pins were pressed into her back. It leaves behind an oil droplet so I had to be careful that neither Maya or myself touched her back. This was the part I thought would be particularly difficult since not many 18 month olds are game for sitting still. To my amazement she gladly sat still. I sat in a chair and just had Maya laying on my chest. She was happy to lay there contently and actually fell asleep for a few minutes while we were waiting to see what would happen. The nurse came in part way through the test to check on us and Maya cried but was fine again as soon as she left the room.

After just a couple of minutes I could see red marks forming on her back and figured that probably meant she was allergic. Sure enough, the nurse came back in after 15 minutes to wipe it all off her back and apply some cream to alleviate the itching and swelling, she said she tested positive for peanuts, cashews and pistachios. Poor Maya is allergic to both peanuts and tree nuts. I’m so bummed for her.

The doctor gave us a prescription for a Twinject, which is a type of epipen along with a list of instructions on when to use it. Pretty much if she ingests nuts and has any sort of reaction, be it a rash, swelling, or shortness of breath we have to administer the epipen and then call 911. Needless to say I was a little freaked out listening to the doctor explain it all.

One of my biggest questions for the doctor was how she ended up with a food allergy since there is no family history of food allergies on either my side or Daddy’s side and she has no other allergies. Well, it turns out that children with a family history of asthma or eczema do have a higher risk of having nut allergies (thanks Daddy’s side of the family ;))

There is a small chance, about 20%, that she will out grow this allergy so we will take her back in a few years for additional testing. Keeping my fingers crossed that she is one of the few who out grow it.

I’m off to do a ton of research on nut allergies, safe foods, etc. I’ll share what I find.