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Q&A with Dr Andrew Clark, consultant in paediatric allergy, who is leading the world's largest peanut allergy study

(109 Posts)
GeraldineMumsnet (MNHQ) Mon 19-Apr-10 10:57:29

Dr Andrew Clark is a consultant in paediatric allergy at Addenbrookes NHS Foundation Trust and he has been in the news because he's leading a £1 million NHS-sponsored study into peanut allergy.

We're very pleased that Dr Clark, whose other research and clinical projects focus on improving the care of children with food allergy, has agreed to answer your questions about children's food allergies.

We'll send over the questions on this thread to Dr Clark on 24 April and put up his answers during the first week of May.

Thanks to Dr Clark, and TIA for your questions.

tatt Mon 19-Apr-10 11:26:16

Hope I may be allowed more than the usual one? If not priorities...

My nut-allergic teenager is rapidly approaching adulthood. Are there any plans to extend the trials to adults? (My teen might want to apply to Cambridge Uni.....)

We live too far from Cambridge to travel for frequent appointments, especially for a teenager doing exams. Do you have any idea when this might spread to other parts of the country?

And a general allergy question - I've always been told piriton is the fastest acting anti-histamine but came across some research suggesting benadryl might be. Which does act quickest on allergic reactions?

orangina Mon 19-Apr-10 12:18:39

Hello,

I have a ds aged 3. He doesn't appear to have any allergies as such, but he does have a viral wheeze/asthma, which he has had on and off since summer 2009. We keep it under control by using his blue inhaler, are not on a preventative at the moment, and he has had about 6 visits to a&e in the last 9 months but has never been admitted.

He eats most foods with no problems, but recently if he has ever had peanut butter (which is rarely as he doesn't even like it!), he starts to cry and hold his throat, and then gets in a panic. It's almost as though he is about to start wheezing. He eats all sorts of other nuts normally (almonds, cashews) as well as flapjacks etc that probably contain then, and has no problem at all. We have no history of allergies in our family on either side.

What do you think? I really don't think he has an actual allergy, but there does sesem to be some kind of sensitivity going on here. Should I avoid peanuts to be on the safe side? Should I avoid all nuts to be on the safe side? And if he does have a reaction like that in the future, or even worse, how do I deal with it? With his inhaler? Or a dose of piriton?

Many thanks,

LoveBeingAMummy Mon 19-Apr-10 12:32:14

Hello Dr Andrew

My DD who has just turned 2 seems to have developed a reaction to banana, it started in Aug last year. Basically if she eats banana normally the next monring when she filled her nappy it would result in almost a burning of her skin. Before this she had eaten them without any reaction, and certainly never ate them excessively. Even a small taste of banana ice cream caused a reaction. Is this a common allergy as I had not heard of it before? Also I suffer from hay fever and wondered if this means she will be more likely to have alleries? What if anything should i do, apart from keeping her away from banans (if that is the right thing to do).

I also wondered if there is anything i can do with regards to hay fever, i would hate for her to suffer from this. My mum knows the exact moment that trigger my hay fever and I would like to avoid any thing like this for my dd.

Thanks in advance

KerryMumbles Mon 19-Apr-10 12:32:16

In Dr. Clark's trials how many children have had severe or anaphylactic reactions to the desensitization process?

Will this cure be appropriate for all pa sufferers?

Is touting a "cure" responsible if it is not appropriate for all pa sufferers?

how is this treatment protocol different from other desensitization treatments that have resulted in anaphlactic reactions, even deaths?

what children would be considered good candidates for this cure?

who is funding your reasearch?

sporadicname Mon 19-Apr-10 12:44:01

My DD had an reaction to egg when she first had a small spoonful of scrambled eggs at about 10 months resulting in an itchy nettle type rash instantly across the mouth area. She has since eaten egg cooked in things like cakes with no reaction. She is now nearly 3, should I be trying her again with egg in forms such as scrambled?

HSh has had 2 other reactions to foods resulting in welts across the body and once with slightly swollen lips. GP was uninterested and said that they can't do tests for food allergies??! shock hmm So I am not sure how to proceed.

TIA

bridewolf Mon 19-Apr-10 13:07:41

how have the first batch of children coped with life after high tolerance level reached?

have they acepted the daily tolerance dose , and have any forgot and reduced their tolerance level?

how long will you moniter these children over the years, to confirm that the tolerance is life long, and stays at a high level?

do you think that these children would be able to give up carrying epi pens?

does the treatment have a positive knock on effect on thier other allergic diseases, such as asthma, or any other food allergies?

I have been told that this treatment , if sucessful will take some years before its widley avaliable, in about 20 -30 yrs, is this correct?

Babbit Mon 19-Apr-10 14:02:42

My daughter has a diagnosed peanut and nut allergy after suffering one reaction at the age of 18 months. She has recently turned 5 and had another RAST test which shows her sensitivity is decreasing (from 2.5 to 1.4). Is it likely this pattern will continue until she is not sensitive at all? (I have been practicing complete avoidance of all nuts and products which contain, may contain etc)

Is there any correlation in your view between sensitivity level and possible likely reaction to exposure?

Can she have ground nut oils (I have been told by an adult I know with a peanut allergy that processed oils are OK but since we have never been referred to a specialist I have not had an opportunity to ask questions and I do not like to experiment!)?

I have loads of questions but I expect some will be covered by others so I will leave it there for the time being.

Many thanks.

beggsie Mon 19-Apr-10 14:16:18

Dr Clark, I am very pleased to have this opportunity to ask some burning questions of you!

My ds (just 5yo) is allergic to Brazil nuts (identified through one clinical reaction - no breathing issues but mild swelling around the eye). He carries anapens for this. Skin prick tests show at present he is not allergic to any other tree nuts or peanuts. He doesn't have asthma or excema.

How likely is it that desensitization will become available for tree nuts?

In your opinion, should he be eating those nuts to which he is not allergic? At present we avoid all nuts like the plague, but I have heard differing advice/strategies. Same question for those annoying 'may contain' labels!

Once desensitisation occurs in the peanut trial, is it necessary to eat small amounts of nut everyday?

I look forward to hearing your answers (and to those other questions) - your work gives me and others great hope for the future!

brimfull Mon 19-Apr-10 14:27:32

Hi Dr Clark , I brought ds and dd to Cambridge for your star study about 3yrs ago I think , could be longer.
We were very pleased that ds could have eggs after the food challenge with a cupcake and now he frequently enjoys pancakes for breakfast -so thanks !

He has had a few slight reactions to some things with eggs though .
Once some homemade brownies that had loads of eggs in them , but cooked over 180deg for longer than 20mins, made his lips swell and throat itch.

Can the sheer amount of the allergen change the reaction?

wheredidmyoldlifego Mon 19-Apr-10 14:28:08

Dr Clark,

Very interested in following the results and outcomes of your current research into desensitizing of children and food allergies.

Our son is 5, has allergies to sesame, tree nuts (but not sure which ones) and egg white as well as egg yolk.

He also had a significant amount of chemotherapy (vincristine, ifosfamide and actinomyscin D) between the months of 3 years 3 months and 3 years 11 months (for treatment of parameningeal alveolar rhabdomyosarcoma).

We had been told his allergies would go or at least decrease upon finishing chemo and his reactions on skin prick test have increased twice now since completion of his cancer treatment.

Any ideas if this means his allergies T1 / T2 cells are so in-bred in his allergies that he won't grow out of the allergies and indeed the chemo did not get rid of them?

Dr Clark, my son ate (home made) seafood risotto when he was around 9 months old (having already eaten prawns without problem before then) and the roof of his mouth swelled massively and remained swollen for 2 or 3 hours. Since then (he is now 18 months) we have not given him seafood again, except for prawns (which our GP advised we should do). The risotto also contained scallops, mussels and a little squid, together with fish stock from a stock cube.

My GP's simplistic approach to this is to say 'just don't give him seafood'. He has not referred him to anyone, but has given some steroids (prednisolone iirc) for us to administer in the event of another reaction.

My concern is that if he starts nursery in a few months time he may accidentally come into contact with seafood (parents provide packed lunches) and any action taken by the nursery might be too late .

Is there a better approach than the one offered by my GP, and if so, what is it?

Should we offer him some seafood sitting in the hospital car park? His sister likes crab sticks but hasn't been allowed to have them since in case he gets hold of them - could we try him with one of these?

(fwiw he also has a milk protein intolerance/allergy, but this is less severe than the reaction to seafood, and we are hoping that he will grow out of it like his sister did.)

TeamEdward Mon 19-Apr-10 15:41:33

Dr Clark,
My husband has a severe nut allergy (all nuts) and our HV suggested that we avoid giving our children nuts. My eldest son has just started school and we are worried about him coming into contact with nuts, but on the other hand cannot honestly say to the school "He has a nut allergy."
Our GP has told us they cannot test for such an allergy unless the child has already had a reaction.
Short of sitting in A&E with a jar of Sun Pat in one hand and bottle of Piriton in the other, what are our options?
Is it likely our sons have an allergy? Where can we go to get tested if the GP refuses?

(Background info - DH is also allergic to eggs. I have no food allergies but have asthma, hayfever and allergy to fur/feathers. Both DS have mild eczema.)

Thank you in advance, TeamEdward

LaDiDaDi Mon 19-Apr-10 16:23:22

Dr Clark,

My daughter aged 4 years is allergic to lentils, peas and soyabeans. She is to be tested for allergy to chick peas, other legumes and tree nuts all of which I currently avoid in her diet.

I have a 4 month old son who is currently exclusively breastfed, would you advise waiting until 6 months before weaning and then not introducing the foods that dd is allergic to until nearer one year or do you think that the overlap between breatfeeding and introduction of allergenic foods is more important? In which case I would introduce these foods earlier as I plan to stop breastfeeding when I return to work when ds is 9 months old.
I would also add that I am a vegetarian and the foods that dd is allergic to feature heavily in my diet and I probably introduced them to her diet when she was weaned at 6 months.

Thanks

LaDiDaDi

tatt Mon 19-Apr-10 17:08:37

just thought of another question

Some gps seem to be very poorly informed informed about allergies as questions on this site sometimes refer to gps saving "nothing can be done" or "no tests are available" when it's clearly not true. Even paediatricians are not always well informed (had to give one information from the Anaphylaxis Campaign after being told a test was unavailable). So what can allergy consultants do to help educate them - maybe some articles for the British Medical Journal?

lenga01 Mon 19-Apr-10 17:59:35

Hello,

My daughter wh is now 4 years old has a nut allergy, but has yet to have an allergy test or any confirmation. I have been referrred countless of times through my gp and via emergency hospital visits but still no tests.

We have been treating her by avoiding all nuts and nut traces as it seems like she is very allergic (she once licked a dairy milk bar and had a very sever reaction). The problem is now that she is starting school in Sept and I ahve started to notice that she is having reactions to other foods and I am getting concerned that if we don't know 100% what she is allergic to that she may have a reaction at school.

Is there anything I can do to get a reliable allergy test that will tell us exaclty what she is allergic to and would we be prescribed with any emergency medicines (such as an epipen?) I am also 18 weeks pregnant and am very concerned about if I should be eating nuts or not? I ahave been told to both eat them and avoid them so I don't know what I should be doing.

Skimty Mon 19-Apr-10 18:48:35

Dear Dr Andrew

My daughter (18mths) had been skin prick tested at St Thomas' and has confirmed allergies to peanut, tree nuts (several but unconfirmed which ones), sesame, egg white and raw eggs (although she tolerate cooked egg as an igredient) along with eczema and wheezy breathing. There is very little family history of severe food allergies and neither myself, my husband nor our 3 year old have shown any allergic reactions. We have been told that she will have to use an epipen when she strrts nursery.

I have three questions:

1) What are the chances that she will outgrow any of these? She hasn't had a rection since 10mths.
2) I am currently pregnant with my third child. I am confused as to whether to avoid peanuts although I am as we have none in the house. Also, what can I do to avoid the new baby developing allergies? I breast fed my daughter and didn't introduce solids until 6 months but in hindsight my own consumption of peanut butter was causing her baby ezcema.
3) My daughters (Sainsburys own brand) nappy rash cream contained peanut oil and I used it on her at a few weeks with very sore nappy rash. Could this have sensitised her?

Skimty Mon 19-Apr-10 18:49:05

Sorry, posted too early. Thaks you for reading!!

PussinJimmyChoos Mon 19-Apr-10 20:44:45

Dr Andrew

What do you think is the cause behind the number of allergies that we are seeing in the modern generation? Do you think that the elimination of so many things for pregnant women is actually contributing to the problem? I appreciate that there are a number of factors to be considered but would be very interested in your view point smile

PixieOnaLeaf Mon 19-Apr-10 21:07:17

Message withdrawn

Squiz Mon 19-Apr-10 21:10:41

Dr Clark

My son had positive RAST test to sesame seeds and a year later to hazlenut, although skin prick tests show negative.

AT this time he was tested for all nuts which were negative beside hazlenuts, since then when he has tried anything with nut in it - brazil nuts, almond (generally in chocolate) he has a reaction which consists of itchy, hot throat, and he vomits if not given antihistamine.

Should we avoid all nuts just in case? Although he has had negative RAST test results for nuts is this because he had never eaten any of them before the tests?

icedcake Mon 19-Apr-10 21:15:58

I know it has probably been asked and answered but I would really like to know the answers to the following from his perspective/research -

1)Should you wait until 6 months OF BF/FF to introduce solids to a baby and why?

2)If you early wean before 6 months then what are the risks of allergies?

3) Is there any link between reflux in babies and allergies?

OkieCokie Mon 19-Apr-10 21:19:57

There is no history of food allergies on either my or my husbands side, although my husband suffers from hay fever. I often wonder why my son has multiple food intolerances and possible allergies to many things including wheat, egg, nuts, diary, oats.

I have 2 questions:

Is there more incidences of food allergies in rural or urban areas?

Is there any link between antibiotics being given to new borns and the subsequent development of food allergies and intolerances in babies/very young children.

Thanks

LadyBlaBlah Mon 19-Apr-10 21:30:13

I think the questions I have have been asked already and I would just like to say loving your work - it is so exciting ! DS1 is allergic to peanuts and almonds and I am beyond excitement that at some point in his life he will probably be de-sensitised......I just hope it is before he enters drinking /takeaway food stage of teenager-dom which is where my worry is concentrated!

I said to him recently that there is a trial going on that may 'cure' him of his allergy and his response was " I don't want to be cured. I like my allergy. If there is something I don't want to eat, I just blame it on my allergy!". Its like he has read the Daily Mail.

Cornishsmartie Mon 19-Apr-10 22:02:41

Hello Dr Clark

I have a daughter of five who has a severe peanut allergy. Her pre-school skin prick developed a weal of over 10cm which took several days to disappear. I am enormously excited about the desensitization program and hope it makes it to Truro before she starts secondary school.

Have you researched alternative medicine wrt allergies? What is your opinion on kinesiology as a "cure" for allergies? I have a friend whose four year old son used to get terrible hives when he came into contact with the cold (hands/face in winter, whole body if he got wet and then cold) and she claims this was cured by a kinesiologist and she is badgering me to make an appointment.

Thank you

topiarygal Mon 19-Apr-10 22:09:57

Thanks for the opportunity here, I have two burning questions, one of which Beggsie has already asked, so I repeat in the hope you'll have time to cover the subject:

Do you plan to widen the desensitisation programme to tree-nuts?

After extensive testing, my child's been diagnosed as iodiopathically anaphylaxic as no cause can be found for some of his reactions, can you see a time when we can simply stay the reaction of the body, irrespective of allergen trigger?

many thanks for all your good work and your time here

needsdirection Mon 19-Apr-10 22:24:33

Hello Dr Clark,

My 5 yo son is allergic to cod (reacted at 16 months with vomiting and [2 hours later] hives, runny nose and eyes etc. When he was 3, he had a tiny bite of some cake with hazelnuts in it, vomited, and was covered in hives again.

Allergy tests classed his allergies as:
class 5: birch, hazelnuts
class 3: cod/plaice
class 2: peanuts, soya beans, and brazil nuts.
class 1: egg whites, almonds, tuna.

I don't let him eat any nuts, however, or any fish. I have read, and people have told me, that a nut allergy can be mild (hives) one time and result in anaphylactic shock the next - is this correct? This makes me extremely anxious most of the time that he's going to come into contact with some nuts and have a severe reaction.

We have also been warned of a cross-reaction because of the birch allergy - carrots, apples. He eats both carrots and apples - does a cross reaction mean that they can cause a problem together?

Sorry for such a long post and thank you for your time.

hobnob57 Tue 20-Apr-10 10:44:36

Dear Dr Clark,

I have many questions I'd like to ask outside the time-pressured appointments system which I suspect are largely irrelevant, but which occupy me nonetheless. If you have time to put me out of my misery I'd be most grateful, but otherwise please concentrate on the other more pressing questions on here. My background is as a lactose intolerant baby myself, DD1 was gluten intolerant as a baby (both through breastmilk and food) & dairy allergic (still is to some extent, but can tolerate enough to make it not much problem), DD2 is EBF and sensitive to dairy, soy, gluten, egg, nuts & oats in my diet.

My questions link in with:

PussinJimmyChoos & OkieCokie (where are these allergies/food intolerances coming from?). Is there any evidence/research being done that links them to environmental chemicals in the mother's bloodstream? What are your thoughts on something like leaky gut caused by Candida in the mother exposing BF babies to antigenic food molecules? (I haven't heard of anyone speak of this, but a friend had leaky gut and I'm just wondering what the effects on a BF baby may be)

icedcake (reflux and allergies)
Both my babies have/had reflux. Both also have swollen tummies and problems with wind. Do allergies cause reflux or is it as simple as pressure from swollen tummies exacerbating it? Why did DD1's swollen tummy only disappear when she stopped Pepti at the age of 3?

Also, does exposing babies to foods (through BM or weaning) to which they are allergic or intolerant do any potential long term damage? DD2 gets dark 'bits' in her nappies if I eat anything she doesn't agree with. If DD1 has too much dairy her face puff up and her nose streams. Am I sensitising them further?

Thank you for reading my drivel.

springinstep Tue 20-Apr-10 12:34:06

Another weaning question:

DD (now 6) is anaphylactic to cow's milk - the last reaction was severe(adrenaline, fluids, steroids, salbutamol - the works!) and she has probable allergies to sesame, egg and some tree nuts. She also has asthma and had eczema as a baby.

We are now weaning our 6 month old who has been exclusively breastfed up to now. I have been avoiding dairy and egg whilst feeding her and she has no eczema (a small patch on her ankle maybe that might become eczema but nothing like my elder daughter).

Do you feel there is an optimum 'window of opportunity' for introducing allergens? Should we be weaning slowly or be more confident that she seems less atopic than our older child? It feels odd to give her yoghurt in the near future given our history - should we wait until a year or is that likely to make things worse?

Thank you for your help!

bruffin Tue 20-Apr-10 13:02:09

My son is 14 and has various allergies to tree nuts (except cashew) and seseme seeds and seems to have had a reaction to poppy seeds and sunflower, so he avoids all seeds. Also has hayfever, animal allergies, plasters and insect bites.

His allergies appeared when he was 4 when in one weeked he had a reaction to seseme and pecan nuts and after that started having problem with peanuts etc

At 12 he was tested again and he has grown out of the peanut allergy but not the treenuts or seseme.

He now eats peanuts, is this wrong or can the peanut allergy return.
Also at this age is there any chance of him out growing the other allergies.

Also are these allergies inherited as my husband has similar allergies.

many thanks

Hi. I was just wondering if there was any possibility of the desensitisation process being applied to other allergies? I'm thinking particularly of dairy and egg, both of which trigger an anaphylactic reaction in my daughter and I suspect she won't grow out of this as it is such a strong reaction.
Many thanks

Weta Tue 20-Apr-10 14:05:01

Is it true that giving formula to a newborn can increase the risk of allergy? My son had 10ml of formula in hospital shortly after he was born because he was screaming (in incubator) and wouldn't/couldn't feed, and subsequently turns out to have a serious dairy allergy. One paediatrician said that often children allergic to dairy had been given formula in hospital - is this right?

yellowbutterfly Tue 20-Apr-10 15:53:00

Dear Dr Clark,

I guess put simply my question is this:

*Can a food allergy or intolerance cause constipation as opposed to diarrhoea ?*

The reason I ask is as follows, (sorry is quite long)

My DD was born at 34 weeks. She was initially fed EBM and and passed nice breast milk stools. The day before her discharge, supplies ran out and she was discharged on SMA prem 2. This led to immediate constipation. After 2 weeks we were advised to change her milk to Neocate (the doctor seemed to latch onto the fact that I have eczema and am allergic to animal hair). We changed to Neocate and things did not improve. We gave lactulose and water, still no improvement. After 6 weeks we changed to Aptimil first milk, after 4 feeds, a wetter poo (yellow, toothpaste).
However, my DD still is constipated, by this I mean she passes yellow, very hard "adult like" stools ranging from rabbit poo, to paste, to hard marbles, to playdough. Lactulose seems to work occassionally, water helps slightly.
DD had subsequently been diagnosed with reflux, also.
I was advised to try Neocate again, but am reluctant to as it seemed not to help, and DD is due to be weaned in around 4 weeks. I am also worried about weaning, as i'm sure this will help with the reflux but make the constipation worse.

As food intolerances/ allergies usually cause vomiting and diarrhoea I was wondering if in your experience you have seen them cause constipation?

DD is thriving, now 22 weeks, 16 corrected, weighs 6kg, her skin seems ok, flaky in patches but not eczematous, no blood in stools, no nappy rash, although erythematous skin around her anus. She rarely vomits. She is also incredibly windy, both ends and her farts often cause her to cry. She sleeps poorly due to farts. She also appears to have a lot of crampy type tummy pain in addition to her reflux pain. Her tummy constantly gurgles.

I know "on line" consultations are ill advised, but GP and hospital are of little help or support and we have been pretty much left to it. As a doctor myself I finding it very distressing and hoping time will sort these problems. If you have come across anything similar that pointed to an allergy I would appreciate a little advice.

Many thanks. Sorry if slightly inappropriate.

aaarghhh Tue 20-Apr-10 20:15:57

Hi , My daughter (age 9) had blood tests at age 7 for her allergies and showed very low levels of IGE eg almond 0.49, peanut 1.1, walnut 1.47, sesame 0.83, as these were all over the negative classification of 0.35, she was classed as having allergies. However, the consultant said that you can still show high IGE levels, but have grown out of the allergy.

She was initially diagnosed as being allergic when she was 5 (not allergic before this), where scratch tests were highly positive (peanut 12mm. hazlenut 3mm). She has had three reactions where her face has puffed up (no anaphalaxis).

The 12mm scratch test for peanut aged 5 does not correlate with the ige level of 1.1 when age 7.

However, she has not had a reaction for a couple of years now (perhaps because we are very careful).

The consultant had suggested oral challenges, but neither we or our daughter are comfortable with this. When we asked if could repeat scratch tests first, he said that this would still not confirm if she was still allergic or not, as they can be falsly positive.

To make it more confusing, though we didn't ask them to thay also tested non nuts and she showed positive Ige levels for milk (0.42), egg (0.53) and wheat (0.79), but she eats all these with no problems at all!!!!

More recently, daughter now seems to have developed allergy to pineapple, cherry and peaches (lip goes a bit puffy).

Question is - is it possible that scratch and ige tests can be so different or is she growing out of allergy, two years have passed should we have more scratch ot ige tests to decide whether to go for the oral testing or not????

hobnob57 Tue 20-Apr-10 20:41:00

Another low-priority theoretical question here. Sorry, but it's not often you get the chance to ask the experts.

If a mother has an immune response to a type of food molecule (e.g. undiagnosed coeliac or similar), she raises antibodies against it. If the antibodies enter breast milk and therefore her baby, does the baby then suffer the effects of the immune response too?

Penthesilea Tue 20-Apr-10 21:25:48

LoveBeingAMummy: "My DD who has just turned 2 seems to have developed a reaction to banana, it started in Aug last year. Basically if she eats banana normally the next monring when she filled her nappy it would result in almost a burning of her skin."

Bananas also give my son (now 4) an allergic-type reaction - swelling around the face, rashes, the sore bum + loose poos you describe, and I strongly believe they trigger his asthma. They didn't show up as an allergy trigger on the skin-prick tests he had done (unfortunately he also has several severe food allergies). I took him to a dietitian and through her we followed this elimination diet:

http://www.sswahs.nsw.gov.au/rpa/allergy/resources/foodintol/sed.cfm

(We were living in Australia at the time). It seems bananas contain chemicals called amines that people can develop a food intolerance to, and he did react to the amine challenge. The dietitian said he could have cheese, chocolate and bananas (i.e. foods that contain amines) in small doses. I kept him off bananas because I don't want to risk anything that might trigger his asthma but I did give him a little bit of chocolate occasionally. This Easter holidays, he had an Easter egg + some mini eggs and I let him have cheese a few times. Oh dear. His skin was raging with eczema within a day. He's now off chocolate and cheese and his skin is returning to normal. I've had doctors (not specialists) say that food intolerance doesn't exist but I know what I see before my eyes!

Brollyflower Tue 20-Apr-10 21:28:14

In your view is it justifiable or sensible for schools to have a blanket ban on nuts (or even just peanuts)?

Lee36 Tue 20-Apr-10 22:13:33

Are we realistically looking at a 'cure' for peanut allergy with your work?

Should we have some kind of public awareness campaign about the dangers posed by food allergies? My DD has a peanut allergy and it can be very hard to get people (eg in schools/on airlines) to take this seriously and understand this allergy can kill its not just me being a fussy parent.

Thank you

tatt Wed 21-Apr-10 10:17:24

hope you don't mind additional questions - feel free to ignore if you do.

Several people have already mentioned testing but some of have experienced problems with the accuracy of skin prick/ RAST tests. Can I ask you about progress on developing more reliable tests e.g.
more accurate test? and whether you consider skin prick or RAST tests the most reliable? Also whether there is any chance of ever developing a test that will predict not only who will react but how severe that reaction might be.

Also a comment - as the parent of a non-asthmatic child who has had an anaphylactic reaction I am extremely grateful that we saw an allergy consultant who believed in prescibing epipens to all those with postive nut allergy tests. Instead of sitting and praying medical help would reach us in time (as I had to do with their first reaction) I was able to deal with the reaction promptly. We can't keep our children away from all allergens, although we can limit the frequency of reaction. I hope you are not one of the consultants who restricts adrenaline to the asthmatic.

Chandra Wed 21-Apr-10 10:43:47

I only have a question, when are these trials expected to be completed, results provided and if successful, is there any timescale about how and when this treatment can be made available to other areas?

ORANGINA avoid peanuts until he is cleared off via testing, what you describe looks very much like a proper allergic reaction, check this website:
http://www.anaphylaxis.org.uk/information/basic-facts.aspx

(I know that Dr Clark will have a look at your question but just thought of advancing some of the info in the mean time )

LoveBeingAMummy Wed 21-Apr-10 15:34:09

Penthesilea - thanks for that, so far no issues with cheese or choc here. There's just so much we don;t know isn't there. I know that when she had some banana ice cream, it was literally two spoons and it effected her.

brightspark2 Wed 21-Apr-10 15:57:50

Arachis oil is in many baby products. I found out this is the Latin name for peanut oil. Could overuse of these oils and creams in the past have contributed to the prevalence of peanut allergies now?

Hensor Wed 21-Apr-10 16:30:25

Dear Dr Clark

I am expecting our first baby in 10 days. I have a severe allergy to all nuts and pulses (my principle allergy is peanuts but i have reacted to other nuts as well as soya, lentils, chickpeas etc) and have been hospitalised on about half a dozen occasions. I carry adrenalin pens, anti-histamine and steroids with me.

What are the chances that our baby will also have a food allergy and what should I do about having her tested? At what age should we consider tests for her?

I have found in the past that GPs are simply not knowledgeable enough about this condition (this is not a criticism as i realise it is a specialist area) and am worried that early signs may be missed (as they were when i was a baby!)

Many thanks

Helen

Krispy20 Wed 21-Apr-10 17:17:04

Hi Dr Andrew,

I had skin prick tests done for my hayfever last year, and they said the result was '8' but I am confused as to what '8' means - is it on some sort of scale?

Also, what would this indicate to you about my hayfever?

Thanks

ADuckCalledBill Wed 21-Apr-10 17:36:56

.

Spoof Wed 21-Apr-10 18:47:56

Dear Dr Clark

My daughter has a purported peanut allergy. She's seven but was diagnosed at 18 months after blood tests taken to analyise allergies due to a cows milk protein allergy, and a skin reaction to peanut butter.

We have carried an epipen around with us ever since. I dont especially want to put her through any more tests than necessary, because she has various other health complications which means she's poked and prodded enough as it is. How likely is it that she will grow out of this allergy, like she has with the cows milk protein one?

That said, she hasn't really had any follow-up care/review for her allergies, and I wondered what sor of care you thought should be carried out with children who suffer allergies severe enough to have to have an epipen?

Many thanks.

Jammygal Wed 21-Apr-10 21:15:02

Hi there,

My son is allergic to egg and sesame and quite possibly nuts although I am not certain.
He first reacted to scrambled egg at nine months old and had a severe hive reaction on his hands and face before throwing up. He also had hives in his nappy area the next day.
He then reacted to sesame in hummus at 13 months and went anaphalactic needing anti histamines, steroids, oxygen and adrenaline.
He was under a paediatrician for a few years but has never had any tests as he was deemed to be too young.
He has avoided sesame, eggs and nuts since then and carries epipens and piriton.
He is now nearly five and I would obviously like to move things forward for him. What do you think our next step should be? I live in South Wales and do not know of any specific allergy clinics nearby.
Thanks very much

PixieOnaLeaf Wed 21-Apr-10 21:24:11

Message withdrawn

ronshar Wed 21-Apr-10 22:07:49

Dr Clark.
Well done for your excellent work in Cambridgeshire. I wish we lived near you!
Thank you so much for agreeing to answer some of our questions. As you can see there are so many of us here with allergic children, all needing more information than we are being given by our own health care professionals.

I have 3 children.
My eldest daughter was dairy intolerant as a baby. Tummy pains and excema linked to it. She also developed a Pistachio nut allergy when she was about 5. Following two anaphalactic reactions. Second one I nearly had to take her to A&E. Piriton just about kept it under control. She is now 10.5 and has an epipen.
Gp refuses to refer for testing as they are not reliable apparently.
My youngest son is 18 months and he is allergic to dairy and soya. But not peanuts as he eats them quite happily.

I would like to ask.
Is there a blood test that can be done which actually measures the immune system response accurately? If so why is this not offered to children?

Are my children suffering because I have developed allergies to dust, dust mite, Birch, cat & dog, since entering my 20's?

Does a mother pass on an immumne response problem via the placenta?

Thank you very much for your time.

calypsoblue Thu 22-Apr-10 11:24:00

Dear Dr Andrew ,
my son has egg allergy is this potencially a problem for him when recieving his vaccinations as i understand that some of them are cultured in egg protein
Many thanks

christie2 Thu 22-Apr-10 11:41:15

My DD is 13 and has anaphalatic reactions to both peanuts and sesame seed both requring an epipen to be used. She has been retested several times (at 5 and 10) and we were told that she will have this condition for life and there is no hope for her in terms of growing out of her life-threatening allergies.

But I read about these de-sensitization trials ( as did DD) and wonder what the future holds as it is promising. But when we both mentioned the UK trials to her allergist doctor (in Canada) he said she was not a candidate for these trials and would not discuss it further.

My questions, is a desenstizaton trial out of the question for her and why ( does it only work for some candidates)? Is it only that the UK is leading in this area and it has not spread to countries like Canada? Is there hope that over time these trials may become more available to all with life-threatening allergies or do we just get on with living with them?

cardamomginger Thu 22-Apr-10 16:57:48

I have a diagnosed severe multiple nut allergy (worst offenders almonds and peanuts) and am currently 17.5 weeks pregnant with my first child. Obviously, I continue to avoid all nuts and carry my epipen with me at all times. I am keen that my child will be able to eat nuts and will not have a restricted diet. However, I am also concerned that due to my own diagnosis, there is an increased risk that she/he will be nut allergic. Should I introduce nut products in the diet once he/she is weaned? At what age is best? Is there a "controlled" way in which I should do this?
Many thanks!

Katisha Thu 22-Apr-10 19:11:05

Sorry you may not have time to answer this one as it's a bit off topic about eggs. Both sons when very young (now 10 and 8) have immediately been sick on eating lightly cooked egg. So we have avoided egg for years. They seem OK with cake now but still can feel a bit dodgy in the tummy after some things that have egg as ingredient. eg ice cream that turns out to have had egg in it.

I would like to know whether they are growing out of it but am rather loath to feed them omelette. Would it be best to have allergy tests somewhere or just bite the bullet and try to persuade them to try some quiche or something?

What I am asking basically is will giving them egg make matters worse or better?

gandababies Thu 22-Apr-10 21:08:14

Hi Dr Clark,

I wondered what the current advice was for siblings of children with nut allergy.

My eldest child is anaphylactic to peanuts. I have two more children and one on the way, the eldest of which is due to start school in September. We have not fed either child nuts but do allow them products with cross contamination issues when our daughter is not with us. I would like to know one way or another before my son starts school, is feeding him a spoon of peanut butter in the car park at the local A & E the best option or can you advise something different - btw he has never shown any sign of allergy.

THANK YOU!

QwertyQueen Thu 22-Apr-10 21:14:20

Hi
My DS, when 2 had a skin pick test for peanut allergy and he reacted a lot with a huge welt and as such since then we carry an epipen and do all the usual avoiding tactic.
He is now 3.5 and had blood tests for allergies recently - they tested the serum (That is the phrase the doctor used) and it came back as highly allergic to dust mites and "boderline" allergy to peanuts. Would this indicate that he may be outgrowing it?
My understanding is that it is not an exact science and I should continue as if he is highly allergic.

jamhappi Thu 22-Apr-10 21:52:25

Hello Dr Clark,

My son has had an allergy to eggs since he was around a year old. This resulted in his eyes swelling up and a red rash coming up. We stopped him from eating eggs. After tests it turned out that he was allergic to eggs, nuts and some fruits. (pears)

My son is now five and is happily eating eggs without any reaction. should we try nuts with him? the same way as we have tried eggs with him???

Thank you.

almondfinger Thu 22-Apr-10 22:31:06

Hello Dr Clark,

My daughter (2.5) first had a reaction to hummus (sesame seed) at about 10 mths. She has eczema since she was 3 weeks old, kept under control with cortisone. She is allergic to all nuts and seeds, egg, tomato, shellfish, beef and lamb.

How common is it to be allergic to beef and lamb? I thought rice and lamb were the 2 things one could eat on a serious exclusion diet and work up from there. My husband thinks its the render from the fat rather then the actual meat. Do you have any thoughts/research on this?

She has now developed hayfever and is in shreds at the moment with an ezcema flare up on her face and the rhinitis.

I am studying nutrition and having some success with supplemetation of probiotics and diet. I'm fast losing faith in conventional medicine where every time I bring her to the doc I'm offered antibiotics and have to bring my consultant's letter to ensure her prescription for .0025% cortisone is filled properly. Last week the doc told me what I had was too strong to use on her (3 month duration) chapped lips and gave me a script for 5%!!!

If you are looking for candidates for your study please let me know where I can apply.

Thank you.

bobafett Thu 22-Apr-10 23:31:25

Hi dr Clarke

we have an 8 year old son with allergies to peanuts, tree nuts, milk and eggs.

My question relates to the desensitisation process you have adopted in the peanut allergy trials, as my son became intolerant to soya milk through over exposure when used as a dairy alternative.
He can now only tolerate soya milk for a couple of days before his excema flares and he begins to come out in hives.
Why is this not the case in the peanut trials?
Would my son have a similar outcome if he was to try the peanut desensitisation?

Many thanks

cakenomore Thu 22-Apr-10 23:46:11

hello Dr Clark,

I would be interested to hear your opinion on leaky gut theories and multiple food allergies. I have read on the internet about the link between increased gut permneability and the body becoming sensitised to food. That certain things can weaken the gut such as an imbalance of unhealthy bacteria. In fact my son of 18 months had thrush in his mouth that we struggled to get rid of due to reinfection through my nipples that had eczema and thrush. could this have prehaps contributed to his food allergies?

Are there supplements or probiotics that you could recomend for a child of 18 months to strengthen their gut, or do you think that would be a waste of time.

I have also read about rotation diets for multiple food allargy sufferers to help prevent them from becoming allargic to more foods. Does this go against your theories. would you recomend rotating foods as much as possible or not?

In your opinion should all children with a peanut allergy carry an eppipen whether asthmatic or not? My son is allergic to peanuts but as has never been exposed to them even through breastfeeding or in the womb i have no idea how he would react if accidentaly exposed.

Thankyou

countrygirl831 Fri 23-Apr-10 10:07:17

My son has just turned 18 and has had multiple allergies all his life, including peanuts, tree nuts, milk, eggs and even lily pollen. He wants to travel during a gap year, which worries the hell out of me but doesn't seem to faze him. He always carries 2 epipens with him and a Medic Alert card, plus Piriton and inhalers.

1. Would he be able to replace an epipen while abroad (Australia or America) if he needed to use one?

2. Do you know of any adult trials taking place?

Holiday123 Fri 23-Apr-10 22:02:22

Dear Dr Clark,

I have a son who is now 19 and has been allergic to peanuts since the age of 2. I was just wondering as you are doing a desensitisation study that we are doing more harm than good by keeping our home totally nut free as maybe if he was exposed to tiny traces it may benefit his immunity better.

I would be grateful for any advice you can give.

Many thanks

VenusdeMedici Sat 24-Apr-10 02:18:48

Dear Dr Clark,

My son was allergic to a number of substances as a baby/toddler (dairy, fish, tomatoes, etc), usually getting hives around his mouth and on his body, although he grew out of these allergies by age 4. Due to this - and a strong family history of anaphylactic reactions to various foods (esp dairy, eggs, fish), bee stings and penincillin, as well as asthma, eczema and hayfever - he was therefore advised to not be introduced to nuts until he is 6 or 7 years old, to prevent him from developing an allergy to them - and so he has never had any nuts whatsoever to this day.

He is now 6, and still has atopic signs, with eczema, contact dermatitis (eg to face paints, Crocs shoes) and possible asthma, but is able to eat everything except nuts (which we have still never tried). Should we now start introducing nuts to him, and, if so, how? Gradually? In things? Which nuts first? How frequently? In A&E? Is there a particular method I could follow, please?

I also have a daughter, aged 4, who, as a result of my son and our family history, I have also been advised to keep nut-free for the moment. She doesn't seem particularly atopic. When should I start introducing nuts to her, and how?

Many thanks indeed.

Sibble Sat 24-Apr-10 02:43:20

Dear Dr Clark

I appreciate that you may not be able to answer conclusively but I was wondering if there is any connection between taking 'GROUND LSA - Ground Linseeds, Sunflower Seeds, and Almonds' during pregnancy and tree nut/sesame allergies in children.

I took this 'supplement' daily during my pregnancy with my son who is severely allergic to both tree nuts and sesame as I thought it would be beneficial to his growth and development. If there is a proven or possible link would it be sensible to advise pregnant women of the possible connection.

Thanks you in advance

VenusdeMedici Sat 24-Apr-10 08:01:01

PS: Sorry I should have added to my post of 2.18am this morning:

I avoided all nuts when I was both pregnant and breastfeeding with my children (as advised, due to my and my family's history of allergies). I have also banned all nuts from the house, and have avoided them myself, since I first becamse pregnant with my first child. Therefore, as I have also ensured that both my children have avoided them completely since birth (again as advised), I am absolutely sure that they have never been exposed to any nuts, even in small quantities. Which is why I am so nervous about when/how I should introduce them to my atopic 6 year old especially, as well as my less-atopic 4 year old.

Many thanks, again, and much appreciated.

CatherineMumsnet (MNHQ) Tue 04-May-10 10:47:10

Hi all, just to let you know that Andrew Clark should be coming back with his answers by the end of this week, which means we'll have them up on the thread by early next week.
Thanks for your patience.

PixieOnaLeaf Sun 09-May-10 15:06:43

Message withdrawn

CatherineMumsnet (MNHQ) Mon 10-May-10 09:44:47

Yes, by tomorrow at the latest

PixieOnaLeaf Mon 10-May-10 16:07:13

Message withdrawn

tatt Tue 11-May-10 10:54:45

Any progress on this? Please at least tell us you have the replies.

PixieOnaLeaf Tue 11-May-10 16:03:26

Message withdrawn

tatt Tue 11-May-10 16:47:40

agree - we've been very patient. I'm fed up of politics and would like to read something important on this site!

LoveBeingAHungParliament Tue 11-May-10 18:11:38

I've had a banana in my hand since April 19th and would like to know if i can give it to dd or not, my arm aches grin

PixieOnaLeaf Tue 11-May-10 18:12:43

Message withdrawn

Chandra Tue 11-May-10 21:36:25

I can't help but think that when it comes to question about allergies there is always a looooooooong wait to get the answers....

(tongue in cheek comment!)

LaDiDaDi Wed 12-May-10 11:23:43

hoping for some answers today

LoveBeingAHungParliament Wed 12-May-10 15:32:25

<cough, cough>

PixieOnaLeaf Wed 12-May-10 15:58:18

Message withdrawn

CatherineHMumsnet (MNHQ) Wed 12-May-10 16:01:43

I've seen the feature and it's almost ready - it will definitely be up tomorrow morning.

LoveBeingAHungParliament Wed 12-May-10 17:51:54

I hope not also although I have just eaten dd's mouldy banana

Cornishsmartie Thu 13-May-10 00:10:07

Just came looking for answers, have the replies been published yet?

Cornishsmartie Thu 13-May-10 00:10:59

AH, it's gone midnight, looks like they will be on here tomorrow.

LoveBeingAHungParliament Thu 13-May-10 08:05:36

<just having a look>

CatherineMumsnet (MNHQ) Thu 13-May-10 10:53:34

Morning all, here are Dr Clark's answers. Sorry for delay.

LaDiDaDi Thu 13-May-10 11:17:22

Thanks very much Dr Clarke smile.

LoveBeingAHungParliament Thu 13-May-10 15:00:58

Thanks smile

tatt Thu 13-May-10 16:00:48

very interesting, although rather depressing that it isn't likely to spread for years.

Odd that although we know of one child who lost their tree nut allergy alongside their peanut allergy but he didn't mention it.

PixieOnaLeaf Thu 13-May-10 17:49:53

Message withdrawn

BlueBumedFly Thu 13-May-10 20:11:59

Tatt - from his part that is patient confidentiality, what I choose to share is different.

beggsie Thu 13-May-10 20:27:16

Thanks Dr Clarke - your time and sharing of your expertise is much appreciated.

beggsie

PixieOnaLeaf Thu 13-May-10 21:27:32

Message withdrawn

Chandra Thu 13-May-10 21:27:33

Thanks, more so for taking the time answering so many questions, it must have taken a considerable amount of time.

tatt Fri 14-May-10 08:55:28

BBF - if he named your child yes it would be a breach but if there is one there are likely to be others. So saying something like "we have on one occasion/occasionally/sometimes seen skin prick wheals for another/other allergies reduce during treatment (or tolerance thresholds for another allergy increase during treatment)" shouldn't breach patient confidentiality. He shouldn't name the type of allergy but don't see why he can't make a guarded reference. Perhaps he was just worried about how reporters can blow these things up.

Was also surprised that he did talk about a "cure" rather than a treatment. That seems premature to me. We all hope it will be but there are unanswered questions about whether the children lose tolerance if they stop eating the nuts.

He says many times that the initial amount required for sensitisation is very small, don't know where that is from but makes it virtually impossible to do anything about avoiding it.

While saying they had never seen the speed of response matter he did confirm piriton is not the fastest anti-histamine. Maybe the campaign for piriton in sachets should be addressed to other drug companies too. Next time we buy antihistamine I may get a different one.

MumOfTwoToo Fri 14-May-10 11:02:31

Thank you very much Dr Clark for giving so much time to answer the Mumsnet questions. Although I did not ask a question myself it was great to have so much information and have answers to so many of the concerns of the parents of all allergic children.

Thank you Dr Clarke - just read the Q&A and it was extremely informative. Still depressing that so little is known about allergies, but good to know you and your team are on the case!

ClaireOB Sat 15-May-10 16:35:48

Thanks indeed to Dr Clark, I have forwarded the link to his answers to lots of friends. And, for anybody who hasn't already done so, this No. 10 petition for better NHS allergy provision will be open until 03 June - petitions.number10.gov.uk/AllergyServices/

ronshar Mon 17-May-10 14:37:10

Thank you very much for your answers Dr Clark.
I shall have to spend some time going through the different links as well.

VenusdeMedici Tue 18-May-10 13:45:10

Dr Clark, I appreciate you have answered many people's questions, however, unfortunately, for some reason you didn't answer my question. I'm therefore still confused and worried about what I should do, and was really looking forward to your advice.

Thank you for your answer Dr Clark. I shall follow up with my hv in a few weeks (will see her then as I'll have a new baby) and try to get her to persuade the GP to give us a referral. She was instrumental in convincing him to refer my dd for her milk protein intolerance, so we can hope for the same success again!

Mobilemandy Mon 24-May-10 15:06:56

Dr Clark

My 6 year old son is anaphalactic to egg, cats and horses. He has bad allergic reactions to dogs tree pollen and dust mite. Please could you advise me if I can join him on any desensitization programs. I would love to desensitize him to egg and dogs specifically as his quality of life would drastically increase. I have been told that his allergy to egg is too strong for him to gain any treatment but I am concerned that this may be an NHS opinion due to funding. I would also like to investigate any programs in the private sector.

I would be very grateful for any advice.

Regards

Amanda Powell

mobilemandy - you're a month late with your question!

misdee Mon 24-May-10 20:00:59

CSWS, just read through that q+a, and see your ds had a reaction. dd4 is under dr hall at lister, who tested her for allergies and gave her an epipen.

hey misdee, how are you? i'm sure that the consultants there are quite good - it's just getting my GP to refer us to them that's the problem! But I'll follow it up in a few weeks when dc3 arrives. Thanks .

tatt Tue 25-May-10 05:56:08

Venusdemedici He made some general comments about this sort of situation. Paraphrasing this would amount to get your child the blood test that gps can do (to which I add but you may have to tell them its available) because of their atopic history. They have both probably already been exposed to nut traces (our allergy consultant said children usually had been by age 3).

The younger child could probably have nuts anyway and the testing method was described - little on the lip and wait 24 hours. Personally I'd favour the slower method our allergy consultant suggested which involved some on the arm or back, then the skin of the face, then the lip.

VenusdeMedici Mon 31-May-10 21:33:43

Tatt, thanks very much for your response. Really kind of you.

ThePhoenixLady Thu 11-Apr-13 11:57:33

Dear Dr Clark, My Daughter is 14 and has had multiple Allergies all her life. We have all come to terms with it and are grateful to all the health care professionals that have helped us understand and live with this.
My daughters life would be a million times better however, if she could eat egg, as this is in so many foods. The tree nut, Shell fish & certain fruits that she is allergic to, she can avoid easily enough and manufacturers are producing increasing varieties that exclude nuts in particular.
We did speak to Dr Kakoo at St. Marys about this, but he said that there are currently no Desensitisation programmes in the UK. I Then stumbled across this page and regained some hope.
Please can you help us in any way?
Kind Regards, Rachelle Oakley

YoniTrix Fri 12-Apr-13 22:34:54

thephoenixlady this thread is a few years old, you'll not get a reply.

Spuderoonerism Sat 13-Apr-13 12:09:37

As YoniTrix said, this is an old thread. Addenbrookes allergy page is here but says they are no longer recruiting for the trials.

TiredFeet Sun 21-Apr-13 21:03:14

Not feeling great so apologies if these questions have already been posted

- my son has multiple severe allergies (diagnosed by blood /skin prick tests) including milk egg soya wheat. I am pregnant with second child and wondering if there is anything I should be doing/not doing during pregnancy/breastfeeding/weaning this next child. (Lots of allergies on both sides of our family)?

- my son had severe eczema from 3-6 months and we were desperate, he never slept for more than 40 minutes at a time, day or night. We were seeing gp's bi-weekly, desperate for help but they just prescribed piriton/emollients. I asked about cutting cows milk out of my diet (breastfeeding) and the gp laughed at me. When we started weaning he had a very severe allergic reaction to his first taste of cows milk and the paramedics had to administer adrenaline. This, whilst terrifying at the time,was a blessing in disguise as we finally got decent advice from a dermatologist and allergy testing. Can more be done to educate GPs? I can't believe their current lack of awareness at the connection between infant eczema and allergies. My sons life (and mine) was transformed when the allergens were cut out.

TiredFeet Sun 21-Apr-13 21:04:11

ah balls just seen this is old thread!

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