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Webchat with consultant paediatric allergist Dr Adam Fox, Tues 18 Nov, 12.45pm

(167 Posts)
GeraldineMumsnet (MNHQ) Thu 13-Nov-08 12:22:52

We're delighted that top children's allergist Dr Adam Fox has agreed to come on to Mumsnet to answer queries about all things allergic. Please post any advance questions here, particularly if you're not able to make it on the day.

lulumama Thu 13-Nov-08 12:31:45

Hello Dr Fox smile

DS, 9, has a peanut allergy,diagnosed at aged 2 have been told he can be tested further around the age of 10 to see if he has grown out of it.

DD ,3, has had peanut butter by accident.. at a friends house, random piece of toast on conservatory floor, inquisitive toddler puts everything in mouth, cue me and my friend, who luckily is a nurse, rinsing her mouth out and phone in hand ready for 999

no reaction , so do i presume she is not allergic, or was she lucky that time?

am not prepared to give either child nuts of any type again unless it is in A&E with a pead present with an epipen in each hand..

thank you very much

trixymalixy Thu 13-Nov-08 12:40:15

I have heard that probiotics can be used to treat/prevent allergies. Can you provide any more information on this?

Thanks

brimfull Thu 13-Nov-08 14:42:01

Hello Dr Fox.

My son(6yrs) is allergic to tree nuts.He is also asthmatic.

He has had skin prick tests for various types of tree nuts and most of them are very small reactions.Cashew was a 24mm reaction.Is this a large reaction?
Is it probable he is only allergic to cashews?
How can we be sure of this ,he is due to be seen in 2 yrs again at Southampton?
Do we need to still carry the epipen if he's only got allergy to cashews?

Thanks

brimfull Thu 13-Nov-08 14:42:01

Hello Dr Fox.

My son(6yrs) is allergic to tree nuts.He is also asthmatic.

He has had skin prick tests for various types of tree nuts and most of them are very small reactions.Cashew was a 24mm reaction.Is this a large reaction?
Is it probable he is only allergic to cashews?
How can we be sure of this ,he is due to be seen in 2 yrs again at Southampton?
Do we need to still carry the epipen if he's only got allergy to cashews?

Thanks

suzi2 Thu 13-Nov-08 14:52:53

I have a peanut allergy, so have (obviously!) not eaten peanuts when pregnant or breastfeeding. My children are now 3 and almost 2, so when should I (well my husband) 'expose' them to nuts? They both have reasonably bad eczema.

Also, what's the latest thinking with eating peanuts when pregnant?

And just for myself... I have had discoid eczema since I was pregnant with my daughter (so about 2.5 years now) and after 2 years of weekly dermatology care, every steroid cream, protopic cream, all manner of bandages, skin patch testing and UVB treatment I'm in no different a position. I was told it was unlikely to be caused by food intollerance. Is this an avenue worth pursuing? How would you recommend someone goes about food intollerance testing?

Many thanks grin

cmotdibbler Thu 13-Nov-08 15:10:28

Hi,

My 2.5 year old son has had cough and wheeze since he was 6 months old. He has had recurrent chest infections since, and is now on inhaled steroids and salbutamol to try and control the cough/wheeze. He is OKish in the summer, but then gets bad each winter (we can always hear his breathing, to the extent that you can track where he is in the house). Although his breathing can get distressed, he never has what I would think of as an acute asthma attack with massive wheezing, its more like his lungs get filled with mucus (and he has had a lobular collapse due to mucus plugging).

He has had skin prick tests for common inhaled allergens, all of which were negative. I have a strong family history of allergy, and have coeliac disease, asthma and eczema myself.

Is it worth pursuing further allergy testing for DS, or is this not a typical picture of allergic asthma in toddlers ?

TheOldestCat Thu 13-Nov-08 15:25:48

Hallo Dr Fox.

Similar question to suzi2. When I ended up in hospital recently after an anaphylactic bout with an accidentally walnutty muffin, the consultant said in five years the government guidelines on introducing nuts to children with a family history of allergy will be reversed. So instead of avoiding them, we'll be encouraged to give our children peanuts/nuts.

Does your experience suggest this might be sensible?

Cheers!

beeny Thu 13-Nov-08 15:33:46

Hello Dr Fox

My 2 year old has had a runny nose often green phlegm since she was 12 months old.She has has had a number of ear infections and courses of antibiotics.She has been referred to consultant at hospital nothing has worked so far.She has a good appetite and is a happy child.Any point in allergy tests?

Thank uou

Jules110 Thu 13-Nov-08 15:51:31

Hello Dr Fox

I am allergic to cashew nuts, but not peanuts. I also have mild asthma and eczema.

I have two daughters (4 and 1/4 and 21 months), both of whom have had milk protein allergy since birth (elder daughter now over it) and episodes of mild eczema. They both get very wheezy when they get colds and go onto inhalers for this.

I recently spoke to my GP about nut allergies, and she wrote off to our local hospital to see if they could have skin tests for nut allergies.

She was told that there was no point, since skin tests are not conclusive, and it's not worth doing them before school age anyway. I understand if it's not definitive (although my elder daughter is at school now), but I have no idea how to go about working out if my daughters are allergic to nuts. I am concerned, as I'm sure that my eldest will come into contact with them by accident soon enough anyway.

Many thanks.

weeglenny Thu 13-Nov-08 15:57:07

Hello Dr Fox

My son, aged 13 months, had a reaction after eating peanut butter and his lips went blue. After taking him to hospital the doctor said that as everything else seemed normal (oxygen count, breathing etc) he thought it was unlikely to be a peanut allergy. There is no history of nut allergies in mine or my husbands families.

We are waiting for an appointment to have allergy tests done, but in your experience would you expect such a mild reaction for a peanut allergy?

Thanks

overthemill Thu 13-Nov-08 15:59:30

my daughter aged 9 has severe eczema (diagnosed 2000 under 1 year old) and asthma (only diagnosed since 2006). She had 'scratch' tests done by her then consultant paediatrician/dermatolgist.

Since then we have moved to a different county and she has had terrible eczema and asthma virtually non stop since. She has had to go back to wet wrapping and her asthma medication has moved up to stage 2 (the combined purple preventer inhaler). She takes antihistamines each day inc vallergan at night - this is like when she was 2 all over again.

Can you suggest anything, our GP says there is no point in repeating the scratch tests but I wonder if she has disocvered a whole new things to be allergic to. We've moved from one rural area to another but with different crops.

she has missed masses of school - one term in each of the two previous academic terms because of her asthma and her dreadful skin. she is always tired and under the weather but after adodgy start she does love her school, so she's not skiving.
HELP!!!

tinytalker Thu 13-Nov-08 16:04:43

My 10yr old has asthma and an anaphylactic reaction to horses. She has also had a positive skin prick test to cat, dog, silver birch, house dust mite & plane tree.
Over the last few years I have noticed she has very dark black shadows under her eyes. I have heard of these referred to as 'allergic shiners'. Sometimes they are so bad she looks like she's been beaten up! At her age she is now becoming quite self conscious and the boys sometimes tease her angry.
My question is... Does she just have to live with this? Is there anything that can help apart from cosmetics? Is this due to the allergies listed above or should I look at food allergens?
Thanks

Shelly75 Thu 13-Nov-08 17:09:36

Hello

My 2 year old is allergic to egg white (diagnosed year ago by blood tests, after a nasty reaction).

As a baby we discovered that she was intolerant of cows milk - it caused bad eczema. She is gradually growing out of the cows milk allergy and can drink milk, but her skin reacts dramatically if she touches milk ..... is it possible to be able to drink milk but not touch it?!
thanks

ToniJones Thu 13-Nov-08 17:44:11

Hello Dr Fox,

I have a four month old baby boy and I wondered how soon he could be tested for allergies. My husband is allergic to cat and dog hair, dust and pollen and I am concerned that my son will be as well. My husband's allergies are quite extreme. I am happy to pay privately for any tests as they are probably not available on the NHS. I have heard of the prick test but not sure if he is too young for that ?

I would be very grateful to hear from you.

Dottoressa Thu 13-Nov-08 18:07:56

Hello Dr Fox,

When my son was a toddler, he ate a piece of walnut bread. He immediately went bright red and fiddled around with his mouth before vomiting.

My husband and I both come from 'allergic' families (his older children have hayfever, asthma, eczema and a severe egg allergy; he and I both suffer from eczema; his father was severely allergic to all nuts).

Following the walnut episode, we duly trundled off to the GP, and were referred to the allergy clinic at our local hospital. When our appointment finally came round, some months later, he was given some blood tests which showed that he was allergic to grass pollen and was "possibly" allergic to nuts. The advice was to have him re-tested when he turned five.

He is now six, but nothing on earth could persuade him to repeat the blood test experience. The blood tests were, unfortunately, done in a rather ham-fisted manner (and had to be repeated as a result), and my son has still not forgotten the whole experience!

About six months ago, my husband gave our son a piece of banana cake with a nice juicy walnut on the top. After eating it, our son said that his mouth hurt; I suggested that he might have bitten the inside of his mouth, which he denied. A couple of minutes later, he went to the loo and suffered one bout of violent diarrhoea and vomiting. It may have been a pure coincidence, but he had no other symptoms of illness and within around three hours, he was pale but hungry!

This is all rather long-winded, but my questions are as follows:

Is there any way that he could be re-tested without the need for another blood-test?

How accurate are allergy tests?

Is it possible that my son could be allergic only to walnuts? (He has never tried any other kind of nut, but eats hazelnut-containing Nutella very cheerfully!)

If my son does have a nut allergy, should my four-year-old daughter be tested, too? To my knowledge, she has never eaten any kind of nut.

We would be happy to pay for tests if only we knew exactly what it was that we needed, and could be sure that the results would be reasonably accurate!

I would be very grateful indeed for any advice...

Dottoressa Thu 13-Nov-08 18:08:39

Oh dear, I always forget something... I should have added that our son also suffers from bad hayfever from the start of May until around the end of June!

smoggie Thu 13-Nov-08 18:25:57

Hello Dr Fox,
THank you for coming on to answer some of our questions.
I have a 5yr old son who was allergic to gluten (now grown out of), egg (recently grown out of), celery (recently grown out of) and nuts (mainly cashew and peanut 19mm skin prick reaction). He is a typically atopic child with mild asthma, mild eczema, quite severe hayfever and is borderline iron deficient.
When would you advise that we try him with shellfish given his allergic history?

All of the allergic reactions above were confirmed with skin prick testing and showed reactions of 4-6mm. His cashew and peanut reactions were 19mm. How realistic is it to hope that he may outgrow these nut allergies?

Many Thanks in advance

10krunner Thu 13-Nov-08 18:27:33

Hi,
My 8 yo son for the past 4 years has trouble breathing through his nose. He snorer terribley and was forever having to blow his nose because it was running. He saw an ENT specialist who confirmed the lining of his nose was thickened and he had a deviated septum (as had I until an op). In May this year he had an op to thin out the lining of his nose and had his adenoids removed which were very swollen and he briefly had some relief from his symptoms but they've all now come back and its as if he never had the op. He was subsequently prescribed Cetrizine to take 2x 5ml at night before bed and this has also made no difference. We've done all the allergy stuff in his room ie. hoover, damp dust, mattress protector, removed the carpet but its also made no difference. Any ideas on the back of a postcard please Sorry this was so long.

10krunner Thu 13-Nov-08 18:28:16

I meant to say, he had some blood tests done which showed he was very allergic to dust and grass.

mumtomaddy Thu 13-Nov-08 19:32:13

When my daughter was about 3, we were told not to give her amoxycillin or ibuprofen as she seemed to develop a rash after taking either - with the ibuprofen one of her eyes swelled up. She's 6 now, and it hasn't been too much of a problem to avoid those drugs. However, she recently developed a very high fever as result of a virus and it would have been useful to have had the option of using the ibuprofen alongside the paracetamol. Having said that, a pharmacist told me that he doesn't think children should be given ibuprofen at all. Is this important enough for us to ask for a test to see if she is genuinely allergic to ibuprofen? And does the fact that she showed a skin reaction mean that she is not likely to have the kind of reaction that makes her tongue and throat swell up?

pumpkinsoup Thu 13-Nov-08 20:29:53

I'm not sure if this (coeliacs/intolerances) is included in your area of expertise, but just in case.... (sorry its so long- didn't want to miss anything that may be important)

My 3 year old daughter has significant problems eating wheat/gluten/oats- terrible stomach pain, was small/light for her age and family, pale skin, huge dark circles under her eyes, bad breath, very runny nappies/loss of bowel control, alot more tantrums and clingyness than normal for her age. This began with pretty awful stomach pain when she first tried gluten, health visitor recommended gluten free diet until 12 months, then gradually reintroducing. Her symptoms gradually reappeared over the following year.

Eventually she was referred to a paediatrician at 2.11yrs as potty training was impossible. He put her on an extremely low wheat, no oats, low fibre diet for two months (no tests). After 6 weeks we had a happy pain-free child with colour to her skin, no dark circles, fresh breath, and a dramatic growth increase (we had to reintroduce soluble fibre). She was diagnosed with wheat intolerance but told to eat a very-low-gluten diet.

After 3 months she was having debilitating symptoms after even tiny amounts of gluten and another paediatrician did a blood test that was negative for coeliacs (also did skin prick tests, blood count +stool sample). Conclusion - "nothing wrong with her", but she still can't eat any gluten without being very ill. So she has no diagnosis = no prescriptions, dietician etc, but a very restricted diet.

Not quite sure where to go from here - I don't think she could complete a full gluten challenge, but wonder if she should be getting more help, health checks etc? What should we do next- if anything? Is there any chance she will outgrow this? Should my other daughter have any tests?

ACL Thu 13-Nov-08 20:42:15

Hello Dr Fox

If I am correct, peanuts and folic acid both contain folate - could taking folic acid in pregnancy (especially if taken for a long while whilst trying to conceive eg for 6 mths plus and for the usual 3 or 4 months when pregnant) prompt a future peanut allergy in the foetus? I was just thinking this as I am wondering why Chinese people do not have a high incidence of peanut allergies despite their peanut diet (ie early exposure) - perhaps do they not take folic acid in pregnancy?

Both my children have (had) allergies and both were born by Caesarean section - does this op increase the chance of developing allergies later in infancy as they have not been exposed to bacteria etc from a vaginal birth?

What training do GPs have regarding allergies - could they be given more? Are the NICE guidelines for allergy assessment/treatment OK (if they exist)?

We have Ehlers-Danlos syndrome - Hypermobility Type (www.hypermobility.org) - could our stretchy and fragile collagen prompt allergies ie in the stomach/gut etc, as could large particles of food (protein?)be absorbed (leaky gut?) and therefore cause allergic reactions? Both children had cows milk allergies (first child undiagnosed), and my second child has allergies to pollen, dust, grass and peanut and has eczema, rhinitis.

Thank you for your help - parents need lots of your reassurance and support! smile
Alison

redH Thu 13-Nov-08 21:40:46

Dear Dr Fox

I am allergic to apples, peanuts, hazelnuts, peaches, celery and carrots (oh and raw parsnip and raw potato as well as silver birch pollen!)So I'm nervous about giving these things to my baby. She is 8.5 months and well into weaning, which she is enjoying.

My GP thinks I am being very cautious and advised me to try foods with her. I just tried apple this week and she has a raised red rash around chin, nose and cheeks, but I think it's from teething (it was there already but has got worse, but might have got worse anyway). What's your advice regarding babies eating foods their mothers' have medically tested allergies to?

I carry an epi-pen as I can have very strong reactions. I'm afraid of her reacting as badly!

Many thanks
redH

Hello Doctor Fox

I have a 5 week old son who I believe is milk intolerant, as was his sister until she outgrew it at around 20 months. I am breastfeeding him and have had to give up eating all dairy products so that the cows milk protein doesn't pass through to him in my breastmilk. He is still however showing signs of silent reflux, and has been prescribed infant gaviscon to try for this.

Are there other allergens which could be passing through my breastmilk and causing or exacerbating the reflux? My understanding is that there is proof only that dairy passes through, but anecdotal evidence suggests otherwise. If yes, then would you recommend an elimination diet for myself, or is there a better way to identify what is causing his pain?

Thank you.

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