7 month old, new diagnosis of allergy to CMP and egg

[poppycat04]

Hi, this is the first thread I've ever started, been a lurker on mumsnet for a while, never been to allergies board before. Was wondering if anyone could help. Have 3ds, first two fine, 3rd ds is 7 months. Ebf until 6 months. Now looking at diagnosis of allergy to CMP and egg. Waiting to see paediatric allergy consultant. This seems to have come out of nowhere, don't know what to think / worry about first. Egg resulted in swollen face, rash. Came up so fast. Few mouthfulls of porridge and rash everywhere, so scratchy he was making himself bleed. Now on piriton twice a day, steroid cream on rash, exclusion diets. Does this sound sensible? I'm medically qualified and due back at work soon and feel so shaky with all this. The thought of leaving him anywhere I'm not supervising is horrible. Sorry for no paragraphs, typing on phone. Not sure even what I'm asking... Just wondered if anyone had any thoughts/ advice. Thanks in advance

[garliclover]

Poor you and poor DS! I'm not sure how to help, but couldn't leave your post unanswered. My DS is also allergic to CMP and egg, plus wheat, sesame and lentils. I was in the same situation as you when he was 7 mo (now 15 mo): had been Ebf'ing for 6 months and due back at work at 7 mo.
Ok, so first question: are you planning to carry on bf'ing, or will you switch to hypoallergenic formula when you go back to work?
I think this might be one of the first things to think about, bm or formula being his main source of nutrition.
On that issue alone you can get all sorts of advice and support from this thread. And anything else as well! Just ask: I'm sure you'll get lots of wise advice from other mums who have gone through a similar situation.

[poppycat04]

Hi garliclover, thanks for replying.

That must be really tough with your DS. I've spent today reading food labels and I can't believe how much has just milk in, let alone wheat, eggs, lentils, sesame..
My gut feeling is that I want to keep breast feeding, I feel like I've got him this far, and it's kept him safe until now. That sounds a bit weird.
Work have agreed to 20 hrs, 2 days 9-5 and one 9-1, which is a massive relief for my speciality plus I've asked to extend to 12 months my mat leave and add AL on afterwards. This means DS will be 11 months when I go back. It'll mean expressing, will have to figure all that out. What did you do?

[poppycat04]

When I saw my GP today he said there wasn't much evidence for excluding dairy and egg from my diet. But the lady from allergy uk said I should... What do you think?

[garliclover]

Doesn't sound weird at all really admire you for continuing the breastfeeding! It wasn't an option for me to continue. Because he had reflux, my DS ended up associating feeding with pain. Things improved so much when I weaned him onto the bottle at 6 months, with a hypoallergenic formula. I think your plan to express is brilliant I suppose you could start slowly building up a milk bank in the freezer? Not sure how viable that is, if for example there is a power cut or something. But am sure other mumsnetters will have advice on that.
As for the GP's advice....hmmmm. I think their standard line up to now has been to say you shouldn't exclude anything from your diet while breastfeeding. However, you can google the new NICE guidelines issued in February this year on how HCPs should deal with allergies in children. There it says (I think!) that advice should be given to the mother about excluding certain allergens from her diet with proper guidance. But I suppose it depends on what you have experienced so far. If your DS has been fine on bm, then it makes sense to continue as normal without any exclusions....

[ChocaMum]

Hi poppy, I hope you're feeling a bit better. We do know how you feel, it is so overwhelming at first and the thought of leaving your little dc is pretty terrifying. But I promise it does get easier. My DD is now 18 mo and has been at nursery since 12 mo for 2 days a week and they bare great about her allergies (nuts, cmp, egg, soya and kiwi.)

I would definitely stay on maternity leave until you feel confident about managing you DS' allergies because otherwise you will just spend the whole time worrying about him. I bf until DD was 15 mo because of her allergies, but started using hemp milk and oatly things like her cereals and oatly cream to bulk up the calories.

I too am in the medical profession. From my experience and others on here I would exclude egg and dairy form your diet. We now see Helen Cox at Paddington (she wrote the nice guidelines on eczema) for our DD's allergies and she really is extremely experienced in allergies, inwent to an allergy masterclass and after seeing her speak I knew I wanted her as our consultant. Anyway she recommended me staying off egg and dairy until I stopped bf.

You are right, there is a ridiculous amount of food containing cmp, but once you work out what is safe you will stick to them. If there's any food tips you need including brands, please ask away. Mumsnet is probably the best help I've had for handling all the allergies. Good luck and hope this helps. :)

[poppycat04]

Hi ChocaMum,
Thanks for your reply. Sorry it has taken me a while to reply. I really do appreciate it.

The good news is that DS's skin really is a lot better. Still got the rash all over but far less angry looking and he's not scratching until it bleeds anymore (has been wearing socks on his hands whilst asleep!). He has been having piriton twice a day and steroid cream (just a little bit on really bad places) but is it usual for things to improve that fast? We've only been dairy free for 48hrs. He seems much happier in himself too.
I've talked to work as well today and extended mat leave to 12 months and then added on accrued AL so that gets us to the end of January. I know how lucky I am to be able to do that.

Now I guess we wait for the paediatric allergy consultant appointment. No idea how long that takes. It was the consultant allergy UK suggested. We're in the North, although will definitely look out for the allergy masterclass re work. Need to read NICE guidelines too. Do you think they'll do skin prick testing / bloods? I've started a food diary for DS and for me, and ordered two allergy cookbooks. I'm wondering how we can plan meals for DS1&2, DH and DS3 and me!!

I guess next is to find out about expressing b milk. And when to start building up a bank. Am I missing anything?

I keep thinking I might be missing something. We use hypoallergenic washing powder etc and I've changed DS bodywash / shampoo from Johnsons. But I guess the fact that the rash has improved so dramatically with our diet change is a major clue.

The GP yesterday said that often children grow out of CMP allergy by the age of one. Is that the case? Plus if egg allergy too that will affect MMR.
I'm just thinking out loud really. Really good to hear that your nursery has been able to handle your little one's allergies. Thanks again for posting.
Poppy

[poppycat04]

Hi garliclover,
Wanted to ask, was it really difficult to wean onto the hypoallergenic formula... (just in case !) The advisor I spoke to from allergy uk said something about taste buds changing at 6 months and the formula tasting a bit grim...
Think I'll pop over to b feeding board in a bit and start asking about expressing! Although do have a bit more time now!

[poppycat04]

Oh and what can I put in my tea to stop it tasting sooo grim?!! ( using alpro at mo )

[Likeaninjanow]

Hi Poppycat, so sorry you're having to deal with all of this. I remember how hard it was at the beginning!

I went back to work when DS2 was 7 months old, and had to express a 2-3 times a day. I found a double electric pump to be an absolute Godsend, and I used a cool bag to transport it from work to home. It wasn't as hard as I thought it would be and, as he got older, there was no longer any need to express as he managed with water/oat milk through the day and then fed for ages when I got home. It was a lovely way for us to bond after being at work . Unfortunately I cant' remember what age I stopped having to express at...but I don't think it was far past the 12 month mark, so you may actually be OK by the time you go back.

FWIW, my DS2 had horribly bad exzema (wet wrapping etc) but, when I excluded his allergens from my diet, it completely disappeared. He is now age 3 and has none at all. When we visited the dermatology unit they said he just had eczema and it was highly unlikely he had any allergies! He's anaphylactic to milk, egg, sesame, nuts and highly allergic to peas an pulses.

[poppycat04]

Hi Likeaninjanow,
Thanks for your post. Have been showing this thread to DH and he's finally realising how great mumsnet is!
With the expressing, how long did it take and were your work understanding? I'm worried that I'm already going to be part time, and my colleagues might not be very impressed with me disappearing with my pump..
Can I just ask, what do you feed your kids? Do you menu plan for the week? And how do you fit meals together for other siblings etc?

[mum2twoloudbabies]

Hi poppycat04 it's really hard to get your head round at first my ds he was ebf for 6months and is allergic to dairy, egg, wheat, soya and peanut now 10mo I am starting to get it sorted in my head. Cutting the allergens out of my diet dramatically improved his eczema.

I meal plan for all of us, it's surprising how easy it is once you start. I've found the key is to cook from scratch mostly and it sometimes means fishing ds portion out early before adding the rest of the ingredients. I've switched the whole family to pure dairy free marg, ds has oatly milk and nutramigen in his food and oatly cream with fruit for a change . Also, get to know your local health food shop as they will stock some weird and wonderful alternatives to dairy products pea protein yoghurts are a big hit here and the free from frozen and ambient aisles (our local sainsbury and waitrose are very good). Do you know if he can have soya? because Alpro soya yoghurts are nice.

As for your tea I like Kara coconut milk in mine it's the only alternative I have been able to stomach and oatly on my cereals (can't stand the soya milk at all).

As for weaning to the formula, yes I have found it very difficult but I wasn't very determined because I am a SAHM and didn't have a deadline to work to. He will now drink it sweetened with crusha which I am gradually reducing this down and it's working. My dietician suggested mixing it with bm to start with but he never took to that but it is a good starting point if he won't take it straight.

Good luck. It makes my head spin every time our routine changes because the food is one more thing to add to the mix, thank god for mumsnet.

[poppycat04]

Hi mum2two!
I've used your message to make a shopping list that was really helpful thank you.

[poppycat04]

I've noticed most mums have a definite list of the things their kids are allergic to. Are these from skin prick testing?
Also I'm completely amazed that we were never taught about allergy / diet in relation to eczema in paediatrics , (although maybe I missed that lecture)

[TheWicketKeeperIsDown]

Hi there, another doc here and mum Tina DD who was diagnosed with CMP and egg allergy at 6 months.

I remember how dreadfully daunting it was at this stage - i felt my world had ended. But hopefully there are some positives from my experience which will encourage you.

Firstly, and most importantly, my DD grew out of her CMP allergy around 1year, so yes it is possible! While she's still allergic to eggs (and is nut-free on the advice of her paediatric allergy consultant), this made life so much easier, as milk is so much more ubiquitous than egg.

Our nursery has been fantastically supportive. I would strongly recommend talking to your child care provider well before starting, to agree a plan. I remember well the stress of leaving her in someone else's care. But ultimately I had to accept that I could not guarantee a 100% risk-free environment wherever she was, not even with me. But you need to be comfortable with where she is and that means discussing the details of eg another baby having a bottle then sucking a toy then DD grabbing it.

Regarding cooking, I found 2 books helpful. Alice Sherwood's recipe book is particularly good for baking, and has helpful tips on dealing with kids with allergies, eating out etc. I also like "How to cook for food allergies". I don't use it so much as a recipe book, but the author is a chef and there are really helpful chapters on substitution of allergens in recipes.

Finally, the BF. I was also very keen to continue and managed to go until 2 years despite working 4 days and 1:3 weekends in a reasonably full-on specialty. DD and my boobs seemed to adapt well and she fed twice a day on work days and 3 time a day when I was at home. It just seemed to work itself out. I drove myself a bit mad in the last part of my mat leave wit expressing, only for little madam to turn her nose up at the EBM! Re your coffee, try Oatly milk, or sweetened soya (even the vanilla stuff if you like coffee with flavoured syrup!) as a more palatable option.

Good luck - but I promise that things will turn out more easy than it currently feels they will!

[fofo4]

Yet another medical mum here with DS allergic to milk but thankfully nothing else. Diagnosed at 5 months when it felt like the end of the world, he is now 10 months old and it feels like a minor inconvenience. It is amazing how quickly you can adapt your family meals and make small lifestyle changes to accomodate the allergy.

I BF a bit longer than planned but felt it wasn't feasible to continue when I went back to work so (after seeing allergy dietician and paediatric allergy specialist) weaned him gradually on to Aptamil Pepti which doesn't taste too bad.

I second the suggestions for Pure sunflower spread and Oatly milk. Alpro yogurts. Mashed potato is good with the above instead of butter and normal milk. I mostly feed my kids the same meals as it makes life easier (DD not allergic). Shepherds pie with mash made with Pure and Oatly, lots of stir fries and fried rice, you need to check the labels but most brands of fishfingers, sausages are OK, jacket potato and baked beans. If I do pasta DD might have pesto while DS has bolognese or dairy free cheese sauce on his. Hummus or mashed up sardines (good sources of calcium) in sandwiches. Roasted veggies with olive oil.

Scratchsleeves (google it) great for eczema softer on the face than socks.

I was worried about nursery but they have been fantastic - had meeting with manager and his keyworker before he started, there has never been a problem.

It really does get much much easier with time.

[fofo4]

PS No skin prick testing for us, diagnosis made on history and we were given a plan by the dietician of introducing the risky allergenic foodstuffs (wheat, fish, peanut butter etc) singly but fairly quickly over a few weeks. Just gave tiny amount first with bottle of piriton to hand then if he was OK gave more.

[manitz]

hi dd1 is now 8. was allergic to milk proteins and egg and had failure to thrive on breastmilk. prob should have followed an exclusion diet myself but realised too late so mix fed from 4 months with nutramigen. it's vile and was first told to mix with nesquick to cover the taste, didnt need to do that for long and she loved it (she was on it till about 6 so i could ensure she had some calcium and vitamins etc prob not best practice).

at nursery explained no dairy and no egg, person showing me round nursery said 'she can have cheese though yes?'. We agreed might be best if I sent her with a packed lunch which I did from then on. Didn't ever give her regular doses of piriton unless she had had something she was allergic to and then gave it as a rectifying medicine if that makes sense. Always had piriton at nursery and her keyworker once gave her proper milk and was suspended, I loved the keyworker though not the brightest and we agreed she should come back. DD didn't have anaphalactic response in allergy but would immediately vomit and come out in hives due to milk protein allergy and swelled up and went purple in response to eggs. at about two years I started to test her on foods, initially those things further removed from pure milk were ok and gradually moved on to more obviously dairy products. would only give her foods in teh morning, initially vomiting and reaction would be delayed so might only vomit a few hours after consumption.

Skin prick test came out as a low level allergy yet the vomiting reaction was not low-level and i was told the test is not that conclusive. We avoided nuts until 5. By about 5 she had grown out of her allergies and now has all dairy although ocassionally has odd unexplained hives. She has always been able to police her own food and I've not had to worry, I tend to go with her lead on food.

hope this is of some use. 80% supposed to grow out of milk allergy by 5ish.

[garliclover]

Hi again, poppycat. So glad to hear about your longer maternity leave and that your DS's skin has got better -- wonderful news. Just a few things to add after reading your latest:
MMR: the egg allergy shouldn't affect this. My DS is very allergic to egg and was fine. Our GP told us that in the few cases where there were reactions to the vaccine, they were not caused by egg.
Tea: I don't think any of the milk alternatives taste that good with tea. I tried them all when breastfeeding and the most palatable was Kara dairy free (made from coconut milk). In the end I settled for rooibos tea with Kara and a bit of sugar.
About pinpointing allergies: We are still discovering some, namely the sesame and lentils (very immediate and obvious reactions to tiny morsels!), but the others we found out about through two skin prick tests and one blood test (and a couple of rather unpleasant 'home challenges').
Formula: Yes, it was difficult to wean him onto the bottle. In the end we hired a 'problem-solving' nanny who was brilliant. She sat with him for 5 hours and once he drank the first bottle he never looked back. But he was only 6 months so more adapable, and was weaned onto Aptamil Pepti (like fofo4's DS) which is far more palatable than Nutramigen or Neocate (it still contains whey protein, albeit massively broken down, so is not advisable if your DS is very very allergic to milk).
This is how we manage the meal plans: we break things down into manageable tasks, so we do meal planning on wednesday evenings, online shopping on thursdays (including through goodness direct), and batch cooking on Fridays and weekends. We use the slow cooker for stews which then last for ages (a large freezer is essential). And every other evening I prepare something simple for the next day, like mashed potato, roast squash, or homemade houmous without sesame. Going out to eat is a bit of a nightmare but I just bought a Thermos hot flask so am hoping we can give DS his own little meal without having to talk to the chef beforehand...Picnics with other toddlers, I have discovered, are horrific and I will be avoiding those in future!
We're still finding our way, and still picking up lots of tips from mumsnetters!

[TheWicketKeeperIsDown]

Yes, Scratchsleeves are amazing! Highly recommended.

[garliclover]

Oh yes, and the scratchsleeves. We couldn't live without them!

[manitz]

hi, just on mmr, our doc insisted that mmr was done under observation in the hospital rather than at the doctors. Was all fine.

[poppycat04]

Just wanted to say thank you for all your messages and support. Am overwhelmed actually by the fact that in a couple of days we have had so much help. I'm going to go back through all your messages and reread them again. Loads to think about. Will post again as I think of questions. Thank you

[mum2twoloudbabies]

on the mmr ds has already has one dose early due to holiday in france and he was fine. our practice nurse printed out the nhs guidelines for me and I spoke to my consultant and all said that it is normal practice to give the mmr at the doctors surgery regardless of allergy. I guess your gp will guide you on that.

[mimmymouse]

Hiya,

sorry to hear of your woe. We've recently been through this too. My DD is 9.5mths now and was diagnosed via skin prick tests at the allergy clinic in the hospital. The appointment took nearly 2 months to get. DD was diagnosed with CMP, egg and nut allergy.

I was most upset as I had EBF since birth. I found it really hard to understand how this could happen - I'd though BF was supposed to prevent this sort of thing! However, we've continued to BF with me expressing like some sort of demented cow. I find I can express, both sides, in less than 20 minutes with a single pump. I take the pump and bottles to work in a lock and lock box that has been sterilised and in cold water sterilising fluid. Easy to replace with a steriliser tablet should you encounter disaster. I transport home in a cool bag. (I have the Medela one which the bottles nestle into.)

On the advice of our consultant I did not exclude eggs and dairy from my diet. DD, who had onset with eczema at 8 weeks, has had no recurrence. Since eliminating dairy from her diet she's thrived. I use most of Annabel Karmel's recipes just eliminating the cheese! DD eats very well and enjoys her meals.

I'm now finding my expressing isn't as good as it used to be. (God only knows why.) We've been given Nutramigen which I've tried putting on her cereal (haven't yet tried as a "milk drink") and which has, so far, been resoundingly rejected. We're going to ask the GP to give us a go on the Aptamil Peptil.....

I wept bucket loads over this, but our consultant very firmly told my DH and I that she fully expected DD to grow out of it by age 2. If not then, age 5. This seems to concur with other posters. (Very reassuring!)

Very, very good luck. Mumsnet has been a totally wonderful source of information and support. There was a really good Q&A with an allergist a while ago which helped me understand. Search for that?

[ChocaMum]

Hi Poppy,

Sorry but I don't come on MN everyday but all the other posts have been so helpful by the looks of things.

Just to reiterate though we had no tests as such, when it comes to the non IgG allergy diagnosis, good old history, history, history! There was no teaching of allergies affecting eczema from what I remember, even the normal dermatologists often deny the relationship just like other posters have said. I think that was possibly the hardest part, being a medic and being completely oblivious to what was happening to my baby was from what I was feeding her.

Vitalite is also cmp free. There is lots out there for dairy free options, it's just the first month or two that feels a bit impossible because it's all new. Redwood do a yoghurt called 'wot no dairy' made from pea protein. Our holland and barret don't do it but I order a lot of things from goodness direct. Although there are lots of soya alternatives to dairy, Helen Cox told us up to 50% of cmp allergy sufferers are also allergic to soya so do be careful when using soya in your diet.

In terms of transferring to a hypoallergenic formula we were told after 1 year is the main problem, at 7 months you should be ok really.

For yourself you can buy things like dairy free chocolate, dairy free chocolate spread, egg and dairy free cakes etc. Plamil do dairy free chocolate, the cake crusader do yummy cakes and it's very handy for things like parties when your DS is a bit older and will want what everyone else is having, naturally!

The majority of non IgG allergy sufferers will grow out of it, along with soya and egg (both also common in eczema sufferers) My DD is 18 mo and we were told between 2-4 yrs is the common age to grow out of it, although it obviously varies. They would do a trial of reintroduction at certain stages when DD was much better, which I think is the norm.

Anyway, I'm really glad to hear your DS is already so much better, as you said it shows how much the diet affects eczema. Otherwise we also saw a specialist eczema nurse who was amazing and she basically told us main aim is frequent emollients use (do this in a downwards direction to prevent folliculitis) high dose steroids that you continue and wean off when skin is better (we use synalar for 2 weeks od, 2 weeks alternate days and then prn) and bath everyday for 10 mins in warm bath, first apply emollient such as dermol lotion all over, then put DC in bath and add oilatum, and avoid all other products. I use epaderm to wash DD's hair with instead of shampoo (it does foam up if you use enough water.) Also you want to try to have as little dust mite as possible, obviously can't completely eliminate it in the house. But wash bed sheets/sleeping bags every 3 days at 60 degrees, washing powder makes no difference, just use loose powder and use a bit less than normal or add an extra rinse cycle at the end. Same with all of the clothes. Any soft toys you can't wash at 60 degrees freeze overnight in plastic bags. I only put DD in cotton and there's a website chalked cotton comforts, eczema clothing, that do body suits with mittens as part of the woke bodysuit and they can be washed at 90 degrees, they do lots of other useful products. At the minimum keep the layer closest to his skin cotton. No let's if possible, lots of dusting especially in bedroom, washing curtains or having blinds instead, washing rugs and deep cleaning carpets when possible. If you have been to a house with pets or a farm or even the park, wash hands and face as they may have pollen, fur etc on them. Sorry if too much information!

The allergy masterclass was fascinating, I went to find out about DD's peanut allergy and ended up finding the answer to all of DD's problems which had been dismissed by 2 different teams of specialists, one being an allergy specialist! Briefly our DD was 14 mo at the time and had lost 1 kg in weight and dropped below 0.4th centime, struggling with food other than mash or purred food by gagging, choking, and vomiting several times a day, and lots lots more that seemed trivial as individual symptoms but were answered by the presentations. Anyway turns our DD has eosinophilic oesaphagitis which I'd never heard of before! The talk was run by Adam Fox (St Thomas') Neil Shah (GOSH) and Helen Cox (Mary's Paddington) so if you see anything done by these consultants it really is worth going along.

Also did your DS have bad eczema before or is it all recent? I'm asking because there's something called the allergic march and the sensitisation to food is thought to happen through the skin so if your skin barrier is poor from a very young age then you are more likely to develop IgG allergies too. This is why the EAT study at Evelina, St Thomas' hospital are doing a trial into early introduction of potential allergens to reduce allergies and it is so far showing very good support for this theory. So if your DS did have bad eczema before be very careful when introducing allergeic foods. And don't expect an instant reaction, our DD had eaten peanut butter 3 times before her anaphylactic reaction on the 4th time.

I'm assuming you know that you accrue AL when you are on maternity leave, just thought I'd mention it if you didnt know. Also by the time your DS is 11/12 mo he will probably only be having 2-3 bf a day which you can do first thing in the morning, last thing before bed and one after midday nap when you are at home or hypoallergenic formula when you're not. If you get on with pumping then great, but I found out a bit too late so this is what I did. It is actually not that difficult to continue bf when working, especially part time. I only stopped at 15 mo because I became pregnant and had awful hypermemesis.

Sorry again for a very long post, I just hope it's of some help. Please do ask away anything you need to, MN is really great for this. I really hope things continue to improve for you all. :)