Your thoughts on 'May Contain'?

[Likeaninjanow]

I'm just back from DS2s appointment at the paediatric allergy consultant. He advised that we should not give DS2 anything that says 'may contain traces of XXXX (whichever allergy)'. What are your thoughts on this?

Currently we allow him to eat anything which states it may contain traces of his allergens. He's not had a reaction to these foodstuffs to date. To be honest, it would be a nightmare to limit him even further, as he's allergic to so many different things.

Ds is allergic to hazelnuts and peanuts. He outgrew an egg allergy a couple of years ago.

I let ds eat packaged food that states "may contain nut traces" and "made in a factory etc", except I do tend to avoid chocolate with this on, unless he has had it before, because he has reacted a couple of times to chocolate stating this.

I think I did avoid these foods more with "egg traces" because it was easier to do probably!

I have a friend whose son has a peanut allergy who had a huge score on his blood test (but no major reactions) who religiously avoids everything which is a nightmare!

We were told the opposite by our consultant. DS is highly allergic to dairy/nuts/egg/sesame but we generally don't take any notice of the may contain labels. However because of his range of allergies we're probably already cutting out a lot of the possible dangers with cross contamination. He's never actually had nuts or a reaction to them so the I think the consultant based his advice on our experience.

From what I've read chocolate in particular causes problems but ds can't have most of it anyway. I've also heard Frosties can cause reactions, presumably because they are made with Crunchy Nut Cornflakes so we avoid those. M&S in particular seems very liberal with its 'not suitable for nut allergy sufferers' labels and ds has never reacted to any of their products.

At the end of the day you've got to make the decision whether you're happy to up the risk factor in return for a greater choice of food for your ds. I know if ds did have a reaction I'd only have myself to blame and my views would probably change considerably!

We only have one allergy, but have gone through different phases based on the advice of whichever specialist we are seeing at the time (we have moved a few times). But we have found that even the same specialist will modify their advice based on the blood test results and to be honest we just tend to follow what we're told.

If it's going to be a nightmare for you, could you raise it with the specialist and ask whether it's really necessary? and explain how hard it would be? how serious are the allergies?

Thanks for your replies. He is anaphylactic to milk, eggs, nuts & peanuts, and we're not sure whether it's chickpeas or sesame that's causing a severe reaction including breathing difficulties. He's also allergic to all peas and pulses & soya, but has not had these for over 2 years so not really got a reaction to gauge the severity on.

However, as I said he's been eating 'may contain' food without issue. It was just the advice this morning that got me thinking we maybe aren't doing the right thing.

Hmmnnn...think I need to speak to DH about it. I'm still thinking we may continue to allow him to eat these things. We don't have a problem with chocolate as he only eats 2 types anyway, which are safe.

Hi

I'm a scientist and one of my previous jobs was food testing using immunology to detect allergens in order for manufacturers to be able to label their foods as 'contains......' or 'MAY contain.....'

Depending on the ppm of the particular allergen, the law states that they have to use particular terminology.

For example if I tested some bread for hazelnut contamination and we got a result of less than 5 ppm it would be reported as negative. However we may have detected 4.95ppm. If that makes sense. So it can vary from product to product combined with the severity of the allergic reaction.

Hope this helps!

Claire (mother of 15yr old, 10yr old, biomedical scientist)

www.clairecrawshaw.co.uk

That's really interesting, thanks Claire. Does that mean then, that all the foods saying 'may contain traces of x' actually will be contaminated?

Hi

No it doesn't guarantee that the products actually contain said allergen, it just means they've had good reason to say it may be (as they have to cover there asses!) like in situations where a 'x' free product has been on the production line, in the huge mixing vats or whatever, and then the staff haven't properly cleaned the equipment before starting production of a 'x'-free product.

We once had a case where (we mostly tested for huge companies or farmers etc) a woman took it up on herself to send in a sample of soda bread she had reacted badly to (she was gluten intolerant). The bread was advertised as 'gluten-free' which meant, back then that it had to be 200ppm (parts per million) or less of gluten in the product. Having got nowhere with the bread producers, she asked us to test for gluten. It was off the scale! We did a series of dilutions and found it to be above 400ppm. She subsequently took them to court and won. The legal limit became 20ppm in January 2011.

Another case of gluten contamination came from a really famous supermarket where the staff simply didnt understand the implications of cleaning down the equipment properly after producing chocolate muffins containing gluten, before starting on the gluten free products. Our director had to go to their factory to actually show the staff what to do as it only takes the tiniest amount to contaminate a product.

I know I've talked about gluten but it applies to everything, nuts, lactose, egg, celery...we tested for all of it and often shops had to remove every product from their shelves.

So unfortunately for people with food allergies, amongst other things, they're pretty dependant on staff to understand the cleaning procedures of equipment...it sounds a simple thing but costs factories a lot of money when they have to chuck it all out!

Claire

www.clairecrawshaw.co.uk

DD has a peanut allergy and no we never buy any may contain. We do ignore the silly Tesco ones about can't guarantee ingredients as long as the factory is nut free. We do eat Galaxy, maltesers and minstrels as the manufacturer ok's them for nut allergies and doesn't place any warnings on them. I personally would never risk a may contain and I teach my dd to treat her food allergies wisely.

like chloesmumtoo we dont give our son may contain. he also has had reactions when he was younger to food with this label. so we are really careful.

until you are more informed about how each product is manufactured , you cant judge the russion roulette side of things.

also, its worth bearing in mind, as parents , we are teaching our kids how to manage their allergies, if we are casual with labels, they will be twice as casual when older.

We ignore may contain labels on the advice of our consultant. He was allergic to most legumes, sesame, eggs and dairy, but had grown out of most legumes. We haven't had any issues.

DS that is!

dd is very allergic to tree nuts, milk, eggs and fish, and we generally avoid foods which say may contain as she has reacted before. I've emailed companies before to ask about specific products with that labelling and sometimes they say it's because they use the same line. dd will react to small traces so it's worth checking if it's something you use regularly.

Trixymalixy - that's so encouraging to hear your DS outgrew his legumes allergy. Do you mind if I ask at what age?

He outgrew most (beans, peas, soya, chickpeas) between the tests he had at age 2 and then age 3. He then further outgrew lentils between 3 and 4. He also tested negative to milk in his tests age 4 but failed the milk challenge, they're hopeful the negative test means he'll outgrow it eventually.

He's tested positive to egg all the way through , and unfortunately tested positive to peanuts for the first time. They are retesting him when he has his next food challenge as they think it's odd he has now tested positive to peanut allergy after growing out of all other legumes.

I must say the answers in this have made me think, I hope I didn't come across as flippant in my initial reply. I take ds's allergies extremely seriously and wouldn't want to be thought of as playing russian roulette or being 'casual' with his safety.

However I do think when there are multiple allergies involved it is so much harder, if ds had only a peanut or nut allergy I probably would avoid all may contain because he would have a much wider choice of foods anyway. When nut is mixed with dairy/egg/sesame (and for a time soya) your choices are so whittled down that I found it quite hard to deal with. This was why I ended up having the conversation with the consultant and he decided it was fine not to avoid may contain (his daugher incidentally has severe allergy problems so he's very well experienced personally as well as medically).

DS was diagnosed at 6 months and is now almost 5 and we've only ever had one reaction due to a misunderstanding so we are extremely vigilant with regards to his safety. He has an epi pen and very high RAST scores to his allergens.

As you say though eragon, how do I explain this to him when he starts policing himself? I don't have the answers but I have written to M&S to ask them to explain their allergy labelling especially with regard t nuts as I don't think it's particularly clear.

I agree bilbomum. DS was allergic to so many things that his consultant advised us not to avoid may contain products as his diet was very restricted as it was. As I said we have never had a problem.

Yes babybarrister you do have to watch for chocolate. Mainly because the cleaning process involves flushing through all the equipment with chocolate and discarding it before its clear to put some through that the manufacturer is confident to be nut free/vegan/whatever they're producing. Also as I said before, you wouldn't believe how many staff have not been informed properly of the procedures or how little you need of an allergen to cause a reaction in some people.....so they take shortcuts.

chocolate, biscuits , cakes, cereals, breads , all particularly high risk for cross contamiantion, so making an informed choice as much as possible is the ideal.
i wouldnt assume that every label is covering their backs........

Some manufacturers take covering their back a bit too far, G&B chocolate fir example. Their dark chocolate lists milk as an ingredient, except it doesn't contain milk. Milk is only listed their because of potential contamination in the manufacturing, it says so on their website. Even though nothing has changed about the recipe, the manufacturing etc, they changed their label from may contain to contains milk.

I don't know if this was on the advice of lawyers or whether it was tested and had a higher ppm than allowed, but it really pissed me off.

Oops listed there !

If a product is not made on a dedicated line then even if they have a thorough clean down routine (or in the case of G&B they flush the machinery with milk-free chocolate and discard the chocolate used for the flushing) it is theoretically possible cross-contamination could occur. The chance is very,very small and is very, very unlikely, but it is possible. In this situation many manufacturers cover themselves with the "may contain" . My son continues to eat items which had "may contain" added after he had safely eaten them for some time (after I had checked with the manufacturer that nothing had changed).

do they really discard the re-work chocolate, because normally that gets put back in the main pot , before they start making the different product.

thats why mars bars have a may contain on them, they made snicker bars first, push the choc through to pick up the bits, then pop it back in the pot and then make the mars bars.

its normal practice for manufacturers.

yes they do clean them. It's just that it takes such a small amount to contaminate a batch they still have to say may contain....especially a global distributor as big as mars

My head hurts thinking about all this. Having talked to DH though, we're going to continue to allow him 'may contain' as I believe restricting his diet any further would be too limiting for him to cope with, we don't have the issue with chocolate as the one's he eats are completely safe.

I agree with the comments above regarding multiple allergies being more difficult in all of this. He's not had a 'may contain' reaction though, I'll need a rethink if he does in the future.