Nut, CMP and Egg allergies - some general questions

[harverina]

Hi everyone,

Some of you may know that my DD is allergic to milk and eggs and we found out last week that she is also allergic to nuts too. She is 17 months old.

My Dh and I have some general questions which have cropped up since the nut allergy was diagnosed. We have always been told to avoid nuts but now we know that my DD is definetely allergic we have some questions:

1. do you give your DC processed foods or do you cook everything fom scratch? My DD had a severe reaction following eating a tin of ravioli, despite the fact that it had no known allergens in it - she had eaten it before a good few times. Our consultant thinks that there has been cross contamination in the production...so that would suggest that all processed food is a risk?

1. Food labels - do you avoid foods which say "produced in a factory handling nuts"? We have always avoided "may contain" but unsure about the "produced in" labels? Our consultant would not give us an answer to this despite us asking several times!

1. I have always previously eaten nuts in front of my DD prior to finding out that she is allergic. She has been in close proximity to, for example, snickers, peanut sauce etc but showed no reaction. Now I am avoiding having any but products when near my DD, but can you share with me what you do?

1. Epipens - we were prescribed epipens by the Paed Consultant who saw my DD on the paediatric ward after her last severe reaction 4/5 weeks ago (this was her second reaction, the first was when she was fed yogurt at 6 months). However, when we saw our allergy consultant she suggested that she wouldnt have presribed them because my DD is not quite 10kg, so she is under the 15kg recommended weight. This has stressed me out a bit - I was beginning to come round to the fact that we had epipens but now I am worried that they are more dangerous for my DD?

1. Now that I know my DD is nut allergic I am washing everything 1000 times in the kitchen. How likely is my DD to have a reaction to traces of an allergen on a washed plate that maybe hasnt been washed correctly? This seems like a daft thing to ask sorry.

1. Do you eat out? I posted a couple of months ago about my DD eating out with us for the first time - i.e we actually ordered for her in a restaurant rather than take her own things. We were delighted. We told the staff that my DD was allergic to milk, eggs and nuts even though we didn't know she was allergic o nuts, but we had been told to avoid them. They prepared sausage and chips for her seperately. Now I cant even imagine doing this EVER again. My DD used to love having chips when we ate out, I always saw these as a safe option???

Sorry for the questions - I probably have 100 more!

Hope everyone is well and thanks in advance for your advice.

:)

Oh harverina, poor you sounds like you've had a rough time of it lately. As for your questions, I think most of them are about personal choice and what you feel happy with. My DH is allergic to nuts but doesn't have epipens as he won't go to the doctors about it (and he's asthmatic - what an idiot!) but he does still eat processed foods that say 'may contain' or 'produced in a factory' etc as he says that otherwise he wouldn't be able to eat anything and that's his choice but I'm a bit more apprehensive when it comes to my son. My DS is definitely allergic to milk, wheat and eggs plus we've always been told to assume he's allergic to nuts because of his history. I have to admit that we don't have any nuts in the house and we don't eat nut products around either him or my husband just in case. However, we eat plenty of the things DS is really allergic to around him so in some ways it's probably a bit daft not to eat nuts too! The thing is, life isn't 'free from' so whilst you obviously need to take precautions you also need to be realistic. What if they brush past someone on the street eating a snickers bar? Or sit next to someone on a park bench drinking a milkshake etc? We do use separate cooking utensils at home but I'm rubbish at cooking (and I hate it) so I do rely on processed foods more than lots of the wonderful mums on here I'm afraid! I know there's always a risk of cross-contamination but there's a risk of that in my fridge/kitchen etc so what's the difference? Obviously, this is just my personal approach and others may well think very differently! Like I said, we all have to make decisions that we feel comfortable with.

On eating out, I have to say that I don't feel confident about ordering food for my DS when we're out other than a plain salad (I add my own tin of tuna or ham). However, we did once order a child's steak, potato wedges and beans at Harvester after reading the allergy book, explaining to the waitress and then praying through the entire meal with one hand on the epi-pen bag! It was worth it (I think) because DS loved the fact that he was having a 'proper' meal like his sister but very nerve wracking for me. Chips are often an issue for us because so many places use the same fat for things in batter/breadcrumbs. Apparently McDonald's are very good for nut allergy sufferers and they're chips are supposed to be safe.

Don't know what to say about the epi-pens thing. Maybe you need a third opinion? Does sound very confusing and you don't need the extra worry!

Hi there - can't resist a questionnaire!

1. Both - bulk cook freezable main meals from scratch (eg cottage pie/spag bol/casseroles etc etc). But have lots of processed food as well for teas, cereals etc. You just have to trust the packet. Also I would recommend signing up for the anaphylaxis campaign food alerts for product recalls (good to join anyway for more help with your questions and support).

1. We are not nut allergic, but same principle applies for our milk/egg allergies - would avoid any labels that suggest cross contamination may occur.

1. All depends on how allergic they are - some kids react to airborne traces (although rare), so you need to consider what is appropriate for your own child. DD1 used to react to touch on milk (eg even if grandad had had a cup of tea with milk, wiped his lips, then kissed her, she would still get a welt), so used to be very careful about hand washing, and we didn't have cheese in the house for ages/used soya milk on our cereals as well etc. She doesn't seem to do that any more, so am a bit more relaxed (I love cheese!). Will still avoid cross contamination where I can though - why tempt fate?

1. We have had epipen juniors for DD1 since she was 1 year old, so well under that weight (in fact I think she's only about 15kg now, at 4 yr old!). No suggestion from any doctors that it wasn't appropriate. Check you've got the Junior version, and look at the leaflet that comes with it as well for what the manufacturer recommends. But if its a lot of epi or an ana shock episode, I know which I'd choose. I wouldn't worry about it, just be glad you've got the epipen, and carry them absolutely everywhere all the time.

1. Again, depends on your DD. It is possible, so for your own peace of mind, you might want to make your house a nut free zone.

1. Not often! The first time we took DD out, she was 3 I think, and only ever to the local pub, as we know they use sausages from the local butchers which are OK, and the chips are not fried with anything else. I think its something that you need to build up your own confidence with, as cross contamination is always a possibility so you need to be sure the restaurant takes the allergies seriously.

Good luck, takes a lot of getting used to.

About the epipens for under 15kg -- we're about to be prescribed them for DS's allergies, so I'll ask that same question (as he is just over 11kg). Will keep you posted!

My DD (2.5) is allergic to eggs and has grown out of a CMP allergy. As far as we are aware she is not allergic to nuts and her peanut IgE wasn't elevated, but she has never had nuts or peanuts on the advice of her allergy consultant.

We have always taken the line of avoiding "may contain" AND "produced in a factory that handles" for the things that we know she is allergic to, as she has had reactions to minute amounts of third-hand contacted allergens. For the nuts, as she (to date) doesn't appear allergic, we don't give her stuff labelled "may contain", but will give her "produced in a factory that handles". This was ratified by her consultant.

I must say that I have limited things with eating out. I won't take her to Italian, Chinese or Indian restaurants as I think the chances of cross contamination are just too high given the ubiquity of eggs and nuts in those cuisines. We do take her out to other places, though but are just really careful to ask the staff about everything before we order it. Our last successful meal out was at a tapas place, where it seemed reasonably straightforward to have egg and nut free choices (apart from the desserts!). We won't go on holiday abroad, however, until she's grown out of the egg allergy (if she does...) as I'm just not confident to do that as I'm not sufficiently fluent in other languages. We had a slightly worrying experience last year on holiday in the UK in a gastropub which had emblazoned on their menu that they are more than happy to deal with food allergies, just ask us before you order and we'll be delighted to help. Good-oh, I thought and asked the manager about egg-free choices for my DD. His suggestion? Prawn cocktail. Given that this was all conducted in English (and was a fairly obviously egg-containing dish), I could deal with that but it did scare us as to what could happen in a similar place in Europe with my pidgin Italian or Spanish.

PS DD doesn't have an epipen - the allergy consultant's take on it was that her weight was way below the cut-off and she's never been anaphylactic. My take was that she's never been anaphylactic but likewise has never actually ingested egg protein, it's all been exposure on her skin which has set off her reactions and so we don't know how bad it could get if she accidentally eats some. She just shrugged her shoulders...

Thanks everyone...garliclover would be interested to hear what your consultant says. My DD is just under 10kg.

And in terms of eating allergenic food in front of DD:

Thankfully she grew out of her CMP allergy around a year, so I was able to finish mat leave still drinking my coffee and eating cake with her around! I just had to scrub my hands before I touched her and not kiss her.

She is 2.5 now, and eating something she can't have in front of her just isn't fair, and actually just isn't an option - "I want some!" I suspect you'll find this an issue as your LO gets older.

DS2 has allergies to milk, soya, egg, peas & pulses, sesame, nuts & peanuts.

1. Most food is cooked from scratch, but we do use some processed foods. Take a look at the other thread running on convenience foods...some good ideas on there.

1. 'May contain' and 'Made in factory handling'...this is a personal choice. Our consultant said not to give these, but we have taken the decision to ignore him. DS2's diet would be too severly limited in our opinion. So far he has had no reaction to any foods labelled in this way.

1. We are a nut free house due to the severity of his allergy, but we take him places there are nuts open in the room. We eat all his other allergens and he is around them often. We are just very careful.

1. I believe the 15k is not a weight requirement.

1. I use the dishwasher!

1. We do eat out. DH & I pretend to really enjoy it, while inside we're totally stressed. The DC reallly enjoy it though. We're always careful to ask, if having chips, what they're fried in and what else is fried with them. Failsafe is a plain baked potato and chicken/ham (check no milk in the ham).

Hope that helps!

Yes about the dishwasher! I couldn't believe how much less stressful it was once we'd got one!

I have nothing else useful to add that hasn't already been said, but thought I'd ask, was it Heinz Ravioli that you gave your DD? Because this definitely lists Egg as one of it's ingredients, and I'm fairly sure this is a recent addition, as My egg-allergic DD used to be able to eat it, but obviously no more...

Hello Harvarina - sorry you are also a member if the multiple allergy club! It isn't fun, but does get easier.

DD (7) has had anaphylactic reactions to cow's milk and is also allergic to egg, nuts, sesame and mustard.

1. For a long while i cooked everything from scratch and have only gradually introduced selected processed foods. There have been no major dramas as yet but i have noticed an increase in tummy aches and some confusing 'does she have a vomiting bug??' episodes. I suspect there has been some cross contamination/minor mistakes but nothng major.

1. We adopt a varying policy depending on how well dd is (more likely to have a nasty reaction if she already has a cold), what type of food it is (eg i am less likely to give her a 'safe' cereal bar because they so are so often made on nutty production lines) and also how well I would cope with a reaction. If I feel extra stressed and fed up, then I am more cautious on the basis that a trip to A&E would be the last straw!

1. We used to avoid having any of her allergens in the house, but I feel more able to cope now...We still avoid having nuts and sesame around though on the basis that they 'shed' particles more easily. There has been many an argument with dh about eating nutty muesli around her - as far as I am concerned too big a risk (sticks to facial hair, easily passed on).

4.I wouldn't worry. We were prescribed one when dd was only just 10kg. It is much more dangerous not to use it if needed imho.

1. i know the feeling. I personally would get rid of the nuts and possibly even the egg at home at first. We were advised not to have egg at home because it sticks to surfaces. I still scrub any egg off before putting in the dishwasher, and have different scrubbing brushes for her plates etc.

1. we do now eat out but very cautiously, sticking to 2/3 main places, and as someone else said mostly pretending to enjoy it! DD loves it and it is worth it for a normal life and a balanced child I think. Overall this is what I have learnt over the years - you have to try to avoid any major reactions but not at the expense of all normality. A child needs to go to parties, to go on holidays and to see food as something enjoyable. To achieve this you will probably have to develop a 'pretending not to worry' face.

For me many of the main problems have become vastly less stressful over the years due to a combination of time and good friends. They are the ones who accepted the need to be cautious and provided environments where she was safe but who also encouraged us to branch out a bit.

Good luck!