peanut allergy - am I doing wrong?

[kels666]

DD has always had a very good appetite and eaten most foods. At the age of one she was diagnosed with a peanut (not other nut) allergy (after consuming peanut butter) And here's the dilemma. Prior to that she had been eating EVERYTHING including foods saying "not suitable for nut allergy sufferers etc. etc...." So as long as the food doesn't contain peanuts, I'm giving it to her. Am I doing wrong? Haven't really had any advice, my GP is useless and refuses to refer me to a dietician. Is anyone else in the same situation?

I'm not sure really, but if she is not having a reaction, i guess that means she is okay. Can I ask what happened when she was diagnosed?

no it does not mean she is OK. What it means is that on some food saying "not suitable for nut allergy sufferers" they are covering their backs because there may be nut traces in it. So far you've either been lucky or she's outgrown the allergy or the test result was positive but it doesn't have clinical significance. How bad was the reaction and who diagnosed allergy?

Change your gp. Really. Forgive me if I sound tetchy - I'm here because my eldest got her test results today. She had an anaphylactic reaction to food that the manufacturer insists was nut free. Her test results show she is getting more allergic as she gets older. You need advice from someone with some sense and that clearly isn't your gp.

There is Department of Health guidance that says you should have a consultant referral if nut allergy is suspected. You may get a consultant with an interest which means they may know less than me but at least they can retest and refer to a dietician. best of luck, she may outgrow it.

NO YOU SHOULD NOT GIVE HER ANYTHING WITH A MAY CONTAIN. MY DD IS ONLY GIVEN THINGS TO EAT WITHOUT WARNINGS AND I EVEN CHECK OUT WITH THE MANUFACTURERS MYSELF TOO, JUST TO MAKE SURE ITS NOT FROM A NUT FACTORY. I HAVE HAD A DIETICIAN BUT IN MY EXPERIENCE SHE WAS USELESS AND ACTUALLY NEW LESS THAN ME -WHICH IS SCARY . NO, ALL JOKING ASIDE A DIETICIAN SHOULD BE GIVEN. BUT I JUST FEEL YOU HAVE TO DO YOUR ABSOLUTE BEST TO AVOID NUTS AS AFTER ALL IT CAN BE LIFE THREATENING. MY DD IS ALLERGIC TO PEANUTS BUT I DONT KNOW ABOUT THE OTHER NUTS. IT TAKES TIME, YOU FIND IT GETS EASIER. SEEMS SO DIFFICULT AT FIRST.

KERRYMUM - I KNOW WHAT YOU MEAN! I HATE TESCO FOR IT AND DID STOP BUYING IN THERE FOR AGES. HAVE WEAKENED RECENTLY TO THEIR ORGANIC VEG/FRUIT WHEN DESPERATE BUT THATS ABOUT ALL. SAINSBURY IS 25 MINS AWAY AND HAS TO WAIT TIL WEEKENDS. I THINK THEY ARE VERY CRUEL TO LABLE IN SUCH WAYS, I HATE IT.

Thanks for all the replies. Two things that confuse me - the pediatrician at the allergy clinic told me to continue feeding her what she had already been eating. Secondly, surely not all peanut allergies are dangerous? I realise the media do a certain amount of scaremongering - but I did read that MOST peanut allergies are mild. My dd's is grade 2 which I assume is quite mild and I'm hoping she'll grow out of it. It's quite worrying that I could be making her allergy worse - do you have any links to the research on this? I'd like to be fully informed before I start to make changes to her diet or change GPs

My son has allergies to nuts and seeds, I think the Tesco labeling is brilliant idea.

It is very clear and much better than the cop out "may contain nut traces." which I once read on a chocolate that actually contained ground up hazlenuts listed in the ingredients which is one of sons allergies.

You have actually misquoted the labeling which is why it doesn't make sense

it should be

recipe: no nuts
Factory:no nuts
Ingredients: cannot guarantee nut free

this was on a tin of pineapple

Whereas the the sainsbury labeling for Jam

"not suitable for nut allergy suffers because of the methods of manufacture."

What they probably mean is that they have wiped down the machine with peanut oil. But why don't they say that!

I wouldn't feel bad Kels666 I think most people are being harsh with you. The dietician from the allergy clinic told me that it was okay to have food with "may contain nut traces"

Had to laugh at the link, son used to love peanut butter before he became allergic at 4.
I thought, excellent a spread he can have only to discover it is made from sunflower seeds. which is another of his allergies

Just wanted to add that I agree with everyone, if your child has a serious nut/peanut allergy you should avoid all nuts/peanuts. Why take a chance. anaphalaxsis is life threatening. The other aspect is by taking a no risk approach, you are teaching your child not to take chances. My dd is now 10 and is great with her allergy. She will pick up something and say, no label, can't eat it. She even instructs her teachers on how to read the labels and if htey say may contain, she refuses them. She does this becauase I never take chances with her no matter how miniscule the risk appeared to be. Remember, you are modeling how they need to manage their allergy on their own someday and do you want your dd to, say, seems ok, let's give it a try.

actually 20% of babies with peanut allergy will outgrow it. www.anaphylaxis.org.uk/information/print_common_food_al.html#item3

If your child was grade 6 they would be unlikely to outgrow it but with grade 2 they may do so. Once they are past 5 I'm afraid allergies tend to get worse rather than better.

kels666 we don't actually know if what you are doing is right or wrong because allergies aren't well researched. All we can tell you is what our doctors have told us. The best allergy consultants in this country will tell you that nut allergies are unpredictable, that grade 2 does not mean your child will not have an anaphylactic reaction and that you should avoid nut as a result. If your gp gives you different advice then at the very minimum you should ask them the basis for their information and why it is different from the advice given by consultants who specialise in allergy. If you are going to risk foods which may have nut in them then you need an epipen. You really need to get your child retested and see if there is any evidence that the severity of the allergy may be changing.

Personally I love Tesco labelling. No company can guarantee its ingredients are nut free becaause they don't control the suppliers. What they are telling me is that their factories don't have nuts in - or that they do have nuts in. We don't touch anything made in a factory with nuts in, we do eat others. Any food you buy may be contaminated with nut traces from someone whose hands had nut traces on it. You can never avoid risk completely. Tescos are more honest about what they know.

This is what can happen when peanut sensitive children are given nuts, webpage it is taken from below

"In 1996, a brave physician, Harold Nelson, M.D. at the National Jewish Center for Immunology and Respiratory Diseases in Denver, Colorado, launched a heroic study of peanut desensitization. This study was extremely well designed and carefully administered. It was a controlled study in which some children were injected with peanut extract and some were injected with a placebo. The injections were only given with full intensive care unit and emergency department support. It is difficult to imagine a safer place to conduct this study than in this world-renowned center, with people who have great respect for the power of allergies. Still, one child who received the peanut injection died seconds later from laryngospasm, before resuscitation was possible. This tragedy abruptly ended the only study conducted on desensitization to peanut allergies."

www.drgreene.org/body.cfm?xyzpdqabc=0&id=21&action=detail&ref=18

Since then there has been another study, with good results, but exposing a child sensitive to peanut to foods that may contain it is a risky business even if you are medically trained.

I' not prepared to call a supplier every time I want to eat prepared food. I wouldn't trust most of them to know the answers anyway, these things change too often.

The anaphylaxis campaign are working on a scheme of accreditation where a manufacturer gets permission to state they've controlled allergens well. May help, I'll wait and see.

there is no point in simply calling the manufacturer the first time you try something new because it may well change before the next time you eat that food. And the manufacturer can assure you the food is free of nuts and made in a nut free factory but it only takes one food handler to eat nuts and you have contamination.

Tescos say they can not control the way ingredients are stored before they get to the factories therefore they cannot state categorically that ingredients are nut free. It would be easier for them to label everything "may contain" as some other supermarkets do.

Unless you grow and rear your own food you cannot be sure it is nut free. That's why we have epipens. After my child's recent anaphylactic reaction the consultant suggested it may have been caused by food fed to the chicken. How many manufacturers do you think go that far down the food chain (if he was right and I wouldn't trust him)?

There are other studies besides the BMJ one. They give similar results. If you want to find out more there are suggestions for the reasons some children outgrow allergy in articles like this one (which I don't claim to understand)

"Peanut-allergic donors show Th2 polarization of cytokine production by peanut-specific cells (IFN-gamma (low), TNF-alpha (low), IL-4 (high), IL-5 (high), IL-13 (high)). Conversely, nonallergic children and children who have outgrown their allergy show Th1 skewing to peanut antigens (IFN-gamma(high), TNF-alpha (high), IL-4 (low), IL-5 (low), IL-13(low)), similarly to nonallergenic food antigens (beta-lactoglobulin, OVA). This finding suggests that peanut antigens do not intrinsically induce Th2 skewing, but that the type of response depends upon the donor's allergic status."

sorry I forgot the labelling issue. Yes there are EU laws, that's why some allergens are labelled now. "Annex IIIa of Directive 2003/89/EC lists 12 ingredients which may induce food allergies or intolerances and for which any derogations to the obligatory declaration of food ingredients are not applicable. This requirement pertains to: cereals containing gluten, crustaceans, eggs, fish, peanuts, soybeans, milk and dairy products including lactose, nuts, sesame seeds, celery, mustard, and sulphites." This came into effect at the end of 2004 or 2005 (before that you only had to label if food contained a lot of the allergen) and they review the list each year.

Lupine flour is being added to the list sometime. Your child is possibly allergic to that too as those with peanut allergy often are.

I obviously avoid everything that says is contains nuts, but things that say no nut ingredients, nut free factory but may contain traces of nut, I let him have it. Although ds2's rast results showed him as having a grade 3 nut allergy, we have never seen ds react to nuts at all. On his notes it actually states that "Allergen specific IgE antibodies can be found without clinical reactions, especially in atopic individuals" I figure that ds falls into this category, so although we avoid nuts like the plague, we are not so worried about these "traces".

I also avoid anything that says may contain traces of peanuts or contains peanuts(my son is not allergic to other nuts) Last night however, my son went out with relatives & they took him to get some chocolate. He started eating "milky stars" (which contain peanut traces) They did not check the ingrediants until he was eating them. My son has had Milky stars a few times before had no reaction to them, so he told his grandparents he was ok having them. His nan took them off him once she realised they contained peanut traces & explained why she took them off him (hed eaten some)& then when he returned home, he complained of a tummy ache, headache & told me he needed to get some air. Gave him his inhaler, calpol & anti histamine. No rash appeared & he soon recovered. I checked him all through the night. He still complained of a tummy ache & slight headache this morning, so i kept him at home as a procausion. I phoned nhs direct up to check i had done right & the nurse said it may have been a coincidence that he had the tummy ach etc & may be coming down with something. Once i explained in moe detail of his allergy she said that if it was a mild reaction then it has now passed. But she seemed to believe that it probably did not have anything to do with the peanut traces in the chocolate. Has anyone any advice? Could it have been a mild reaction & if so why had he not reacted to Milky stars before, or could it just have been a coincidence? I certainly will not allow him to have them again(or milky way) as im pretty sure they contain traces of peanuts also, just incase he did or would have a reaction to the trace!

Well, sometimes a trace can be present in these products and other times may not be. Chances are on most occassions it may be fine but there could be a time when its not. I dont risk any foods with warnings on either. Even other nuts or seeds to which she isnt known allergic. It may have been an allergic reaction but you just cant tell.

Chloesmumtoo- yes i supose i wont really know if it was a reaction or not. He was fine though before eating these. He does tend to make himself worse by getting in to a panick though & worries incase he has consumed something containing peanuts or traces, which is understandable i supose. I feel he then makes himself more ill by worrying. He told me this am that he will not buy the milky stars again as they made him poorly.

Chloesmumtoo- Do you think it is best then to avoid all nuts , even if not allergic to them. My son is allergic to peanuts & has been tested for hazlenuts, alomonds, coconut & brazil nuts & he is not allergic to these. Highly allergic to Peanuts though. His consultant, advised some years ago not to allow him to eat any nuts(but he had been) especially foods which may contain differnt nuts, as peanuts are sometimes present with other nuts, especially the nuts like what the ice cream man uses. He then told me a few years ago that becausee he is ok with hazlenuts & brazil nuts that if he wanted a kinder bueno or ferrero roshai(s?)(as i had been letting him have them) that i can allow him to have them, but to be extra careful about ground nuts & if anything has lots of nuts in a certain food, as peanuts may be present.

Well it sounds like you are more informed than me. They have not tested my dd on different nuts or given me any advise on them. I was just told from scratch to avoid everything. The thing I tend to have heard is that you can have an increased allergy risk to other nuts and so you could bring on another allergy by eating them. Also yes I have heard all nuts can be stored togeter ect contamination can occur. Its a difficult question julia! I personally prefer to avoid everything.

Yes i was also told to avoid all nuts(even when he tested and came back negative to them)!because of the fact that he is allergic to peanuts & at risk of developing an allergy to these nuts, even though tested negative to them. He was alot younger then. I mentioned to the consultant at another appointment that he had been regularly eating chocolates containing these nuts but been ok. He then said that if he wanted to eat these nuts or chocolates containing them that he could, as no allergy had occured & he tested negative to them previously. I buy nut/peanut free chocolate & i know it can be boring sometimes for him to have the same but he understands & is grateful he can eat it. He sometimes picks chocolates which say may contain nut traces or nuts & i let him eat them but not peanut or peanut traces. He is due to see the consultant in July, so i will mention this again to him, but you are doing the right thing by avoiding nuts , if this is what you have been advised. Some would say i am doing wrong by letting him have these & may be im being a little irresponsible or maybe very irresponsible , i dont know. I would never put my son at risk though & i take all the precausions i can. I know for definate though that my child is not allergic to the nuts i mentioned & has not had any reaction to any of them in all the years he has been eating them, so i do not think he is at risk by becoming allergic to them as he has had them on so many occasions, if you know what im mean.