How fast are allergens transmitted through your milk?

[AngelDog]

2.2 y.o. DS has had a diagnosis of various nut allergies today. I've just eaten a cake, only to discover it has nuts in . I'm sure it's fine - and it's the nut to which he's least allergic - but I am kicking myself now. I'm off to the doctor's in an hour to pick up his epi-pen.

How fast might it be before it gets through to him in my milk? He feeds relatively often.

Oh I'm so sorry about your DS's diagnosis but better to know than not. I guess it's time to become an avid label checker (I am just starting to learn this - who knew malteasers had wheat in them oops).

I have no idea how long it takes for an allergen to get into your milk but it wasn't a main ingredient (like say in coffee and walnut cake) or you would have noticed it (I hope!) and if it's his least allergic one......well, how long is a piece of string. I would wait to bf until after the epi-pen is in your possession though just to be on the safe side.

Could you speak to a local IBCLC or I could ask on an email group for bfing support people (BFPS/BFC/IBCLCs) if you like (PM me details if you do).

Thanks, Truth. As you say, better we know - and I was kind of pleased to get a positive result rather than having to wait for loads of skin tests etc. We're doing a gluten-free trial at the moment, so I am getting into the swing of label-checking.

He did have a very quick bf when he got up, but not much. He seems okay so far, so I'll discourage any more bf'ing till we've got the epi-pen.

I feel a bit that although I've been avoiding nuts, I had been eating quite a few coconut macaroons. Now we've discovered coconut is one of his allergies. No wonder I've been having to use steroids on his eczema a lot lately.

I have done the same so often since DD3 has been on a wheat-free diet (allegedly) Malteasers, iced gems (major doh! moment there ), sausages, crisps. I feel like such an idiot I didn't know wheat was in half this stuff (though with the iced gems I just forgot!) so didn't think to check.

It now takes what seems like 5 hours to go round the supermarket which is great fun - no longer can I just throw things in the basket and off I go.

Just realised it sounds like she has a rubbish diet but she doesn't it's just she doesn't have these things everyday so I don't give them much head space.

I can really rec. the sainsbury's sausages on the 3 for £6 offer (they aren't labeled as gluten free but they don't have anything in them bar meat and herbs) but check the ingredients as not all are gluten free just a couple of the varieties on sale so be careful (she says!). Young's do wheat free (poss gluten free too) fish fingers, you can get gluten free breadcrumbs to make goujons/nuggets, garlic bread and all sorts now I was so surprised. The bread is vile though - it tastes like Oasis feels like (the green powdery stuff that florists use) - yuck!

DD3's eczema has been dreadful recently and she is on oral anti-biotics and eumovate at moment as her back/shoulders/ankles/knees were running with pus but I have been so careful recently so I don't know what is triggering it (bar poss. a cold).

I haven't told to go wheat free myself though (I did ask and got told no) but I have very little milk and she feeds so infrequently now (perhaps 2-3 times a day for a few minutes) so it may well not be worth it for us (plus no firm diagnosis yet).

Hope your DS is okay and you don't make so many newbie mistakes as I have

Ah, I'll have a look at the Sainsbury's sausages - thanks. We only eat gf bread as toast - your Oasis comparison is spot on!

That sounds nasty - your poor DD. :( DS has been like that a couple of times before; we never got to the bottom of why his skin got infected. His eczema is pretty well controlled now although we have to use strong steroids most weeks (Elocon, the next strength up from Eumovate).

Our old dermatologist told us that allergies almost certainly weren't causing it because it wasn't all over his body. Now I know they were a factor - he's allergic to 5 different types of nuts, several of which he had eaten.

I'm reasonably hopeful that gluten isn't actually a problem for him. I did a gf trial for him before, and although his eczema flared up when we reintroduced it, he was getting a cold, which always makes it worse. I really hope he isn't, since he hates potatoes, which makes non-wheat carbs more expensive.

It takes a while to get the hang of what's in what. I discovered I was lactose intolerant a year or so ago, and it took quite a while before I realised there was milk in some sausages, stuffing, gravy powder and margarine.

Sainsbury's is by far the best for exclusion diets anyway IMHO. They seem to have the best labelling and the best range of free from products.

We've got skin tests for ds2 on Wednesday but I don't know how many they'll do as he's only 7m. We need confirmation for dairy, apples, pears, bananas, and I'm not sure about wheat and onions. Or leeks.

I've got it 'easy' though - I only have to control his diet as I stopped bf at 7wks for various reasons. I know my nephew was affected within half a day. Don't know if that helps!

Her eczema is so different this afternoon - it's dry, scaly, and pink (well the fresh scar tissue where she was oozing is pink). Totally different to even yesterday so that's something positive! I never thought I'd be glad to have a dry, scaly toddler

Good to know there is somewhere to go if Eumovate doesn't work. It worked so well before Christmas - no eczema at all completely clear skin for the first time since she was a newborn than BAM she got a cold/asthma attack and every single eczema patch she'd ever had flared all at once. Horrific! Do you know why colds cause flares?

DD3's had skin prick tests for dairy, gluten and wheat with no reaction and a blood test for wheat but no results yet (takes 6w apparently) so if it's not wheat?? I only asked about wheat allergy as she had horrible nappies/nappy rash following wholemeal/50:50 kind of bread but now she seems to react to small amounts. What sort of tests did you have done for your DS (if you don't mind me asking?)?

I am not up on allergies at all (even though I have a couple myself - cucumber/melon amongst other things but they are very easy to avoid) so floundering - it's nice to know someone who is going through the same stuff - perhaps you could be an Allergy Peer Supporter

I think my DDs have something funky going on with them - DD1 has had 3 or 4 bouts of cellulitis in the last year which have required anti-biotics (pus-y knees/fingers) and DD3 with her pus-y eczema - I wonder if they are connected (DD1 used to have eczema but doesn't now she is older).

No, I don't know why colds cause flares. I guess the body is so busy dealing with the virus that it can't put its attention into preventing irritants getting into the skin.

I like the idea of being an Allergy Peer Supporter, although I'm not sure I know that much about allergies (yet!). My own allergies are less bothersome (penicillin, cats, hayfever).

DS has only had blood tests for nuts, after DS had a skin reaction (hives) a couple of times after eating hazelnut butter. I've done food exclusion diets for dairy, soya, eggs, gluten and nuts (the last of which didn't seem to make that much difference, but I think I must have picked a nut he wasn't allergic to!) I think it's hard to tell - he has enjoyed eating almonds, which apparently he's slightly allergic to, and I'm pretty sure he's eaten peanut butter which he is now definitely allergic to.

The GP has asked the dermatologist for skin tests for nuts too - I don't know whether I can suggest they test for other things just in case.

Has your DD been reacting to only small amounts of wheat since you reduced/eliminated it from her diet? If so, that suggests it could be a problem for her - when you're eating lots of something it can cause fewer symptoms than when you stop & re-start it again. e.g. when I ate dairy, I was generally rather tired but had no other symptoms, but after stopping it for a fortnight, I got diarrhoea every time I ate anything with lactose in.

That dry scaliness after the infection sounds familiar. I found that was horrible - the patches scabbed over and then cracked. It was really sore for poor DS - his eczema is mainly on his face. We had a couple of nights where he woke 15+ times because it was bothering him (hooray for co-sleeping!).

I found that applying emollients as often as I could during the day and every time he woke at night soon improved it. Creams are better than ointments when there's an infection or weeping eczema. The only thing DS could tolerate on his face when it was like that was Dermol, which normally we only use for washing.

Apart from the Elocon cream, we have Protopic to use when we don't need steroids. It's an immune-suppressant which stops the skin getting so irritated. You can't use it if there's an infection (since it stops the skin fighting back) but otherwise it's pretty good. Some people find they don't need steroids if they use Protopic. We still do (often!), but it does make a difference, and helps to avoid the 'rebound' effect when you stop using steroids.

button, thanks - Sainsbury's is my local supermarket so that's good. :)

She used to be able to eat anything except high fibre type bread but could take pappy cheap white bread no problem - now if she gets the slightest hint of wheat in anything we are in for a fun night! After her initial week long wheat free trial I thought it hadn't made much difference (I had noro-virus that weekend so was a bit bleurgh) and I agreed to DH giving her a hot cross bun and a sandwich - she screamed until 3am and when she first woke up (prob around 9pm) she had lips like Lesley Ash!! Luckily we had infant piriton at home and gave her some and the swelling did go down fairly quickly bur she was beside herself and couldn't settle at all until we did skin to skin (the fish lips made it impossible for her to bf).

Interesting that when you are swamped with an allergen your body goes 'meh' but if you only eat a tiny bit it goes all out at it.

She gets creamed a lot (hydromol) and always gets creamed (and bahs) when she wakes in the night. DH thinks the compression garments aren't helping her as her skin is so much better today and she hasn't worn the suit for about 3 days now. You can barely see any eczema on one of her knees when it was a weeping sore mess just a few days ago - the other isn't as good but it was worse to start with. All her eczema patches have shrunk and her skin is just in a better state than even before the infection.

I found though that when she was infected you couldn't put anything on her skin as the pus and/or straw coloured liquid was running off and the cream wouldn't adhere to her skin - it was nearly making me sick as her back was so raw there wasn't any skin left in parts it was just flesh - this is all shiny bright pink now so it is healing.

She is wearing 4 pairs of socks to bed though (one pair on her feet under her leggings and one over, one pair under her sleeves and one over) as this seems to stop the scratching. She wasn't keen to start with as she sucks her fingers and 'honks' her own chest while she sleeps!!

We are going to taper down the eumovate - it's twice a day now, but will go to once a day when it's clear and then once every other day then every two days then stop so she doesn't rebound (hopefully)

That sounds like a pretty severe reaction. :( The GP has given DS an epipen (or JEXT as they're called nowadays) pending further advice from the allergy clinic. We've been told that if he gets swelling like that, we should use the JEXT and ring 999.

That's great that her skin is clearing up again though. :)

Unfortunately the gradual reduction in Eumovate didn't work for DS, but gradual reduction + Protopic did. Although now we use Elocon, you don't gradually reduce it as you can only use it for 5 days at a time on children IIRC.

If she had the compression garments on when it was getting infected, that would probably have made it worse - they trap the infection inside and prevent it being properly dealt with.

Something is making DS's eczema bad at the moment. He has an odd rash on his face which has been coming & going for the last 3 or 4 days, and his hands have flared up too

I got the impression that her reaction wasn't that bad at all - it was just a low level type!! No mention of a epipen/JEXT or ringing 999 Because we do need more reasons to ring 999 in this house (had two ambulances in 5 days one week!).

I think I need to ask for a referral to an allergist & a dietician as well as the eczema specialist. She's only under SALT, audiology and general Paeds so a few more specialists won't hurt

Hope AngelPuppy's skin gets better and you find the trigger.

:( at the ambulances. You have a rough old time of it in your house. It was only after the blood test results that we were told to ring 999 in the event of any swelling.

No harm in having lots more professionals meddling. I wish we'd been referred to an allergist sooner - we'd not have had 18 months of me feeding DS nuts if we'd seen someone before now.

The GP did tell me that if I were going to exclude any major type of food (eg dairy or gluten) from DS's diet for any length of time, I'd have to see a dietician.

The steroids seem to be clearing the rash, which is good.

I am seriously considering painting a big red cross on the door and getting some of that biohazard tape (and poss. some biohazard suits too!) to wrap around the fence.... Maybe an 'Abandon all hope ye who enter here' sign too - just to be on the safe side you understand!

:( (if that makes sense).

DS now has all the evidence of slapped cheek disease, which probably explains why his face has been so bad recently.

Poor little sweetheart. How long does slapped cheek last? Not a long illness I hope.

DD3's eczema was so clear yesterday but today has has gouge marks on her thighs and her wrist is cracking and going pus-y again. It's never ending at the moment!

I've no idea how long it lasts. He seems to have a bad cold as well. He's been grumpy, tired & lacking appetite, all of which are unusual even when he's very ill. The GP gave him the OK though. I have to have blood tests to find out whether I've had it as it can pose risks if you're pg.

It's so up and down, isn't it, eczema? :(

I really hope you are immune/already had it Angel and I hope the blood test results come back very quickly so you have peace of mind.

It isn't fun when they are so poorly especially when they are too young to plunk in front of cbeebies and cuddle the day away with

I never realised just how difficult eczema could be to deal with - DD1 & DD2's eczema was/is nothing compared to DD3's and that's with DD1 not being able to be in the same bath with DD2 if you used ordinary shampoo on DD2's shampoo. This is so difficult, it feels almost on a par with DD2's arthritis!

Thanks. Most people are immune apparently - it's just a precaution.

Fingers crossed anyway!

Well, DS's eczema has flared up badly since re-starting gluten, and the bad cold that he seemed to be getting over has taken a turn for the worse. Ominous. This morning he fell asleep bf'ing 2 hours before naptime, and has been asleep for 2.5 hours so far - very unusual (and that despite a reasonable night's sleep last night).

At least I feel I have concrete grounds on which to ask for testing for gluten now. I'll ask the dermatologist when we go on Monday. They're already planning on doing skin tests for nuts, so I can't imagine that one more will be a big deal.

His slapped cheek seems to be better though, and I've not had any symptoms so far. :)

Can excess mucous be part of the immune response (i.e. mimicking a cold)? I know when I get a cold my goblet cells go in to overdrive (they are the cells responsible for mucous production) and I get all congested and wheezy and my asthma kicks off.

I imagine it will just be another box to tick on the blood work form before it goes to the lab rather than lots more paperwork (though they might need another vial of blood too).

Hope he picks up soon and you stay clear of the slapped cheek. Sleep is healing though so lots of rest may be the best thing for him. Take him in if you have any worries though about breathing or if he can't stay conscious for long (obviously!).

Angel...just saw this, there is mixed advice about the impact of allergens in breastmilk but as far as I am aware, there would be no need to avoid breastfeeding in your situation with the cake...my dd is allergic to milk, nuts and eggs and is 23 months. I still eat allergens but avoid lots of raw dairy as this does impact her if she is breastfeeding lots. Pm me if you want to chat. Allergies are so daunting :(

You are right, haverina, I think I was over-reacting in the stress of the moment.

It does seem that his eczema has flared up after I've eaten nuts, on several occcasions. We've a first appointment at the allergy clinic in a fortnight so I'll talk to them then about it.

That's interesting, Truth, about your congestion/asthma.

I suspect this is probably another bad cold and a coincidence - but normally his eczema flares before the cold symptoms start (when the viral spots first appear), so I do want to get the gluten thing checked out.

DS slept for 3.5 hours at lunchtime! (mostly on my lap) and would have gone back off again if I hadn't kept him awake. He has been missing a bit of sleep lately, as being ill means he gets overtired, then is awake lots in the night, up early, then extra tired etc etc. Hopefully he'll feel more cheerful tomorrow.

DD3 does a cycle thing with a cold - her eczema flares, she gets a cold and then she ends up on a neb in hospital - all within 2 days (luckily we have avoided hospital since October as she has been on Flixotide since then).

I had what was called 'Viral Asthma' - meaning that my body's response to a virus was over the top with masses of mucous (I get mucous in my digestive tract and elsewhere ) but I don't think that term is used any more.

I also had wheezing episodes in response to allergens - natural gas (bunsen burners at school/college and gas ovens), cucumber, melon, cat hair, dog hair, freshly cut grass, acid gases (idiot chem. teacher did an experiment NOT in a fume cupboard as 'it wouldn't make much gas' - within moments of the reaction happening I was wheezing as I was sat on the front lab bench....) and I can't run as I wheeze then (usually though it was on the school fields so how much grass and how much running I don't know!). I also have hay fever since I was pg with DD1 don't know to what though.

Fingers crossed the big nap has broken the poor sleeping while ill cycle.

:(

I get some wheezing/coughing in response to cats - although mostly it's sore throat and watery eyes. Yours sounds bad though.

A year or so ago DS had a chest infection which went on for months and the GP was going to test for asthma, but I gave DS antihistamines and it cleared up overnight. So he obviously has some susceptibility to breathed-in allergens (it got particularly bad after a day walking along very dusty paths).

DS was up again in the night - boo - but we slept in so that was okay. He's not needing resettling much at night (which he was when he first got ill) but for some reason he seems unable to stay asleep for naps unless he's being rocked/bf'ed on my lap. It's given me the opportunity to plough through Adventures in Tandem Nursing (rather than doing housework) so I can't complain.

I was fine with cats for years (we had cats at my mum's when I was growing up) but then when I was about 17 I looked after a friend of mum's cat when she was away and the cat had a bad skin condition and shed skin everywhere - I came back from her house with eyes like gobstoppers! The conjunctiva had swollen up and was squeezing my eye balls - blee!

I moved out of home a few months later and didn't have a cat again until last year and we have just had to give the cat to my mum as I was getting to wheezy. It was okay when she was a kitten but as soon as she matured and started shedding I got wheezy a lot and had two chest infections the month she 'matured'. I can't risk exposing the baby to repeated anti-biotics courses and stronger and stronger meds just to keep the cat as much as we love her (my mum is pleased though!).

Sneaky DD3 managed to shove a small piece of bread in her mouth and a small bit of cake (about a tablespoon in all) while I was busy at DD1's birthday party - she is so quick she had grabbed the bread and shoved it in her mouth and swallowed it before I could fish it out, she then did the same when I was cutting the cake for party bags.

She was not a happy bunny this afternoon, eczema has flared all over (not too badly luckily) so she has had generic prition before bed. DD1 is getting a cold (and so am I)so it is only a matter of time for DD3 to get it.....