Allergies - DH has severe allergies, should I be worried for DD??

[New2Mumming]

Hi all,

Interested to hear others' experiences and guidance.

My DH has had severe allergies all his life to dairy, eggs and nuts. He carries an epipen. He also has very bad eczema on his hands (is prescribed steroid cream for them) and asthma, still using blue puffer about 5 times a week.
I myself had bad eczema as a child and still get it in my hands from stress/not looking after myself.
DD is 3 months old and formula fed. Within 3 weeks of birth she exhibited signs of CMPA: pooing after each feed, generally fussy, wheezy, reflux, slow to gain weight. She is now on Neocate and thriving. Tried her back on Aptimil after 2 weeks on Neocate and it went straight through her.

MIL already talks as though DD is destined to have the same allergies as DH. How do I best approach this? Here's what's on my mind:

1. Should I test her on a cows milk formula again? If so when and how?
2. I saw morrisons sells goats milk formula shall I try that?
3. When should I wean her? HV said as late as possibe
4. To avoid popular allergens or try them out early?
5. Try out allergens in the A&E carpark?
6. When can she be tested for allergies? How do I get to a paediatric dietician and allergy clinic without her having her a severe reaction?
7. DH is really fussy (I would say even avoidant) with food and I don't want the same for my DD. How do you parents of kids with allergies manage this?
8. MIL told me she won't eat nuts around the baby. Is she right? Or could this make it worse?

Thank you! Would appreciate answers to any or all of my questions or just to hear your own stories 💗

This is absolutely not a question to ask strangers on the internet.

You need to get a referral to a paediatrician and discuss it with them and only them.

Random anecdotes from anonymous people are at best worthless and at worst, dangerous

Both mine have dairy allergy. Not sure why you would try aptamil again after being prescribed milk.
You should be referred to a dietician to discuss weaning but they say not before 6 months in allergy babies generally.
They will give you information on completing a milk ladder where you give them a little bit at a time and build it up.
I have a peanut allergy and have the choice of trying ds on it at 6 months and over. You could also avoid them if you wished instead.
I'd have a chat with your HV to get some clarity.
They don't recommend using Soya or goat milk over formula really

As your DH has severe allergies and needs an epipen, I would speak to your GP about this. I have allergies and so do all my kids, it is generally inherited. Given how rapidly aptanil went through your daughter, I would not try goats milk, especially as she is on Neocate and not any of the hydrolysed milk protein formulas for cmpa babies.

The proteins in the milk is what causes the allergy, goats milk protein is very close to cows milk protein, but not the same. Soya is very similar too in protein and often goes hand in hand with a cmpa allergy in babies.

"As late as possible" for weaning would be around the 6 months mark
In regards to fussiness, only one of my kids has fussy eating and his is down to sensory issues around food rather than his (many!) allergies.

It will depend on whether she has a IGE or non IGE allergy. Non IGE allergies so ones that cause an upset stomach can only be confirmed through elimination from diet rather than a skin prick test.
As others have said your GP should have referred you to a dietician to help with any question you have and how to challenge the allergies with the milk ladder.

Milk is one of the main 14 allergens, as you probably know, but "milk" covers all animal milk, including goat, so not just cows' milk. So I wouldn't have thought changing animals, so to speak would make any difference if she's already had problems with cows' milk.

I’m not sure you can get tested on the NHS without having a serious reaction first. A lot of babies grow out of cows milk allergy, so GPs usually watch and wait, I believe, so perhaps you should push through with a referral to the allergy clinic due to the family history. Then you’ll have access to ask all the questions you have to the team there.

Definitely don’t try milk again until you’ve spoken to them.

My DS reacted to egg when weaning and it seemed to set his system off as he started reacting to lots of foods (on a lesser scale) that he’d happily eaten before. It was so frightening and I felt I couldn’t feed him anything substantial.

NHS would do the tests to confirm egg as he’d gone through A&E, but nothing else (years ago, mind, it may have changed). I took him privately to see Prof. Gideon Lack at The Portland and they did a full panel to determine what to avoid and gave great advice, prescribed epipen etc.

Now the allergies are all identified, we’ve switched to the local NHS team, who are fantastic and we get an annual review, blood tests etc.

DS’s dad is allergic to nuts and also has asthma and pet allergies. DS’s uncle is allergic to egg and has eczema. My DS ended up with all the top 14 allergies bar dairy and soy (but he exchanged those for a few rarer ones). Navigating school/childcare was difficult at times, but he’s a thriving teenager now.

Oh my goodness, all 14 bar 2 allergens plus rare ones. The poor soul! Glad he's a thriving teen now!

Get the book "understanding allergy" by Sophie faroque from the library and read it ASAP. You actually may be advised to wean early for certain allergens like peanuts.

GP knowledge isn't great and an allergy referral will take you past weaning stage, it's a very overstretched service with increasing demand. If you can I'd book a private appointment to discuss all of this.

Definitely no more cows milk, you have followed the removal of allergen then reintroduction advise so no need to try again until you do the milk ladder.
Allergy testing won't show anything for CMPA or other none IGE allergies, and if baby hasn't had those allergens yet the body won't yet have mounted an immune response so testing will be tricky.

I know how scary it is so please arm yourself with as much info as possible

Ask for a referral to you local prescribing dietitian. Health authorities have these, they are experts in (paediatric) dietary allergies and both prescribe specialist milk and help with tree introduction of dairy (in the case of CMPA) via the milk ladder which is a specialised and tested route for determining if and when a child can tolerate dairy. They will also offer advice on all other weaning and Any relevant vitamins etc required.
Many practitioners advise a trial once a baby has moved on to to AA milk of re introducing the standard formula to see if it really is the formula causing the effets so you were not strictly wrong to do this. Some practitioners agree that this is unfair so don't bother though. Due to this similarities in protein structure is is normally advised NOT to try soya or other mammalian Milks if your child has CMPA.
Whilst you should always take advice, not eating nuts around a child with no evidence of nut allergy serves no purpose and is an old fashioned perspective which isn't necessary. There are techniques for trialing exposure to nuts etc which usually involve starting by touching a drop of peanut butter or similar on a baby's outer lip and looking for any reaction and inly ever trialing one new food at a time. The dietitians will advise.
It is true that a strong history of allergies is hereditary, however this does not mean that your child will be as severely affected or allergic to the same things as her father. It is great to wean into a wide as possible variety of foods early in so that your child had both a wide interest in food and exposure which can in some instances help.
Please do ask for referral, you area may have a paediatric alleviate rather than a prescribing dietitian so either is great. It can be scary but my child went from being so allergic to dairy that she stopped breathing every time she had it to eating a very complete diet and drinking 4 actimels (I know not ideal) a day. There is support for you.

Have you been referred to a Paediatric Dietician and the Allergy Clinic? If not, I'd push the those referrals urgently.

Disagree. Mumsnet is exactly good for offering a supportive environment and knowing you're not alone. Of course I'd not risk my little one's health, I'd go through a doctor before I tried out any allergens as she's doing well. But our health system doesn't make access to specialists easy so hearing others experiences has been helpful.

Completely off topic but if your OH is having to use a blue puffer so often his asthma would appear to be poorly controlled. Does he have a steroid inhaler?

Yes I'm pushing him to go to GP but e says itsnjust cos he's been moving around a lot and takes time to get used to places... he does have the red one and seems to use it too often. This is all new to me but I'm trying to learn what is and isn't ok

Thank you all. Going to library today I hope to get the Understanding Allergies book!
I wouldn't risk anything without Prof medical advice first but it's so good to hear from all of you. This is a new world to me and I'm just trying to learn and know what to expect and what I should be asking the Dr for.
Who knows, maybe she'll take after me and eat everything!
Must say its daunting knowing she may have these allergies. But reassuring to hear how you've been managing.

If you can afford a private consultation and if you are in the south of the country I’d highly recommend going to see Dr Michel Erlewyn-Lajeunesse. He’s a world expert on paediatric allergy and absolutely wonderful. The NHS referral is likely to be slow unfortunately.

I have severe allergies my children have none.

however my colleague has mild allergies and his daughter has the same and a million times worse

you need a referral

Just be mindful when getting advice from non health professionals and books that allergy advice changes rapidly.

My DD has a nut allergy. When she was first diagnosed, she was told to totally avoid every single nut - treenuts and peanuts (only x2 nuts diagnosed at that point).

At her next appointment 3 years later, the advice had changed to introducing nuts that came up clear on her prick test in a controlled way and if she doesn't react, to keep these nuts in her diet regularly.

A book from the library may well not have the latest, most up to date advice.

Not a clinician but in a similar position (expecting end Jan with two atopic/allergic parents) and I’m an academic in a somewhat related field so used to engaging with research literature.

I would still highly recommend some personalised advice but in the absence/wait for that, BSAIC and Anaphylaxis UK have some good resources. Re: your questions 3&4 - Latest research evidence seems to suggest that early and quite substantial introduction of other allergens (eg peanuts, egg) is preventive. All statistics on a population level of course, and there is some conflicting advice in terms of whether it’s a good idea to introduce allergens that are not normally part of the family’s diet.

Hope these might be of help:
www.bsaci.org/wp-content/uploads/2020/02/pdf_Infant-feeding-and-allergy-prevention-PARENTS-FINAL-booklet.pdf
www.bsaci.org/professional-resources/resources/early-feeding-guidelines/

There is also quite a handy Facebook group that might be a good resource, led by a pediatric allergy clinician who gives semi personalised tips and offers remote private consultations (I think).
www.facebook.com/groups/allergysupportgroupwithdrhelenevanshowells/

Wow thank you @helehan this is invaluable. Have signed up to the FB group now reading through the literature.🤩 This is a whole new world to me!