As I sit and write this, it seems that I am beginning the food allergy journey all over again – I’m currently exploring (together with my pediatrician and our family allergist) the possibility that my newborn Alti has a soy allergy. Today, February 6th, marks the first day that she has been on milk-based formula and by the time you read this, we’ll either have a formal diagnoses of a soy allergy (or one heck of a coincidence!)
The truth is, sometimes it can be hard to recognize a food allergy. In the months leading up to my oldest daughter’s diagnoses, we were at the pediatrician on an almost weekly basis because she was constantly vomiting. As I told the doctor then, she seemed perfectly fine before and perfectly fine after; so when exam after exam turned up with no apparent cause (fever, stomach virus, ear infection, etc) they kept sending me home.
The same goes for the terrible diaper rashes I used to bring Idy in for as an infant. I remember a doctor telling me that it was a normal diaper rash and giving him A Look. A Look that said ‘See here. This might be my first child, but I’m not an idiot and I don’t have enough money to throw away on a co-pay so you can tell me this diaper rash is normal. It isn’t normal.’
He wasn’t very impressed with my Look, though, and sent us home.
Now that we’re considering the idea that my newborn has an allergy as well, I can recognize that she has similar symptoms: a diaper rash I can’t explain, congestion, dry patches on her cheeks. All very normal things (other than the severity of the diaper rash) except that they all get noticeably worse the more formula she gets and the less she nurses. While I’m hopeful that it’s all coincidental, I’m also not holding my breath.
So how do you recognize reactions of a food allergy and take the next step of getting a diagnosis?
Well, there are many different foods that cause reactions in little kids; most notably, eggs, milk and nuts (which are often outgrown) as well as poultry, wheat, soy, chocolate and seafood – though the last isn’t as big of an issue in the Kosher-keeping community.
Allergies are caused by a misidentification in the body which causes the body to release the chemicals (like histamine) which in turn, triggers the reaction that will fall into one of four categories:
1) Skin: hives (itchy red bumps), eczema (dry and scaly patches of skin that usually itch), itching and swelling of the lips, tongue and/or mouth.
2) Gastrointestinal: Vomiting (immediate or delayed), abdominal pain and nausea.
3) Respiratory: Runny or stuffy nose, coughing, sneezing, shortness of breath, swelling of the air-ways.
4) Cardiovascular: Lightheadedness or fainting.
While reactions are usually immediate in the case of a severe allergy, there can be a secondary (and more severe reaction) hours after exposure. Alternatively, in a minor reaction, it may take some time for an initial reaction to occur – case in point, when Idy had some milk accidentally this past Pesach, it took about 15 minutes for the first eczema patches to appear and they then continued to appear throughout the day.
Once you’ve recognized any of these symptoms in your child (or someone around you; family recognized Idy’s allergies while I stayed unsafely ensconced in Denial), it will be time for a visit to a pediatrician to discuss the possibility of testing, as well as the best way to go about it. Current medical practice is to perform a blood test to confirm allergies in children under the age of one and to perform a skin-prick test on children older than one. (The blood test can be done by your pediatrician while the skin-prick test will need to be done in an allergist’s office.)
It is important to bear in mind, however, that both the skin-prick test and the blood test are not 100% accurate. For example, Idy outgrew her egg allergy per the skin-prick tests months before she was able to eat a plain egg without breaking out in eczema. With that said, the most accurate way that’s left to confirm an allergy is by eating the food in question. If the person being tested reacts, they’re allergic. However, it is not medically suggested for fear of a possible fatal reaction – if you seriously suspect an allergy, do NOT do this at home.
One final method of detecting a food allergy is a food elimination diet – what I’m currently doing with Alti. By removing soy completely from her diet, we are allowing it to pass out of her system and see if the symptoms remain or disappear. If after 4-5 days (per our allergist’s recommendation; your allergist may suggest differently) her congestion and diaper rash clear up, we’ll most likely then spend a day or so adding it back. If her symptoms then return, we’ll move on to obtaining a more formal diagnosis.
Once you’ve determined which food it is your child is allergic to, your doctor will recommend removing it completely from your child’s diet. Current medical belief is that complete avoidance is not just the safest thing for your child, but also the best way to help your child grow out of their food allergies. By practicing strict and complete avoidance, my daughter Idy outgrew her egg and nut allergy less than a year after her diagnoses.
In order to be sure that you’ve completely removed the offending food from your child’s diet, you’ll need to become a pro at reading labels as well as take up cooking and baking specifically with this diet in mind (depending on what the food is). You’ll not just need to eliminate milk, for example – but anything that contains it (butter and ice cream, for example). Furthermore, if your child is especially young when diagnosed, you’ll need to discuss appropriate substitutions with your doctor to make sure that your child is getting the proper nutrition at this very important growing stage in their lives.
If your child is allergic to milk, will you need to increase the amount of protein-heavy foods he or she eats (like chicken, fish and meat), as well as calcium-rich products (like sardines, broccoli and spinach) to make up for what they’re not getting by having eliminated the milk from their diet?
In upcoming articles, we will discuss the popular substitutions to be made when eliminating any of the Top 8 allergens from your diet.
Think I missed something or just want to share your own Chronicle of Diagnoses? Leave a comment here and join the conversation!