This is the second installment of the Journey with Food Allergies series. Check out my first post when I described how we discovered Baby V had food allergies. In this blog, we’ll look at the second step in food allergy discovery – the testing and diagnosis.
When I last left off, we knew that Baby V had had a reaction to eggs, and then experienced a reaction to something else we weren’t quite sure of (we had suspicions, but no clear answers at this point). We were waiting for our referral to the pediatric allergist, meanwhile still had to feed our baby girl. I felt anxious around giving her high-risk allergen foods, like peanut, tree nuts, soy, dairy, and shellfish. Though she’d had these foods before with no issue, as we learned from her (now pretty much confirmed but not yet tested) egg allergy, allergic reactions can occur at any exposure, not just in the first few. And, that sometimes allergic reactions can happen with late onset – usually baby will react within about 15-20 minutes after eating the offending food, but sometimes (as in our case) it can be a long time after. I was on edge for weeks every time she ate a potential allergen as we waited for that appointment.
Finally the day came, and I took my little boo to see the allergist. The doctor listened to our history and looked at the photos I’d taken. She asked questions about our family history with allergies (both food and otherwise) and to clarify important facts about V’s eating history. She then decided on a selection of foods to test, including egg yolks, egg whites, walnuts, pecans, cashews, almonds, and pine nuts. The doctor was awesome at keeping V calm and distracted while performing the allergy test – a simple scratch test on her arm. Baby girl was a trooper and kept her cool throughout the whole thing (despite being loooooong past naptime!)
Finally we had some answers: baby girl was indeed allergic to egg whites (which we knew), walnuts (which we suspected), and pecans (which I don’t think she’s ever actually had, but I guess they’re similar to walnuts?).
It was good-news-bad-news time. The good news: egg allergies are common in children (as are dairy allergies), and 9 in 10 children will outgrow this allergy by school age. Yay! The bad news: only 1 in 10 will outgrow a tree nut allergy, so she’s likely to have that one for life. Fortunately walnuts and pecans are not too complicated to avoid (though we still don’t know her tolerance on cross-contamination on these), but we have discovered that eggs can hide in sneaky places. That’s a story for the 3rd installment of the series!
Because Baby V was tolerating small amounts of egg products (eg the frozen waffles I buy have egg as an ingredient), the allergist suggested that she likely would outgrow the allergy in time (yay!). She gave us information on an “egg ladder”, a method of introducing small amounts of egg protein over time, the idea being to gradually increase her tolerance and, eventually, lead to eating actual eggs again one day. As a dietitian, I found some of the information she gave us super interesting (like that egg protein reacts differently when baked in a wheat-containing food like muffins or cake than it does when baked in a non-wheat food like meatloaf). But as a parent, I found the whole experience very overwhelming and confusing. I was getting lots of instructions, lots of paperwork, and at some point it started going in one ear and out the other. After getting home and re-reading all the recipes and instructions and details, it was still super confusing to me. I ended up calling the office back a few times to clarify things, and found a group of other food-allergy moms who had been through a similar experience who helped to ease the anxiety.
We also got a prescription for an Epi-pen. Thankfully V’s allergies have never manifested as anaphylaxis, but there was the possibility given that she had multiple allergies and that each could have the potential to produce anaphylactic reactions. Better safe than sorry.
While it was certainly helpful to have an official diagnosis and answers as to what was causing her reactions, it also opened our eyes to all the potential lurking dangers in her foods that could cause a reaction. Not to mention the anxiety that still rises each time we progress a step further on our “egg ladder”! We will continue following up with the allergist periodically. When V is old enough to understand more, we will have to educate her about allergies and food avoidance, and what her Epi-pen is for. It’s been an adventure to be a food allergy mom, and I know we’ll have many more challenges to come as we try to continue fostering a positive relationship with food while managing allergies, and helping V to become a self-sufficient little person who can live in the real world even when allergic to things.
In the next post in the Journey series, eating and living in an allergic world.