This post is the fourth in a series about our experience of living with food allergies. Today I’ll share our experience moving up the “egg ladder” over the last year and our next steps.
Disclaimer: This post is for information purposes only and should not be a substitute for advice from your medical team.
When I last left off in this series, we were embarking on our journey up the egg ladder, a series of steps to gradually introduce egg proteins and monitor for tolerance. As a brief recap, Miss V had been tolerating baked egg items well (like muffins, breads, etc) but we hadn’t yet exposed her to less-cooked egg containing foods, which she’d previously reacted to. Miss is also allergic to walnuts and pecans, which she has not had any exposure to since first reacting at 9 months old.
Miss V had previously reacted to egg contained within foods like breaded meats/fish, fresh pasta, and French toast with itchy welts and a rashy face. So while I thank my lucky stars that we never had to deal with a severe or anaphylactic response, I was still hesitant to put my kid through the discomfort of having a reaction as a direct result of ME giving her the thing she was allergic to ON PURPOSE! It was a bit of a mind-bend to purposefully prepare these eggy foods, and watch her like a hawk every time she ate them to watch for even the slightest sign of redness or bumps. But, this story has a happy ending – Miss did a great job and tolerated these cooked egg-containing foods well! She was now able to eat the same foods as the rest of the family, which was a huge relief whenever we ate at relatives’ houses or restaurants and no longer had to worry about what brand of pasta was used, did they forget to exclude eggs in that lasagna, and saying “Yes, honey, you can have the chicken fingers on the kids menu if you want them” (though she still prefers grown up food anyway, which is fine by me!)
The real test came when it was time to challenge her with straight up eggs. With great anxiety, I made a long-baking quiche recipe, followed by a well-baked frittata, and eventually worked up to scrambled eggs, omelettes, and hard boiled eggs, all with complete success! Unfortunately these foods aren’t her favourites, because she is now 2 1/2 years old and doesn’t really have any memory of eating these things before, now they are new foods! And of course, toddlers tend to be a bit suspicious of any new foods, so it’s been a bit of a challenge to convince her to continue these exposures to eggs to monitor and maintain her good tolerance!
Fast forward to this week. We had our follow up visit with our allergist, who performed another scratch test for eggs, walnuts and pecans. She took a history to find out what we have been exposing Miss to in the last year (lots of eggs, no walnuts/pecans, lots of exposure to other tree nuts with no issues). The scratch test revealed exactly what we had suspected:
See that W in a circle near the top of her arm? That’s the test for egg whites. And see how there’s ABSOLUTELY NOTHING NEXT TO IT!??!
SHE OFFICIALLY OUTGREW HER EGG ALLERGY!
Shout from the rooftops!!! *confetti everywhere!*
The “W” is walnuts, which is still a great big positive and actually a larger wheal than last year’s test. Pecans (the “P”), however, was suspiciously negative. Now truth be told, I don’t actually remember if Miss has even EVER eaten pecans. It’s not something that I use super often anyway, and after having reacted to walnuts at 9 months old of course I was leery to introduce any more tree nuts before seeing our allergist (which is when they tested for many nuts and found pecans to also be positive). The two nuts are related, somehow.
Our recommendations were to continue with exposure to eggs, and start to try less-cooked eggs (runny/soft eggs, raw egg products like mayo, etc). And, continue total avoidance of the walnuts. Pecans is a bit trickier though, because the scratch test was negative. We were offered some options on this…
- do an in-office oral challenge, where Miss would eat something containing pecans in the allergist’s office and monitor her for 3 hours afterward for reactions.
- do a blood test, which would show for certain whether she was actually allergic or not.
- try something with pecans at home, however knowing that walnuts and pecans do tend to travel together so it would be potentially challenging to prevent cross contamination.
- continue complete avoidance of pecans too.
It’s tricky because her scratch test last year WAS positive for pecans (the second positive she’d gotten doing these tests), but this year turned up negative despite having NO exposure to pecans in the last year. A blood test would show for certain whether she was carrying pecan-allergic immunoglobulins, but I wasn’t so sure I wanted to put her through that, particularly for a nut that isn’t really a big part of our lives anyway. The oral allergy test was a good option to try, but unfortunately, we know that her reaction to walnuts was very, very delayed, much longer than 3 hours (she had eaten walnuts at lunchtime, and broke out in hives around 10pm!!), so the in-office test might not be so helpful after all.
So that left us with doing an oral allergy test at home, or complete avoidance. The allergist suggested at this time to continue complete avoidance, which I agreed to – but to be honest, I’m still back and forth with these options. I have considered giving her a pecan-containing item at home and monitoring for reactions with my Benadryl and epi-pen handy just in case… as much as I don’t want her to go through the pain and discomfort of having a reaction (or, should she turn out to have a worse reaction, I certainly don’t want to be the cause of her suffering!), I also am hesitant about delaying her introduction to pecans another year – after all, again, I’m not actually even certain if she has ever even eaten a pecan before! We know now through more recent research that earlier introduction can be protective against allergy development, and recommendations by the Canadian Pediatric Society have recently changed to reflect this. But, because of that risk of cross contamination and that pecans and walnuts are, apparently, closely related, I’ve been scared to try. At this point I will go with the recommendation of avoidance for safety’s sake, but, that momguilt is still in my mind….
So, our new reality? Miss is officially no longer allergic to cooked eggs *WOOHOO!!!!!*, allowing us to try less-cooked eggs. This opens up a whole new world of food choices, restaurants and social situations, and I’m so excited to have this fear lifted off our family’s shoulders! The remainder of the reality is that some tree nuts are still a big old NOPE, but who knows what we’ll learn next year when we see the allergist again!
Stay tuned for more updates on our journey with food allergies.