Isobel, now 13 months, is allergic to dairy products, eggs, lentils, beans and also has a slight reaction to tomatoes and occasionally salmon, tuna and grapes. She also has mild eczema (dry, red, itchy patches), which is exacerbated by the food intolerance. It never once occurred to me when Isobel was born that our little one would be heading down this route, although my husband's family does have a history of intolerance to egg, peas and cheese. Arrogance? Unshakable faith in my genes? No, simply that food allergies and eczema were just not something I had ever encountered within my family and I had absolutely no frame of reference for. Believe me, I have irrationally raged against my husband's family genes! If only this wasn't happening to us! Why me? As if bringing up a little person wasn't hard enough anyway, let alone having to do it with an unnatural obsession about meal times! This is how Isobel's story unfolded.
Eczema was the first to surface - newborn milk spots that lasted ages (weeks 3-9), a course antibiotics for infected neck skin very early on in her little life and red blotchy skin that was never calmed or cured by the string of Health Visitor emollient products (or the small mountain of herbal salves and potions I had purchased in desperation!). Eventually after quite a few visits our Doctor referred us to the Paediatric Dermatology clinic at the West Suffolk Hospital where the consultant diagnosed classic atopic eczema and immediately prescribed a fabulous emollient product and hydrocortisone cream. Before we had attended this appointment however the food allergies surfaced.
We started weaning Isobel at the magic Health Visitor preferred age of 20 weeks. She was a joy to wean and progressed really well from baby rice to pureed veg. A vehement bottle refuser Isobel was 100% breastfed and at the point where I wanted to try things like Weetabix, expressed milk was become increasing hard to obtain. When the Health Visitor suggested I could use normal milk instead of expressed milk for mixing with cereals I was overjoyed ñ Yippee I thought, no more mid morning battles with the pump- easy life. How wrong I was to be. The first time I mixed milk with Isobel's cereal she broke out in red patches with raised white bumps a bit like a nettle sting within about 10 minutes of ingesting it. The patches were on her hands where she had touched the milk and over various parts of her body. The red patches were hot to the touch and she was sad and crying. A cool bath and 20 minutes saw the reaction subside, leaving Isobel fine, albeit a bit itchy where it had made her eczema flare up, and me decidedly wobbly. Thankfully it never affected her respiratory system. We experienced a similar reaction with Ω an egg yolk mixed with veg puree, although this reaction was a little more violent and targeted every single pulse point on her body ñ eyes, ears, armpits, groin, behind knees etc. Our final pair of reactions were less severe, appeared after a delay of 2 hrs and were to lentils and canellini beans.
I was now a bit unsure about how to proceed and nervous of progressing her eating experiences and expanding the variety of foods. Thankfully the Paediatric Dermatology clinic appointment was imminent but the advice, unsurprisingly, was to avoid all those foods until we returned to the clinic for some skin prick tests. This appointment of course was many months down the line and whilst there could not have really been any other advice offered I don't suppose, my heart sank. I saw before us more months of struggling through weaning, envious of other mums for whom the basic task of feeding their little one wasn't a big deal. Sometimes it was hard enough accommodating and tempting Isobel's ever developing tastes and skill level, let alone when many of the easy and obvious food options were forbidden. I felt the specialist needed to offer advice better balanced between the practical and the ideological ñ he had obviously never weaned a baby!
As a precursor to the skin test appt they suggested a blood test to test for wheat, dairy and egg allergy. I was shocked to experience the phlebotomist attempting to take blood from a ten month old, as you would do an adult ñ in the arm using a tourniquet. Needless to say it was extremely distressing for all involved and no blood forthcoming for testing. A Practice Nurse has since ventured the opinion that hand or foot are good alternatives, but at the time I was told there was no alternative to the arm.
I naively thought that the skin tests under the Paediatric Dept would therefore be more baby friendly (air syringe type arrangement where many suspected allergens could be tested for simultaneously). The test actually involves placing drops of the liquid allergen onto the inner arm and holding the arm still whilst a scratch is made through the liquid. Isobel did not react well at all to the looming consultants and the peering and pulling at her body. At the point where she was purple from screaming I questioned whether the appointment was worth it ñ surely I could have just fed her the danger foods at home and watched for a reaction?! I am seriously considering this course of action for the review test next year. In defence of the Allergy Clinic Isobel's shy nature coupled with her traumatic blood test memories made the testing a distressing ordeal. I do know of a one year old who was so fascinated by the procedure when he had skin allergy prick test that he stayed still and quite for the whole thing! For the two things they managed to test for (any more drops of liquid would have been impossible!) there was positive reaction and we were told no dairy or egg for another year and not to be tempted to try as it can delay the natural growing out of the allergy. My heart sank - another 12 months feeding Isobel without all these foods! One of the most disappointing parts of the appointment was the lack of advice and interest on the practical implications of this verdict to Isobel's health and development. Perhaps if Isobel had taken to the procedure better some of the foods on my suspected list could have been explored/discussed. However, instead I am now about to embark on a home test programme to identify conclusively foods on our suspected list. Hopefully she will now have grown out of them, but if she hasn't I will have one hot, red and itchy sad little girl to dunk in a cool bath!
Luckily the Paediatric Dietitian Clinic has captured us and here I have found a source of advice on the more practical aspects of Isobel's food allergies. I say luckily for the contact came about accidentally when our Dermatology nurse suggested a prescription only 'milk free' milk formula (obtained via the Paediatric Dietitian!!) Had this not been the case I would have felt decidedly despondent and unsure of where to turn for advice. I shudder to think that we only had contact with the dietitian through this accidental and indirect route. The Paediatric Dietician has since given us a RDA of calcium for Isobel, which is wholly provided for by the infant formula, and the aspect in all this I was most unsure and worried about.
Where are we now? We have products to keep her itchy skin at bay and this makes it easier to spot possible food troublemakers. I always have a feeling of doing things differently to other Mums and not sharing quite the same experience of parenting. I spend too much of my time making endless chicken and meat casseroles, which are still relatively chunk free, worrying about the lack of variety in her diet. I do this so I can hide good fortifying ingredients such as spinach within in a vain attempt to compensate for the lack of calcium from other sources. Although as the dietitian said she would have to eat a huge plateful for leafy greens to make any significant contribution! I fret and struggle about how to progress her eating habits (a meat and veg diet doesn't lend itself very easily to tempting finger foods it seems. one day she will eat a boiled floret of broccoli I'm sure!). They expect her to grow out for the dairy intolerance in the next couple of years and the egg one by the time she's five (She'll probably hate eggs the first time she tries one at that stage!). As to the other foods we know and suspect there is an intolerance to, well, fingers crossed for my home feeding trials. Allergy spotting is not an exact science though. Is an itchy neck and head with speckly eyes (Isobel's trademark problem areas) caused by food, environment, teething, just being a one year old, temperature? The answer, I suspect, is sometimes a combination! I can drive myself insane looking for triggers and patterns to the flare ups and eventually have to just administer a dose of Piriton to control the itchiness and move on.
My best advice is to write things down as they occur and get specialist/medical help and support as early as possible. It is often difficult to tell which home solutions work ñ was it the herbal cream or the food which made things worse?? You drive yourself crazy and probably never identify what it was. Having specialist support eliminates much of the uncertainty. Time lines quickly blur too and it is difficult to recall what happened when. We now keep a food diary recording everything she eats with accompanying notes about skin in a hope to try and spot the food culprits or recognise a pattern. I frequently kick myself for not having done this food diary along time ago. You read in books to make a note of when new foods are introduced in the weaning process. Who really does that, I thought? How I wish I had! Once captured by the medical profession the allergy story is one you will have to tell over and over again to different people, each keeping their own separate record! Try recounting the story with an unhappy child on your knee and details soon become muddled!
Finally here is our list of hit products that have helped us: -
- 1% and 0.5% Hydrocortisone cream for very bad eczema patches - prescription only. (Do not be tempted to buy off the shelf Hydrocortisone products.)
- Pure Potions Skin Salvation (a beeswax herbal product), which I use on all areas of her face and body when the patches are not too bad. www.purepotions.com
- Epaderm moisturiser (like Vaseline, but easier absorbed and less sticky). Available to buy from a chemist, but also on prescription.
- Neocate Infant formula - a prescription only milk free formula.
Finally, finally keep your eyes peeled in the next mag for a tried and tested egg and dairy free cake recipe!
Sally H
Below is Maria, also weaning without dairy.
