Sunday, November 16, 2008

Recognising the symptoms of food allergies...

(Part of the Food allergies awareness month)

Disclaimer: I have no experience of allergies and no medical background. So if you do spot any information that isnt accurate here, please feel free to point it out to me and I will put up the correct version.
This started a while ago when Tharini of WinkiesWays sent out an email asking if some of we mommy bloggers would be interested in writing about childhood food allergies. Frankly I had had no experience of the same, though I could write a thesis on problem children and how to manage monsters under three feet in mall and restaurant situations. With much agony and heart felt emotion at that.My first instinct was to cry off. After all, it was Ganapati time, I was already stressed out. But Tharini was gently persuasive. And it struck me that if one parent and one child could be helped by what I wrote about allergies on the blog, it would be worth it. After all, it was just a matter of an hour's dedicated put my butt to the seat kind of work which would be good for me to do, rather than the regular five minute and done kind of post I tend to do.I chose to write on symptoms of allergies and how to recognise them. Plus treatment. Broad outlines of course. Why? Primarily because I had no firsthand experience of dealing with allergies. I have, touchwood, not faced this thus far with the brat. And I would like to be informed in case I ever had to come across such a situation, so I would be able to recognise the symptoms for what they were and deal with them in the best way I could. Yes, selfish interest at the heart of everything.It is scary with children. They are so very vulnerable. You never know what could set off an allergy attack. And while some allergies are mere minor annoyances, some can be lifethreatening. Which is why, I think it is essential for anyone to be able to recognise the symptoms of an allergy attack immediately.What is an allergy? It is basically the body's reaction or defence to something it considers hostile. These hostile things, called allergens, are more often than not, something that most people can live with very comfortably. Food allergies in young children are more common than in adults, but most children outgrow them by the time they get into school. But, it is also possible to develop a food allergy as an adult, even if you never had any when you were a child.Allergies are a miscommunication between the body's auto immune system which generally works fantastically to protect us from the irritants, toxins and potentially infectious agents with it misreading the threat levels from a certain anything one is exposed to. This creates an inflammatory response within the body. The bone marrow releases eosinophilis and other cell types from the immune system get on overdrive creating an inflammatory response overload to fight with these perceived hostile allergens.In a person with allergies, the immune response is oversensitive. When it recognizes an allergen, it releases chemicals, such as histamines. This causes itching, swelling, mucus production, muscle spasms, hives, rashes, and other symptoms, which vary from person to person.The specific symptoms of the allergy is what can help pinpoint the allergen that causes it. Allergens that are breathed in often cause a stuffy nose, itchy nose and throat, mucus production, cough, or wheezing. A food allergen can cause nausea, vomiting, abdominal pain, cramping, diarrhea, or a severe, life-threatening reaction. Allergies to plants or any thing that touches the skin surface like a chemical or a metal often cause a skin rash. Drug allergies usually involve the whole body and can lead to a variety of symptoms. Some medical conditions, such as eczema and asthma, are linked to allergies.If the body develops a sensitivity to an allergen once, you are likely to develop the response everytime you get exposed to it.Allergens comprise air borne allergens like pollen, mould, dust and pet dander which could trigger asthma attacks. Poison ivy or certain chemicals in detergents, or creams, soaps, etc can result in skin allergies, and the scariest of all, especially for kids, food allergies which can create such a dangerous reaction - anaphylactic shock - a true medical emergency. Insect stings are another potentially life threatening allergy.According to research, breast-feeding children for at least 4 months or more may help prevent atopic dermatitis cow milk allergy, and wheezing in early childhood. If there is a family history of eczema and allergies in a parent, brother, or sister, you need to discuss this with the child's pediatrician. The timing of introduction of solid foods and the use of several specific foods, can help prevent some allergies.There is also evidence that infants exposed to certain airborne allergens (such as dust mites and cat dander) may be less likely to develop related allergies. This is called the "hygiene hypothesis" and sprang from observations that infants on farms tend to have fewer allergies than those who grow up in environments that are more sterile.
As far as food allergies are concerned, problem foods include peanuts, tree nuts (including macadamia and Brazil nuts, pecans, cashews, pistachios, almonds, hazelnuts and walnuts), fish and shellfish, cows' milk, eggs, soya and wheat. Interestingly, a child having one food allergy may also react to other foods (cross-reactivity). For instance, a child allergic to prawns may also react to other shellfish. People with hay fever or an allergy to latex may also have a cross-reaction to certain foods.
If you have a food allergy, your body mistakes certain foods as harmful, and produces antibodies. This is known as sensitisation and may not cause symptoms. However, the next time you eat the food, the antibodies are ready to react with it. This causes the body to release chemicals, which lead to a range of physical symptoms known as an allergic reaction.
Some food allergies result in immediate, severe and even life-threatening symptoms, such as severe peanut allergy
Allergy SymptomsAllergy symptoms can be categorized as mild, moderate, or severe.Mild Allergic ReactionsMild allergic reactions can include:RashItchy, watery eyesCongestionMild reactions do not spread to other parts of the body.Moderate Allergic ReactionsModerate reactions can include symptoms that spread to other parts of the body, including:ItchinessDifficulty breathing
Food and the immune system
Anaphylactic shock is caused by certain insect venoms; drugs such as penicillin; and foods like fish, peanuts, nuts, eggs and seeds.WARNING: If a person is experiencing more severe symptoms than what is listed above, they may be in anaphylactic shock.Anaphylactic shock is a medical emergency which is an acute systemic (affecting the whole body) allergic reaction. It occurs after exposure to an antigen (allergen) to which a person was previously sensitized. It can progress in minutes to serious levels.Symptoms usually appear rapidly - within seconds or minutes - after exposure to an allergen, but in some rare cases, reactions have been delayed by as much as 12 hours.In anaphylaxis, cells in the immune system release large amounts of chemicals - including histamine. As a result, blood vessels open up and begin to leak fluid into surrounding tissues, producing swelling.The signs and symptoms of anaphylactic shock include the general symptoms of a common allergic reaction, PLUS:Rapidly worsening symptoms (or previously severe reactions to this allergen)Swelling of tissues such as lips or jointsWheezing, noisy breathing or shortness of breathRash or redness of the skinLoss of consciousnessAnxietyItching of the skinHeadacheNausea and vomitingAbdominal crampsDiarrheaLow blood pressureConvulsionsItching of the mouth and throatHoarseness, change of voiceChest pain and tightnessA feeling of warmth and flushingThe feeling of having to urinateSweatingConfusionCall emergency ambulances or 911 if any of these symptoms occur with an allergic reaction. Anaphylaxis can result in death if not treated in time.Doctors will treat anaphylactic shock by injecting adrenaline (epinephrine) to constrict the small blood vessels, raise the blood pressure and dilate the airway. This may be followed by injection of antihistamines and/or steroids, plus the use of life-support systems.Do noteEating contaminated food can cause a reaction similar to that caused by a food allergy. Some medicines can also trigger allergic reactions like skin rashes.Diagnosing an allergyBefore an allergy is diagnosed, you need to go through a battery of tests and a detailed history to correlate symptoms and history.Allergen testing will reveal the specific allergens you are reacting to, the most common is skin testing, including scratch and path testing depending on the doctor's recommendation for individual cases.Some sensitive individuals will go through RAST testing. This is a blood test (RAST : radioallergosorbent) which measures the levels of specific allergy-related substances.Other blood tests that may help reveal allergies include:Antibody/immunoglobulin (particularly IgE) levelsCBCComplement levelsA simple method employed by some doctors is to avoid certain items, or use the suspected allergens in a controlled setting to monitor the reaction.While the ideal treatment would be to avoid all the factors that are known to bring on an allergic response, this is not always practically possible. The most appropriate medication depends on the type and severity of symptoms.Allergy shots (immunotherapy) are occasionally recommended if the allergen cannot be avoided and if symptoms are hard to control. This includes regular injections of the allergen, given in increasing doses (each dose is slightly larger than the previous dose) that may help the body adjust to the antigen.Some children generally outgrow an allergy as the system becomes less sensitive to the allergen, but normally once a substance is proved as provoking an allergy attack, it will continue to do so lifelong.Finally, as research has proved there might be some credence in the old wives tale that children who play in the mud grow up strong. The lack of exposure to allergens and the extremely sanitised environment we are bringing our kids up in could be one of the reasons for the increasingly levels of allergic diagnosis amongst our children.Nonetheless, do not take allergies lightly. Be aware of the symptoms, and know your line of treatment if you have a child suffering from any. Forewarned is forearmed.
Finally, here are what some more moms from the blogosphere have to write about childhood food allergies.
Tharini
Sujatha at Blogpourri
Indianmommies
Dotmom
Everyday Life

Cross posted at www.karmickids.blogspot.com.

Monday, November 10, 2008

Pat a cake, pat a cake

Pat a cake, Pat a cake
Bakers man
Bake me a cake as fast as you can
Pat it and Prick it and mark it with a T
Then put it in the oven for Teddy and ...

“Chip!” Chip completes the rhyme excitedly. And then asks, “Does that cake have egg in it?” “No sweetie.”, I reply. “That’s a special cake. No eggs.”

Chip is allergic to egg. Both yolks and whites. It means that his body does not recognize the egg protein as a harmless food. It attacks the egg protein by releasing immunoglobulinE that cause certain histamines to be released in his blood, causing a severe reaction. He gets hives, his face and ears inflame, he itches, gets unbelievable stomach cramps and finally his body tries to get rid of the offensive substance by making him violently sick. When Chip was younger, he would also wheeze – his airways would get inflamed as well. Fortunately egg allergies rarely result in an anaphylactic shock – something that nut allergies can snowball into.

For Chip, the tiniest amount of egg causes a severe reaction. (For differences between intolerance and allergy refer to Tara and PG’s posts). Pastas made on equipment shared with products that have egg in them. A bite of a bread brushed with egg whites. A tiny dot of ice-cream containing egg yolks. When he was younger, even touching egg products would bring on a dermatological reaction – the site of contact would get itchy and he would develop rash or hives. As he has grown older, the response has toned down in its ferocity. Instead of suffering for a few hours, he suffers for one. His pediatrician thinks he might outgrow the allergy by the time he is 5 or 6, and even if he doesn’t, it would downgrade to an intolerance level- he should be able to enjoy a small slice of cake or half a muffin by the time he reaches adulthood. He might not be able to eat a plate of eggs all his life.

Chip was diagnosed with egg allergy when he was 10mo old. The allergy had manifested itself once before, when I gave him a dot of peach ice-cream, he grew red instantly and howled and vomited multiple times. But he suffered from colitis as a baby and we attributed it to that fact. When he started flailing his hands and turning red and having severe bouts of vomiting, twice, when I fed him french toast, I suspected an allergy and the doctor confirmed it. Chip also has eczema and asthma, which put him in the high-risk group for food allergies as is.

Having an egg allergy is difficult. A lot of foods have egg or egg derivatives in them. Baked goods, salad dressings, battered foods, ice-creams, chocolates, potato chips, corn chips can have egg in them. So do influenza vaccines (which Chip does not get). The first few months after the diagnosis were hard. Two years ago, many foods did not list egg as an allergen 9many still don't), so before buying every processed product I had to learn to read labels. Before buying every ice-cream at the concession stand I would have to ask to see the list of ingredients. Before buying every pizza, I would ask the restaurant to provide me with a list of ingredients. Often we would turn back with Chip not getting the ice-cream, pizza or chicken nuggets. Baked goodies were avoided like the plague. The nanny was taught to spot an allergic reaction and dispense Benadryl. Then the same process repeated when he started daycare.

The first thing we realized in dealing with Chip’s allergy was that we had to make him aware and educate him. By the time he was two, we taught him to ask “Does this have egg?” when offered a new food. And to decline if it did. He did admirably, most of the times, but sometimes it was hard for him, especially when a plate of birthday cake with colorful icing was offered to him, and on many occasions he ended up having a meltdown and refused to accept substitutes. But he learnt. We reminded him of what an allergic reaction would do to him. It was not the world’s most pleasant experiences. He also learnt to identify when he was having an allergic reaction and alert a grown up.

He did me proud a few weeks ago. We had carried chocolates for our family when we visited India. Twix and mars bars and three musketeers, that sort of thing. Someone offered Chip a chocolate and he ate it –nobody thought chocolates had egg in them. A few seconds later, Chip ran into the kitchen proclaiming he was having an allergic reaction. “To what?” I asked. He said he had eating a piece of candy and it had egg in it. The signs were all there. He was itching, his face had inflamed. I gave him ½ tsp of Benadryl, but it was too late. His stomach started to growl and he started to howl in pain as cramps twisted inside his little tummy and a minute later, he violently threw up. This was not the first time Chip had eaten candy. He ate lollipops and gold coins all the time – it was just luck that he had never consumed candy with egg in it – I really had no idea candy would have egg.

It’s hard for Chip at birthday parties. And other social occasions. And it’s hard for us. I wish people were a little more sensitive to his allergies. Especially in the desi circles. I remember an incident a few weeks ago in India. We were visiting some family and they had bread (the paav, not the sliced bread) for dinner. It came from a small bakery, with no nutritional information anywhere. A similar paav had caused an allergic reaction in Chip once and I was cautious. I asked Chip’s aunt if there were any rotis for Chip or rice. The paav might have an egg glaze. She said she could make rotis, no problem, but could he not “try” the bread and see if it had egg in it? I did not know whether to laugh or beat my head against the wall.

Parents whose kids have allergies are most understanding. I have two such friends (one of them is gnd) who will always have a ready substitute on hand for Chip. And for that I am grateful to them. Another friend is also very understanding. Her child has no food allergies, but knowing how hard it would be on Chip, she asked me before her daughter’s 1st birthday party if it was OK for them to cut cake in front of Chip. I thanked her for her consideration and quietly took Chip away to the garden while cake was served. Most people don’t realize what it is to have a food allergy, in a social sense, for a young child. To be “different” like this. It’s not easy for a child. So, I have taken the liberty of compiling a list of dos and don’ts for all of you out there that are fortunate to not suffer food allergies.

Don’t feed my child without asking me first.
Although Chip will ask if a food has egg in it, he is only three and very often he will forget. Check with me or his father before you feed him anything. For parents of young children who are allergic, there is a good selection of tees and onesies at cafrepress.com. Just search for 'allergy' and you will get results for tees with things like “Don’t feed me, I am allergic to XYZ.” It’s great if you are attending large parties or if your child is starting a new daycare.

Do inform the parents which foods with common allergens will be served at a party
While your menu should be allergen-free when a child with severe allergies (like nuts) is invited, for most other non-anaphalytic shock causing allergies (like egg), a warning will be appreciated. The parents can then decide how best to handle the situation.

Do serve alternate foods
Don’t make it a party where the child can only eat potato chips and nothing else. Children are very sensitive. Do offer some, other non-allergic foods.

Don’t pity my child
Not to his face, at least. Admire his courage instead, when he declines a piece of most yummy looking cake. I have had friends exclaim loudly to me at parties “This is such a pity. So sad he can’t eat the cake.” To Chip’s face. Don’t rub it in.

Don’t thrust a cake in my face when I am shaking my head to a “no”
This does not mean I am disrespecting your party/guest of honor. It only means I am going to give my son some company while he sits by himself, unable to enjoy the goodies. And yes, please refrain from asking things like “Even if Chip can’t eat, you can eat, na?” in Chip’s presence. Especially when he is whining for that item. The child is old enough to understand. And if you do ask, don’t be offended by what I answer.

Do educate your own child about food allergies even if your child doesn’t have them
No parent wants their child to be weird of different. In the US at least, there is a growing allergy awareness and kids are understanding. In India, even adults think allergies is a firang disorder and will tell you so. No idea what their kids will do.

This post is a part of an allergy awareness month started by Tara. Please share your stories and comments and help spread the word around.

Cross posted on : http://thekarmacallingblog.blogspot.com/2008/11/pat-cake-pat-cake.html