People say to me “Wow, that must hard” when I tell them about my daughter ’s food allergies. “Eh,” I say with a shrug, “you just do what you have to do.” And I almost never cry about it. (You can read about the last time I cried).

But last night, I read an article about a 30 year old guy who collapsed in anaphylactic shock and died after taking a bite out of a cookie that contained peanuts. He had 2 previous reactions in his life, according to the article: when he was 3 months old, he had a rash and blistering after peanut oil got on his skin, and when he was a little older, he had blistering in his mouth after eating a chocolate. Then, 29 years later, a fatal reaction.

After reading the article I suddenly felt sick to my stomach and my whole body tensed up. I went to talk to my father, a retired pediatrician, about the article (I was visiting my parents) and as I spoke, I began to cry. I’m not sure why this particular story affected me so much, but I think it was because of what Gina at Allergy Moms said about this story: “This is a tragic reminder that past reactions cannot predict the severity of future reactions…”

When my daughter was tested for cashews, her scratch test indicated she was allergic, but according to the allergist, the test is not a reliable indicator of the severity of the allergy. Then, her lips swelled one time after kissing someone who ate cashews. I asked the allergist about the need for an epi-pen, and he thought that I was being overly cautious. He didn’t think it was necessary because since she hadn’t had a systemic reaction, meaning that her blood pressure didn’t drop the first time, then she most likely is not at risk for anaphylactic shock. Most likely. Well, unless that doctor could tell me that there was a 100% certainty that my daughter is not at risk, I was getting that epi-pen prescription. My father and my daughter’s pediatrician agreed with me. Why not carry one? Plus, I don’t know what would happen if she actually ate a cashew. So I am erring (in the allergist’s mind I guess) on the side of caution.

One of the things that I uttered to my father through my my tears was “I feel like I’ve done everything that I can do for her, but then it’s out of my control.” There is a feeling of powerlessness that parents of food-allergic children have. We can control our immediate environment, but beyond that we have to hope that our children really understand the seriousness of their allergies, we have to rely on other people to remember the dangers, we have to trust that schools are prepared for an emergency, we have to have faith in grandparents and friends that they will not take it lightly, and then, after all that, we just have to pray that everything is going to be all right. (Breathe.)

I think we are allowed a little cry now and then, don’t you?

Filed under: Babies & Kids, Peanuts/Nuts Allergy, Symptoms, Emotions | 5 Comments »

Peanut and tree nut allergies can cause severe reactions, even anaphylaxis. Parents would give anything to have their children outgrow the allergy, but how realistic is this wish? It is a possibility for some children, but not for most, according to a report put out by the Division of Allergy and Immunology at The Johns Hopkins University School of Medicine.

9% of children allergic to tree nuts (almonds, pecans, walnuts, cashews, Brazil nuts, hazelnuts, pine nuts, pistachios and macadamia nuts) passed an oral food challenge, meaning that they were able to eat the food without a reaction. This included children who had severe reactions in the past. 58% of children with low levels of IgE antibody to tree nuts (5 kilounits per liter or less) also passed the oral challenge. 20% of children allergic to peanuts will outgrow their allergy.

Another finding in the study was that children who are allergic to more than one type of tree nut are unlikely to outgrow their allergy.

The researchers from the study recommend that children with peanut or nut allergies should be regularly re-evaluated to see if they are still allergic, and they say that blood antibody levels (IgE) can be used as an accurate guideline in predicting the likelihood that a child has outgrown the allergy. If you would like to know if your child has outgrown a peanut or nut allergy, ask your allergist for repeat testing and discuss the possibility of an oral challenge under careful supervision.

Related reading:
Will your child outgrow egg allergy?
Peanut protector dogs are here!
Cashews cause more severe reactions than peanuts

Filed under: News & Research, Peanuts/Nuts Allergy | 1 Comment »

A dog that can sniff out peanuts — yes, it’s true! In Texas they are training dogs to detect peanuts to keep peanut-allergic people safe. In addition to accompanying you to public places, your dog can sniff guests who enter the home and “discreetly scan them for peanut residue in order to minimize the chance of contamination.”

I think this is a great idea, especially for peanut-allergic kids who (unfortunately) always need someone to scan their environment to make sure it is safe. Who wouldn’t want the extra protection? Unless you don’t like dogs or are not a dog-person, like me (boo, hiss! — sorry, when you grow up with asthma and allergies, dog hair plastered to your clothing and being licked in the face aren’t the most appealing things!) I think even I might consider a dog if it meant keeping my child safe. What do you think — good idea?

For more information, visit Peanutdog.com.

Filed under: Peanuts/Nuts Allergy, Food Allergies | 7 Comments »

For parents of food allergic children, especially those who could have an anaphylactic reaction, it is very scary to think about where the food allergen may be lurking. Even if parents are able to control what their child eats, they still have to worry about what other kids have on their hands, and what is left on desks, cafeteria tables, drinking fountains and playgrounds. I have wondered how much of the allergen is really left in these places — how dangerous is it? As long as everyone uses wipes, is it okay?

One 2004 study shed some light on these questions. The purpose of the study was “to detect peanut allergen under various environmental conditions and examine the effectiveness of cleaning agents for allergen removal.” Here’s what they did:

• They smeared peanut butter on tables and then used different cleaning methods and tested the peanut allergen remaining. The cleaning methods used were plain water, dishwashing liquid, Formula 409 cleaner, Lysol sanitizing wipes, and Target brand cleaner with bleach.
• They randomly tested other surfaces in schools, such as desktops, water fountains and food preparation areas for peanut allergen.
• They applied peanut butter to people’s hands and used different cleaning methods to see how much of the allergen remained. The cleaning methods used were plain water, antibacterial hand sanitizer, Tidy Tykes wipes, Wet Ones antibacterial wipes, liquid soap and bar soap.
• They had people wear personal air monitors to detect airborne peanut allergen during different simulations — people eating peanut butter sandwiches (school setting), people shelling and eating roasted peanuts and walking on the shells (a sporting event), opening and eating a little bag of unshelled peanuts (an airline flight).

Here were the results:

• Tables: All cleaning methods except the dishwashing liquid removed the peanut allergen. After cleaning with the dishwashing liquid, 4 of 12 tables still had peanut allergen of varying quantities on them.
• Other school surfaces: peanut allergen was found on 1 out of 13 drinking fountains, none of the 36 eating or food preparation areas, and none of the 22 desks sampled. Note that the schools had either peanut-free tables or food prep areas, or were entirely peanut-free.
• Hands: All cleaning methods except plain water and antibacterial hand sanitizer removed the peanut allergen. Water left residual peanut allergen in high concentrations on 3 of 12 hands. Antibacterial hand sanitizer left residual peanut allergen in high concentrations on 6 of 12 hands.
• Air: There was no detectable peanut allergen in any of the airborne simulations, leading the researchers to question whether there is a different peanut protein that becomes airborne, not the one that they tested for.

The researchers concluded overall that “there is a relatively low risk of exposure to significant concentrations of [peanut allergen] when table surfaces and hands are cleaned with common household cleaning agents and that school cafeteria tables and desks are not likely to be a source of significant exposure for most peanut allergic patients.”

Does that make parents feel better about the possibility of exposure to peanut allergen while at school? I’m not sure. On one hand, it’s great to know that normal cleaning of tables and hands pretty much takes care of things. On the other hand, parents of allergic children can’t be sure that other parents and school staff are cleaning tables properly and wiping kids’ hands after they eat.

Still, I think I feel better overall, knowing that peanut allergen, or any other allergen, isn’t some super-entity that can only be removed with special powers — thank goodness for wipes! (But stay away from the drinking fountain?)

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I often get asked why more people have food allergies today. Some people are concerned, others are skeptical. I hear the tone in the person’s voice — they are thinking that food allergies are somehow invented by parents. They might say something like “When I was a kid, there weren’t any food allergies around” as if to say that people in society today have become neurotic, blaming food allergies for everything.

The fact is that food allergies are real and are on the rise. That is why we are hearing so much about it now. More kids today have food allergies than when we were kids. According to one study, peanut allergy doubled among children between 1997 (1 in 250 children allergic to peanut) and 2002 (1 in 125 children allergic to peanut).

Why have food allergies become more prevalent? No one knows the answer, but here are a few theories, as explained in the Food Network special show Edible Enemies about food allergies (it will air again on October 19 at 10 AM):

1. Mothers are ingesting more allergenic foods like peanuts and breastfeeding their children and then causing an allergy. According to Dr. Scott Sicherer, researcher at the Jaffe Food Allergy Institute at Mt. Sinai, studies have shown that this doesn’t seem to be the case. [I have read other opinions, however, that say that this might be a cause because the food proteins pass through the breast milk, sensitizing the child.]

2. We are eating more peanuts. According to Dr. Sicherer, there isn’t really evidence of this.

3. The Hygiene Hypothesis or Cleanliness Hypothesis

“We’re living in such a clean lifestyle that our immune system becomes misdirected. It’s looking for something to do. [We] wash our hands all the time, we have vaccines that keep us from getting germs, if we get an infection we take antibiotics right away. And instead it ends up attacking things it doesn’t need to, and in this case, food proteins, causing food allergy.” - Dr. Scott Sicherer

4. Modern day food processing

“This may be one of the reasons why food allergies are on the increase, because we’re being exposed to these microscopic amounts, in very subtle ways, that may not produce a full-blown allergic reaction, but may continuously sensitize the body. Today’s kids are most at risk since their immature immune systems can’t cope with ever-earlier exposure to a large number of readily available processed foods.” - Dr. Richard Firshein

Examples: the addition of milk proteins (whey and casein), soy protein and wheat to foods that we are consuming — just check the labels of the foods at your house and you will find these ingredients in almost everything!

Other theories:

• “One explanation for this phenomenon as it relates to peanut allergies may be the way the nuts are prepared. Most peanuts in the U.S. are dry-roasted at high temperatures, and experts say the high temperatures may change the protein structure of the nuts, making them more allergenic. In China, on the other hand, most people eat boiled peanuts, and Asians have a much lower rate of peanut allergies.” (from Qualityhealth.com)

• The rise in food allergies may be caused by a lowered immune function due to increased antibiotic use, vaccinations, high processed food and pesticide use. (Food Allergy Initiative website)

Whatever the reason, this rise is alarming. Many parents with no serious food allergies are finding, sometimes by terrifying circumstances, that their children have them. I am hopeful that some sort of cure will be found in the near future.

You can learn more about food allergy from the doctors at the Jaffe Food Allergy Institute:

• An interview with Dr. Scott Sicherer about peanut allergy (from 2003)

• An interview with Dr. Hugh Sampson about food allergies (from 2005)

Filed under: News & Research, Babies & Kids, Peanuts/Nuts Allergy, Food Allergies | 3 Comments »

A new study in the European medical journal Allergy found that children with cashew nut allergy had more severe reactions than children with peanut allergy. Wheezing and cardiovascular symptoms were reported more frequently in the cashew-allergic children.

I think this study is important, not to downplay peanut allergy, but to bring awareness to other nut allergies as well. When I say that my daughter is allergic to cashews, people are surprised. I still see peanut butter on the playground every time I go there, and wonder how we are going to ever solve the problem of the rise in nut allergies and the presence of nuts in our society. The best solution is to get rid of food allergies of course, and researchers are working on that (if you want to help, consider donating to food allergy research).

But until that happens, I just hope that society will become more aware and compassionate about food allergies - yes, they exist and no, we aren’t making it up, and yes, it’s really really hard and no, we don’t want to impose on you, but *sigh*, please try to understand!

Filed under: News & Research, Peanuts/Nuts Allergy | 1 Comment »

My family and I are off to Mexico for a vacation. We are staying at the same hotel we usually do, but this time I am bringing something new - an EpiPen.

It was at this hotel where we had the “cashew incident.” Months before, my daughter had tested positive to cashews (and other things) on a food allergy skin-prick test, but she had never eaten one, and to this day never has. At the hotel bar they routinely put out chips and salsa and a big bowl of mixed nuts. My daughter knew to stay away from the nut bowl, and I kept it out of her reach, but beyond that I didn’t think much about it.

A little while later, she started scratching her face around her lips. It was a bit dark so I didn’t think anything was serious, until she said to me “Mommy, my lips hurt.” I focused my eyes on her lips and saw that they were swollen. In an instant I scooped her up and went running to our hotel room where I had a bottle of Benadryl. I called my dad, who is a pediatrician, in a panic. I gave her the Benadryl and waited for her symptoms of food allergy to subside. It worked. Within a half an hour she was as good as new (and a little high off the Benadryl).

I was relieved and confused - what set off this allergic reaction? When did she eat a cashew, or maybe there was something else she was reacting to, but she had not eaten anything that she hadn’t had before. I voiced my confusion to my in-laws who had joined us on the vacation. It was my father-in-law who volunteered that he had been playing a game with my daughter where she would bring him a tortilla chip and he would give her a little kiss. In addition to the chips, he had been eating from the nut bowl - and picking out the cashews in particular. Wow… wow. I was a little stunned - she had a reaction to cashews via a kiss.

I had heard of the peanut-kissing story back in November of 2005, where a Canadian girl died after kissing her boyfriend who had eaten peanut butter 9 hours before. Months later, the coroner said that she did not die from an allergic reaction to peanuts, but by then the case had already received so much media attention that nobody knew this conclusion to the story. What did come out of this news was that a study was done on peanut allergens in saliva. It concluded that peanut is detectable in saliva right after eating a meal with peanuts, but that it leaves the saliva after several hours. In other words, don’t kiss someone who has just eaten the thing you are allergic to!

When I told the pediatric allergist of the incident, he asked “Did she have any trouble breathing?” “No.” “Did she have any drop in blood pressure” “No.” He concluded that she did not have an anaphylactic reaction and therefore probably does not need an EpiPen. That made me feel better, but then I thought - if she had that reaction just from a little contact, what would happen if she actually ate a cashew?? My daughter’s pediatrician and my dad agreed with me and felt it was better to be safe than… well, you know.

So off we go to Mexico with an EpiPen. It makes me nervous to have it, but nervous not to.

Related topics:

• Learn how to use an EpiPen.
• Read the Tree-Nut Free Guide.

Filed under: Peanuts/Nuts Allergy, Food Allergies | 5 Comments »

I took my girls to the playground today and my 2.5 year old daughter made a new friend. Some kids just hit it off, and these two girls were giddy with each other. They giggled, tackled, and hugged. Both were cruising around with remnants of their lunches in their hands (I can feel the mothers of food-allergic children cringing right now) - my daughter had a last piece of gluten-free tortilla and her friend a piece of bread with jelly. Right after the hug, the little girl’s mother told her daughter to be careful because her hands were messy… with peanut butter.

Alarms went off in my head - peanut butter! I felt like I was seeing one of those TV programs where they go into the hotel rooms with a black light to see where the… um… “mess” is. Anyway, I was imagining peanut butter everywhere - on the playhouse that sits in the sand, on the sides of the slide where kids run their hands as they spiral down, on the chains holding the swings, and on the handle of the bathroom door.

Luckily for me, my kid isn’t allergic to peanut butter (according to tests). Cashews yes, and I have seen kids with baggies of cashews on the same playground, but I don’t worry about cashew butter around the place (maybe I should?)

So today I am asking the question - do parents of peanut-allergic children bring their kids to playgrounds? If so, how do they keep their kids safe? Please comment below and help the other mothers out there!

Filed under: Babies & Kids, Peanuts/Nuts Allergy, Food Allergies | 4 Comments »

Has your doctor warned you about eating peanuts while pregnant or breastfeeding? A new study has just been released that links eating peanuts during pregnancy with an increased risk of peanut allergies in infants. The research out of Montreal showed that eating peanuts during pregnancy quadrupled the risk of allergy in a child, and eating peanuts while breastfeeding doubled the risk of a toddler developing allergies. The recommendation is to avoid peanuts if the parents have any kind of allergy (even if it’s not a food allergy). Read article here.

WHY is this so, you may be asking. Well, it has to do with the peanut protein (the allergenic part of the peanut). A study in 2001 proved that peanut protein passed into the breast milk of some women within 2-6 hours after ingestion. One theory of why peanut allergy develops is that it is triggered by early exposure. So, an infant consuming peanut protein in breast milk is being sensitized to peanut and is at risk for developing a potentially fatal peanut allergy. (This pertains to babies with one or more parents who have asthma, eczema or allergies.) Read that article here.

Some people advise against changing one’s diet until more research is performed because they don’t want it to lead to nutritional deficiencies in the mother’s diet. In my opinion, if the food being avoided is not necessary for good health or whose nutrients can be found in other food sources (which most can), why not be on the safe side and cut it out? Yes, it is a commitment to change your diet, but it’s for your child - believe me, it won’t be the last sacrifice you make as a parent!

Related reading:

• Peanut Allergy Basics
• “So Confusing…”

Filed under: News & Research, Babies & Kids, Peanuts/Nuts Allergy | No Comments »

It was reported in the UK that an 80-year old woman went into anaphylactic shock after receiving blood from a 19-year old woman with a severe peanut allergy. She ate a muffin with peanut butter in it 2 days after the blood transfusion. Doctors are now considering whether donors need to be screened for food allergies.
For more details, read the news article.

To learn more about food allergies, read

• The Top 8 Food Allergens
• Allergy vs. Intolerance.

Filed under: News & Research, Peanuts/Nuts Allergy | No Comments »