Category Archives: Lactose

The Peanut Puzzle Part II

To continue where I left off the last post, this is all summarized from “The Peanut Puzzle: Could the Conventional Wisdom on Children and Allergies Be Wrong?”

Since the conventional wisdom about when to introduce solid foods to babies was overturned in 2008, Doctors Sampson and Sicherer have continued to study food allergies. They have been experimenting with giving children low doses of the food they are allergic to, sometimes in a different molecular structure, to reeducate the immune system that the food is acceptable.

They observed, “…for example, that baking caused milk proteins to change shape in a way that could be less provocative to the immune system. The allergic person might be able to eat the altered proteins and become tolerant of them in all their forms.”

The article also follows Maya, a little girl with an anaphylactic reaction to milk. In spite of her parents’ vigilance she’d had some frightening reactions. On a family outing she struggled to breathe and lost consciousness after eating something labeled “vegetarian cheese.” Another time she was rushed to the hospital after eating a hot dog that contained milk protein.

Under the instruction of Sampson and Sicherer, and in the presence of a nurse, Maya was given a muffin that contained a small amount of milk. She took one bite and had no reaction. Then she ate the rest of the muffin and after a few minutes the vomiting started and hives appeared. They gave her an injection.

When the reaction stopped, they sent Maya home. Her parents received specific instructions to feed her baked goods containing milk every day. Maya came back six months later and they inserted an IV and had epinephrine at the ready. They gave her a slice of pizza. She ate the entire thing without a reaction.

“It was nothing less than miraculous,” her mother said.

Maya returned the next day and drank a glass of milk. As soon as she finished drinking she began vomiting but they were able to control her reaction with Benadryl. A few months later, Maya was able to eat macaroni and cheese but still unable to tolerate a full glass of milk.

“Even if she never progresses past this,” Maya’s mom said.  “I have no regrets about being in the study, because now she can go to a birthday party and have a slice of pizza. It’s huge.”

It is miraculous. So miraculous that I was considering doing some baking. Then I remembered Josie’s food allergies – egg, whitefish, soy and tree nuts. Codfish pecan muffins, anyone?

The Peanut Puzzle Part I

After my last post, I know you’re all relieved to know that we finally settled in around the one pool in the greater Las Vegas area that did not have loud music. It was a plain rectangle that was in the shade of the high rises until 1:00 every afternoon but we made do.

The highlight of my reading was this: “The Peanut Puzzle: Could the Conventional Wisdom on Children and Allergies Be Wrong?” Sorry, they won’t let you read the article.

Um… YES.

Since 2000 the “conventional wisdom,” endorsed by the American Academy of Pediatrics, has said that parents should wait until a child is 6 months old before introducing solid foods. Then parents should start with the foods that are least likely to cause allergic reactions. This late introduction was thought to make children less likely to develop food allergies.

In the past decade peanut allergies have doubled. Clearly there’s something wrong with our “conventional wisdom.”

I hated giving Josie formula. Spooning powder from a can seemed like the antithesis of nourishment – it was the ultimate processed food. I was anxious to start her on solid foods, but I followed the conventional wisdom and waited until she was 6 months old to give her a bite of cooked sweet potato. In spite of my efforts, or maybe because of them, she’s currently allergic to eggs, soy, white fish and tree nuts.

Doctors Hugh Sampson and Scott Sicherer at Mount Sinai Medical center have found that food allergens are unavoidable and babies come into contact with protein molecules though particles in the air and on skin and in other food and that by giving them such small doses we are actually making their systems more sensitive and more likely to develop allergic responses.

“You can’t avoid food proteins,” Sampson, said. “So when we put out these recommendations we allowed the infants to get intermittent and low-dose exposure, especially on the skin, which actually may have made them even more sensitive.”

Based on a report submitted by Sampson and Sicherer, The American Academy of Pediatrics overturned this practice in January of 2008, stating – “Current evidence does not support a major role for maternal dietary restrictions during pregnancy or lactation… There is also little evidence that delaying the timing of the introduction of complementary foods beyond four to six months of age prevents the occurrence of [allergies].”

Now what? The retraction of the previous recommendation leaves a hole where the current advice should be placed, but there’s nothing there. At this point, all we know is that we don’t know what we thought we knew and I guess that’s a great first step.

When did you introduce solids? How did that work out? Does your child have allergies?

To be continued…

Trust

Back in the spring when it was clear something was wrong in our house, when Josie started behaving like a colicky baby, waking up for two hours every night and screaming for two hours every day, I took her to a new pediatrician. He came highly recommended for complex cases and was considered to be fairly woo-woo. A friend told me he had a naturopathic physician in his office – my dream come true.

At our first appointment, he ordered more blood work, an EEG of the frontal lobe of her brain, and a breath tolerance test. The tests were going to be such a pain and I really didn’t think they were going to find anything. Here was an MD I respected who was taking my thoughts and concerns seriously and making suggestions and all I wanted to do was roll my eyes and say, an EEG, really?

The EEG was awful. It didn’t hurt her but I did have to hold her still for a long time then try to get her to fall asleep. The blood draw was hard to get. It took 3 visits and multiple tries. By the time we were done, Josie was crying, I was crying and I think the phlebotomist was on the verge.

When those tests came back normal, I decided we needed to take a break. The final piece, the breath tolerance test was supposed to take 3 hours and I just didn’t have it in me. A few months had passed when I finally decided to schedule it, not because I thought it would yield illuminating results, but because I wanted to see this doctor again and I didn’t feel like I could go back without following through with his recommendations.

So I started talking to Josie about the test a few days in advance. I explained that we’d go in the morning, that we wouldn’t have any breakfast, that she’d drink a glass of special juice, then breathe into the tube every 30 minutes for 2 and a half hours. They’d be able to tell by her breath if something (lactose) was giving her tummy ache. If she was unable to digest lactose they would find a level of hydrogen in her breath that would reach its peak after two hours – that’s why we had to stay so long.

We arrived the morning of the test, loaded down with bags of her favorites books and toys and a few snacks for when it was all over. We’d had three breath samples, and had been there for about an hour when the tech came out and told us we were done. We could go home.

But… Wait… I mean, we haven’t even touched the DVD’s yet. She’s only just now started rolling on the floor. We still have toys to play with. We’ve been pacing ourselves!

We were done. They sent us home after an hour because she’d already reached the top level, demonstrated the strongest reaction possible. They didn’t even want to see what happened when the level of gas in her tummy peaked at 2.5 hours.

Apparently our girl is totally off-the-charts lactose intolerant. You guys, I almost didn’t have her take the test because it was a hassle and because I didn’t think it was the real problem.

This is something I’ve had a problem with in the past. There are so many tests I wish I’d had. The things I could have learned – that I had endometriosis, that I was allergic to gluten, that I was B12 deficient. I should have let the doctors do their jobs. Here’s what I’m learning: when looking for the cause you’re bound to run into some dead ends, but you’ve got to go down those roads to see where they lead anyway because eventually, one of them may actually lead to a castle or a princess or a pony in a field, and I’ve always wanted a pony in a field.