Thursday, 14 February 2019

The Sibling Debate: When one child has a food allergy and the other doesn't

What do you do when one child has food allergies and other child doesn't?

I have a gorgeous 3 year old allergy-free son, with a personality that is larger than life and now a beautiful 9 month old daughter, Matilda, who has a severe cows milk protein allergy. Since Matilda started weaning, my husband and I have often discussed...

 Should we make the whole family dairy free or just keep Matilda dairy free?

At our first paediatric dietitian appointment when Matilda was 6 months, our dietitian said that our whole household would most likely eventually end up dairy free, to which my husbands response was simply, 'no chance.' Myself however, having been on a strict dairy free diet while breastfeeding up to this point, knew it was easily manageable. And thus began our debate.

Should you deny one child because the other cannot have it?

The answer is not straight forward and neither can it be. Every child's allergy is different and so is their type of reaction. In cases where the child reacts when allergens are airborne or by touch than it is without doubt that the allergen needs to be eradicated from the environment. It is never worth the risk.

However, if an allergic reaction occurs when the allergen is ingested, is it easier to control the environment so that an allergic reaction can be avoided?

Matilda only reacts when cows milk is ingested. When we were about to begin weaning, my husband and I had to decide whether we needed to eliminate dairy completely from our household. Up until this point, I had been dairy free breastfeeding and as an adult was able to safely ensure I did not consume any dairy. Then after six months, I made the difficult decision to stop dairy free breastfeeding which you can read about more on my post The End of Dairy Free Breastfeeding: My Experience This meant that my three year old had six months experience of me being dairy free. He was used to offering me food and me responding 'thank you darling, but that has milk in it and milk makes Matilda sick.' He even used to frequently ask me whether the food he had contained milk and on a couple of occasions, including in one very busy restaurant, shouted across at me while I ate, 'MUM YOU CAN'T EAT THAT, IT HAS MILK, YOU WILL MAKE MATILDA SICK.' even long after I stopped breastfeeding! He was very aware and conscious of it. By having those six months of me being dairy free and the discussions that came with it, we felt he was very well prepared for when Matilda started weaning. He has never tried to feed her something without checking with me first and he still asks if something contains milk while I am feeding her. Therefore, we were able to keep dairy in the household for my husband and son to safely consume.

However, the situation is now changing. Matilda started crawling early and is now nearly walking. Her increased mobility has increased the risk factor. It is now no longer safe for my son to eat dairy containing snacks as Matilda will cheekily try to steal it from him, or if he drops a single crumb, she races there at the speed of light attempting to eat it before I remove it from her grasp.  

Our main concern now, is by having dairy containing products in the house, we are creating the risk of her accidentally ingesting it and having a severe reaction. After all mistakes are easily made, especially when we are tired or distracted. I have a severe allergy to penicillin and once managed to accidentally ingested it when my son had been prescribed penicillin for a bad chest infection. One day, as I administered him his dose, a small drop fell on my hand, as I was trying to persuade him to take it. I automatically licked the drip of my hand before realising what I had done. I could have kicked myself, its not something you would do even if you weren't allergic, but the endless sleepless nights from him coughing had clearly affected my ability to think clearly.

And this is where the problem lies. Even with the best intentions and highest level of organisation and 'control,' we are only human. We do make mistakes. Therefore, in keeping food that contains an ingredient that one child is allergic to, does increase the element of risk. And as a mum of a child with allergies, don't we spend all our time striving to eliminate that risk?

Our snacks are therefore, now all dairy free and with Matilda now being at the stage where she can pretty much eat the same as us, our meals are becoming more and more dairy free also. It has been a natural progression for our family. One that at the beginning, we thought would be impossible, but actually hasn't been as big a sacrifice as we first thought. The ever growing vegan population and increased products available has been a great help. One we couldn't be more grateful for. 

It is a tricky one and I don't feel we can judge others for what decision they make for their family and child. As I said earlier, every child's allergy and reaction is different. What works for a baby may not work for a toddler, or again for an older child or even an adult. It is such a minefield, an exhausting one. Just remember, you can only do what you feel is best at the time and somethings, as scary as it is, are just not in our control.

Wednesday, 6 February 2019

What happens when CMPA symptoms don't disappear with a dairy free diet?

Three months ago Matilda transitioned from dairy free bottle feeding to an amino-acid based formula and we also began our weaning journey. From day one, she began to wheeze briefly after her bottles, which at the beginning we put down to her just adjusting from breastfeeding to the fast flow of a bottle, but when it continued after a period of time, I began to worry.

This wheezing also occurred after eating some foods, but I just could not determine if it was one particular food setting this off or something else as it did not happen consistently when she ate.

Matilda was also screaming in pain with every bowel movement. It was the same ear piercing scream we experienced early on after she was born, before we discovered her CMPA.

Another symptom that caused me great concern was after feeding Matilda a homemade dairy free tomato and spinach frittata, she developed a rash across her face. It was the first time she had eaten both egg and tomatoes, so one of those must have triggered it.

All of this together gave me the following concerns:
1. Is Matilda allergic to the Neocate formula? She had already had a reaction to the Nutramigen,   could it be happening again? If so, what options do we have left?
2. Does Matilda have other food allergies than just cow milk protein?

So I rang out Paediatric Dietitian's office and left a message with her assistant relaying the issues and concerns we were having. Yesterday, just over a week later, she returned my call.

Firstly, we discuss the concerns over the wheezing after her bottles as well as sometimes after eating. She seemed concerned but reassured me that it could not be the Neocate formula causing this. My dietitian claimed that the chances of a child being allergic to the Neocate are extremely rare and that Neocate was really the last resort option for formula feeding Matilda. Instead she explained to me that sometimes after children with CMPA allergies omit dairy from their diet, they can still experience symptoms and may need referred on to a Paediatric Gastroenterologist. She urged me to make an appointment with my GP and get Matilda checked over and discuss the possibility of a referral.

We then discussed the rash Matilda developed after eating the frittata and both agreed it was most likely the egg that caused the rash. My dietitian urged me to be brave and try Matilda again with egg but have it baked in something and see how she tolerates it. If Matilda reacts again, I need to inform her right away and she would make a referral to the allergy clinic for testing.

Later that day, I took Matilda to see our GP to discuss what the dietitian had said. I had my larger than life three year old with me at the time which if you have ever tried to have any important discussion with a three year old around, you will know how challenging it is. I packed a box of snacks, including a chocolate reindeer he had left over from Christmas for bribery and set off on our short walk to our local doctors' surgery. We were half way there when my darling three year old screams 'I need a poo.' I should know by now this always happens at the most inconvenient of times, so we rushed back home, did his business and set off again. Luckily, I am obsessed with time keeping and had allowed half an hour for a ten minute walk.

I felt a massive sense of relief when I walked into the duty doctors office and saw which doctor it was. We have meet with this doctor before regarding Matilda's allergy and he was brilliant, some of the other doctors unfortunately were not always as supportive and knowledgeable as he was, but today we were in luck. My dietitian had already sent him an instant message detailing what we had discussed during our earlier phone call which made life so much easier. While my three year old worked his way through his bribery stash, we discussed my concerns and he examined Matilda and was in agreement with our dietitian. Egg was to be removed from our diet and to gradually try and challenge her with foods that had egg baked in them. The wheezing he concluded was done to silent reflux, making it hard for her to catch her breath sometimes while eating and drinking, and the painful bowel movements he put down to colic. We were the prescribed Ranitidine to be taken twice a day to relieve these symptoms but if nothing improved, we had to return and would be referred to the Paediatric Gastroenterologist. 

Just when I thought we were getting into the swing of things with the dairy free diet, we are thrown a curveball. We will follow the medical advice and proceed with what was proposed. Fingers crossed it all works out...

Sunday, 3 February 2019

My Quest to find the Perfect Dairy Free Cheese

So I am on a mission to bake the perfect dairy free cheese scone. Cheese scones are a family weakness. We just love them. My three year old especially adores them and they soon became our go to snack while on the go when he was younger. There are so many reasons why cheese scones are a fantastic snack for young children. On top of being utterly delicious, they:

- are easy and quick to make using ingredients you usually already have in your home.
- they don't squish or fall apart in a lunch box or sandwich bag so are easy to transport.
- they fit into little hands easily and do not slip out, so are perfect for eating on the go in a pushchair.
- they are rather filling as well as being super tasty when served either hot or cold.

Therefore, despite Matilda's milk allergy, I really wanted to find a way of making them for her. I decided the best way to start was to simply swap the dairy products in my usual family recipe for dairy alternatives. I swapped cows milk for Oatly whole and tried the Violife block instead of my normal cheddar cheese. Here are the results...

Although they passed the Matilda taste test, I wasn't 100% satisfied. They were a little drier than normal and the flavour was very mild. She was happy with them but I wanted something that had more flavour for her, especially as I hoped I could convince the dairy eaters in our household to switch over to the dairy free option. It just wouldn't do. I needed to try again.

I had read recommendations about Tesco's Free From Mature Cheddar having a good strong flavour so decided to give that a go in my next batch. I once again followed my family recipe, swapped the Violife cheese for the Tesco alternative and just increased the dairy free butter alternative by 10g. This time round the consistency was much better, they were not dry like the previous batch and they did smell very cheesy. Great I thought, this is it! Oh how wrong was I. They were hideous and tasted of sick. The Tesco Free From Mature Cheddar just did not work for this recipe. The last lot may have only had a delicate flavour but at least they were easily edible. I couldn't make it past one bite of these ones. The kids however, including my very opinionated three year old, enjoyed them. But despite the children enjoying them, I am just not satisfied.

Overall, the Violife gave a better taste but was just not strong enough to make it taste cheesy. Both cheeses even when grated finely, did not melt fully or blend in with the rest of the mixture, making it a little lumpy in places. My quest continues...

I may have only tried two different cheese alternatives so far and I am not ready to give up on my dream of the perfect dairy free cheese scone, but it has made me there really a good dairy free alternative to cheese?

Our dietician told us there wasn't and just to avoid them as they were all disgusting. But with the rise of veganism, there must be the perfect non-dairy cheese out there somewhere for us.

So I was wondering, have you found your perfect dairy free cheese? If so let me know!

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