Memorial Day is just a few days away and we're sure many of you will either be hosting or attending family picnics. We love this time of year; being able to celebrate the brave men and women who have defended our country while enjoying the warmer climate with family and friends. Though Memorial Day will certainly offer a host of quality events we know that this can create some angst for parents of children with food allergies. Below we have outlined some tips for enjoying a food allergy free Memorial Day weekend:

1. If you are attending a picnic check with the host to see what they are serving. Most outdoor parties involve grilling, and that’s great because grilled meats are among the easiest to make allergen-free. Ask the host to prepare a portion with nothing added and no sauces for your food allergic child. That might mean no cheese in the burger, or no sauce on the chicken. Stay away from hot dogs and sausages unless you are sure of the ingredients. Ask to have your child’s portion cooked first on the grill, to eliminate the possibility of contamination, and skip the bun.

2. Offer to bring an allergen-free side dish. Typical side dishes for picnics – macaroni salad, potato salad, and cole slaw – tend to be made with milk and eggs. One of our favorite recipes is the Allergen-free Coleslaw from Living Harvest.

3.Bring your own serving utensils and serve your child a generous portion first, before everyone else digs in.

4. Try fruit salads for dessert. Fruit salad is often a good choice for food allergic families, or choose one of the great new non-dairy frozen desserts on the market, like the new Tempt ice cream bars. With flavors like Blueberry Pomegranate Swirl and Chocolate Fudge, you can’t go wrong. Be sure to bring some for all of the kids at the picnic, because these are so good everyone will want them.

Most importantly, follow your food allergy safety rules, and always carry your child’s medications. On behalf of everyone at Nutricia North America, we would like to wish you and your family and happy and food allergy free Memorial Day!

Previous to this study done this year, there had only been 3 studies regarding passenger reports of in-flight allergic reactions to peanuts and tree nuts. This study shows that the reactions are an international problem. Passengers’ nationality differentially affects what preflight notifications or in-flight preparations allergic passengers will make, however it doesn’t affect the odds of using an Epi-Pen. What is hopeful is that certain passenger initiated behaviors may reduce the odds of experiencing a reaction in flight.

The study was done to look at international in-flight experiences and determine the efficacy of certain risk-mitigated strategies. They did this my using a questionnaire through websites and social media.  The results showed that 349 reactions were reported out of 3273 respondents from 11 countries; only 13.3% received epinephrine as a treatment! Flight attendants were notified about 50% of them. Sixty nine percent reported making preflight accommodation requests, although just 55% of reactors (those who had an allergic reaction) did so versus 71.6% of nonreactors. Those who made accommodations requested peanut and tree nut-free meals, wiped their tray table, avoided airline pillows and blankets, requested buffer zone and asked other passengers to not consume peanut/tree nuts containing products. These people had significantly lower odds of reporting a reaction!

Studies like these can put hard science behind the importance of making appropriate accommodations before a flight for people with food allergies.  

What tips do you have for people living with food allergies when it comes to flights?

Safe travels this season!

 -Christine

Since many of your little ones have food allergies and other types of allergic conditions, we like to keep you updated on relevant new research findings. A recent study[i] found a link between persistent pollen exposure during infancy and the development of allergic disease, specifically asthma and hay fever.

The increased risk was found for babies exposed to pollen during the first 6 months of life and the association was strongest when pollen exposure occurred during the first 3 months of life. This may suggest that babies who experience their first pollen season prior to reaching 6 months of age are at a greater risk than babies who don’t. Since pollen levels are usually highest in the spring as the weather warms, babies born during winter and spring are exposed to more pollen during their first 6 months than babies born during summer and fall.  

Remember that an “increased risk” does not mean that high pollen exposure causes allergic conditions. Many babies born in winter and spring do not develop allergies and many babies born in summer and fall do. However, these findings suggest that being exposed to high pollen during the specific window of 0-6 months of age may contribute, along with various other environmental factors and genetics, to the development of allergies and allergic conditions.

Keep in mind that pollen levels vary from place to place. The amount of pollen in the air tends to be higher in warm, dry climates, and lower in cool, rainy climates. Therefore, babies living in warm, dry areas will be exposed to more pollen than babies in cool, dry areas, regardless of season.

So, does the season of birth affect the risk for developing allergies? The short answer is that it may, since babies born during the winter and spring tend to be exposed to high pollen counts during their first 6 months, which may be a contributing factor for the development of hay fever and asthma.

Pretty interesting, isn’t it?

-Mallory

Many Neocate families are on constant “high alert” for severe allergic reactions, especially when away from home. For many children and adults with severe food allergies, coming into contact with a food they don’t tolerate can cause a number of reactions, including anaphylaxis, or shock. Anaphylaxis hits fast, and causes breathing to become very difficult, very quickly, or even worse. If you or a loved one has ever had an anaphylactic reaction to food or an insect sting, your healthcare team may have prescribed an epinephrine auto-injector to keep on hand as an extra precaution. An injection of epinephrine can buy time while emergency medical care is on the way in the case of anaphylaxis.


A new development in epinephrine auto-injectors debuted recently. If you haven’t heard about it yet, it’s the Auvi-Q auto-injector, made by Sanofi. The Auvi-Q works the same way as other auto-injectors, by delivering a quick shot of epinephrine to the thigh. What makes Auvi-Q unique is that it provides voice instructions, which can guide the patient or a bystander through the injection process. Each Auvi-Q auto-injector contains a single doses of epinephrine.


Many families might prefer an epinephrine auto-injector with spoken instructions, since use of an auto-injector might be scary or difficult, especially for someone unfamiliar with anaphylaxis. If you’ve been carrying an epinephrine auto-injector and are interested in the Auvi-Q, you can view a video demo on the Auvi-Q website. Still want to know more? Ask your allergy team for more information.


- Rob

Nutricia North America does not promote or sell the Auvi-Q epinephrine auto-injector

[Image Source]

In recent years, there has been an increase in the number of babies born by caesarian section (C-section), especially in developed countries such as the US and UK. The rate of pediatric allergies and asthma has also been rising, leading some to wonder if there might be a connection between the way babies are delivered and the development of allergies and asthma during childhood.  

With vaginal deliveries, babies are exposed to their mother’s microflora (friendly bacteria) in the birth canal. This exposure affects the composition of the baby’s intestinal microflora, which plays a role in the developing immune system. Some theorize that birth by c-section affects a baby’s developing immune system, making them more susceptible to develop allergies and allergic diseases. Research into the connection has been inconsistent. Some studies find a definite link while others don’t. In today’s post, we’ll summarize some of the research available on the topic.  

Research:

o   A 2005 study from Oregon Health & Science University found an increased risk of being diagnosed with allergic rhinoconjunctivitis (AR) among children born by c-section. They also found an increased risk of asthma, specifically in girls born by c-section.

o   A Mayo Clinic study published the same year found no association between delivery by c-section and the subsequent risk for developing childhood asthma.

o   A 2008 study out of Children’s Hospital of Boston found a link between c-section and atopy and allergic rhinitis among children who have a family history of allergies and asthma.

o   A 2008 study out of Denmark found that c-sections are associated with a moderate risk increase for allergic rhinitis, asthma, hospitalization for asthma, and possibly food allergy, but not for inhalant atopy or atopic dermatitis.

o   A 2009 Norwegian study found no link between c-section and the development of food allergies in children during the first 2 years of life. 

o   A 2012 study of Greek children found that delivery by c-section is associated with asthma and atopic sensitization in childhood. Family history of allergic disease did not seem to influence the connection between c-section and asthma; however, the connection between c-section and atopy is stronger when there is a family history of allergies.

This year, researchers from Henry Ford Hospital presented their findings at the 2013 Annual Meeting of the American Academy of Allergy, Asthma & Immunology in San Antonio. They found that children born by c-section are 5 times more likely to develop allergies when they are exposed to high levels of common indoor allergens. They also found that in comparison to children born vaginally, children born by c-section are more likely to be sensitized to at least 1 food, when the mother has a history of allergies.   “We believe a baby’s exposure to bacteria in the birth canal is a major influencer on their immune system”, said Christine Cole Johnson, PhD, MPH, chair of the department of health sciences at Henry Ford Hospital.

It’s important to note that none of the above studies show that c-sections actually cause the development of allergies and allergic diseases, but some do suggest an association. This information may give clinicians some clues as to how allergies develop and provide insight for how they might be prevented or treated in the future. 

-Mallory

Photo source:

http://www.flickr.com/photos/vinothchandar/8515615966/

References:

1.       Pistiner M , et al. Birth by cesarean section, allergic rhinitis, and allergic sensitization among children with a parental history of atopy.J Allergy Clin Immunol. 2008 Aug;122(2):274-9.

2.       Kolokotroni O, et al. Asthma and atopy in children born by caesarean section: effect modification by family history of allergies – a population based cross-sectional study. BMC Pediatr. 2012; 12: 179.

3.       Renz-Polster H, et al. Caesarean section delivery and the risk of allergic disorders in childhood. Clin Exp Allergy. 2005 Nov;35(11):1466-72.

4.       Juhn YJ, et al. Mode of delivery at birth and development of asthma: a population-based cohort study. J Allergy Clin Immunol. 2005 Sep;116(3):510-6.

5.       Kvenshagen B, et al. Is there an increased frequency of food allergy in children delivered by caesarean section compared to those delivered vaginally? Acta Paediatr. 2009 Feb;98(2):324-7.

6.       Younus M. Abstract #82. Presented at: 2013 Annual Meeting of the AAAAI; Feb. 22-26, 2013; San Antonio.

7.       Bager P, et al. Caesarean delivery and risk of atopy and allergic disease: meta-analyses. Clin Exp Allergy. 2008 Apr;38(4):634-42.

Here at Neocate we provide solutions and support for families affected by nutritional and food allergies like CMA, but allergies can affect us beyond what we eat. It's quite possible that many of you, our readers, are not only dealing with you or your little ones food allergies but seasonal allergies as well. If this is the case, you are among the 35 million Americans face each year as the pollen from trees, grass, flowers, and plants makes it way into the air. Allergy-sufferers shouldn't fret too much. Like food allergies, there are managable solutions for facing seasonal allergies. In the following article, WebMD explores natural solutions for managing and overcoming seasonal allergies.

• Relieve allergies the natural way

Per WebMD's recommendations, it is good to couple medicine with natural solutions. Do you have seasonal allergies? What's been the best method for managing them?

For more information on seasonal allergies:

• Spring and seasonal allergies
• Allergies and genetics

As we continue our CMA video series, Jo, mother of Niamh explains that getting a diagnosis is only the first step in treating CMA. The next step is understanding where to find information and having a support group.

For more resources on cow's milk allergy, please visit the following links:

• World Allergy Organization: CMA Guidelines
• Common Symptoms of a cow's milk allergy
• Outgrowing a cow's milk allergy

Last week we began our CMA video series that focused on providing information and resources surrounding cow's milk allergy. In this week's video Dr. Adam Fox explains the difference between cow's milk allergy and lactose intolerance.

To learn more about lactose intolerance and cow's milk allergy please visit the following links:

• Lactose Intolerance or Milk Allergy?
• Switching to soy?
• Hidden food allergens series: Dairy

During the month of April we will be sharing resources on cow's milk allergy (CMA) through a video series designed to help parents gain more understanding of the allergy. Each video will spotlight a parent whose child suffers from CMA and how they navigated the process of finding treatment. Additionally, some of the videos will include resources from pediatricians. 

Today's video comes from Rachel who shares that her daughter, who has a CMA, sometimes consumes milk by accident.

To learn more about CMA, please visit the following links:

• 8 Signs of a Milk Allergy
• Common Symptoms of a Milk Allergy
• Cow's Milk Allergy Education: Diagnosed, now what?

Easter is just a few days away! You and your families are probably planning for the big day by dyeing eggs, putting together baskets and taking pictures with the famous Easter Bunny. As you prepare we have an Easter-friendly and allergy-free recipe that you and your family are sure to enjoy. If you try it we would love to hear your comments!

Peach Potato Puffs (from Kids With Food Allergies)

By Danielle (deestricky1)

2 cups mashed sweet potatoes

1 tsp lemon juice

2 tsp brown sugar

1/4 tsp salt dash ginger

2 tsp dairy-free, soy free, corn free margarine

6 canned peach halves

In a medium-sized bowl, mix all the ingredients except the peaches. Whip with whisk or mixer until nice and fluffy.

Take whipped potato mixture and pile some into each peach half. Arrange the filled peach halves in a greased or sprayed 6x10" baking pan and dot with additional margarine. Bake at 400 degrees Fahrenheit for about 20 minutes.

On behalf of everyone at Nutricia North America, we want to wish you a Happy Easter!