Food Allergy Living is a resource for parents of children with food allergies, brought to you by Nutricia, the makers of Neocate. For more in-depth information about our purpose & authors, see our About Food Allergy Living page.
We've shared R.J.'s story before (and his little brother Ken). As a child he had severe,painful eczema that covered his entire body. His parents tried everything, but he didn't find relief until they switched to Neocate.
We wanted to share this sweet video that his parents sent to us recently. Today R.J. is 5 years old, and doing great! He is still allergic to milk, but Neocate has helped make him a happy and health little boy.
-Sarah
In food allergy circles, we usually think of symptoms and side effects as results of food allergies, not the other way around. In most cases that’s true. Science has shown a strong link between food allergy and atopic dermatitis, a form of eczema. Last month Dr. Jon Hanifin, a respected dermatologist, gave a talk to colleagues discussing the link between atopic dermatitis and food allergies. The research he presented suggests that for some patients it may actually be atopic dermatitis that comes first and acts as a precursor to food allergies.
Atopic dermatitis is often one of the first signs that a parent or caregiver notices in their child which helps lead to the diagnosis of food allergy. As Dr. Hanifin explained, about 6-10% of children are diagnosed with atopic dermatitis, and of those about a third will be diagnosed with a food allergy. Which begs the question: If parents notice signs of atopic dermatitis first, and an allergy diagnosis comes later, couldn’t atopic dermatitis be causing some instances of food allergy?
-In cases of food allergy, offending foods cause reactions in the body which involve the immune system
-Immunoglobulin E antibodies (IgE) are immune substances which are normally in our bodies at low levels, but are higher with food allergy
-Allergy symptoms often involve the skin (including our digestive tract, which is like an inside skin), an important barrier that keeps most outside “things” from getting inside
-One factor of atopic dermatitis is “holes” in the barrier our skin provides
In the past it was assumed that food allergies came first, causing both high IgE levels and atopic dermatitis. Dr. Hanifin suggested that in some patients atopic dermatitis is caused by “gaps” in the skin (likely due to genetics), which means that foreign substances can enter the skin and cause adverse reactions. He thinks it may be proteins that get through these gaps which allows the body to become sensitive to certain foods, leading to a food allergy.
What does all of this mean? The biggest message here is that patients with atopic dermatitis, especially those under five years, should be tested for food allergies. While avoiding food allergens may not help improve atopic dermatitis, it could certainly prevent or improve other serious side effects of allergies. The second message is that more research needs to be done into the causes of atopic dermatitis and its relationship to food allergies. Any research that leads to better health, through reducing instances of atopic dermatitis and/or food allergies, is good research! Tell us about your experience: Was atopic dermatitis the first sign that you saw of your child’s food allergy?
- Rob
Happy New Year! Before we jump into 2011 on Food Allergy Living, we wanted to recap our top ten blog posts of 2010. We tackled topics from food allergy recipes to tube feeding and everything in between and had some excellent guest bloggers share their stories. Based on reader traffic, here were our most popular posts:
In this post, Christine talks about how to tell if your child has a typical rash or if it is a sign of an allergic reaction to cow’s milk.
Mallory tackled the topic of GERD, or gastroesophageal reflux disease, and two other conditions commonly associated with it: dysphagia and silent aspiration.
If you or your child uses an EpiPen, this blog is a must-read in case you ever have an accidental injection.
Children with food allergies don’t have to miss out on summer camp fun with these allergy-friendly options.
If your child is underweight or has been diagnosed with failure to thrive, the supplement Duocal can help provide extra calories in their diet.
Thickeners can help treat reflux, but children with food allergies often react to the rice cereals or oatmeals that are commonly recommended. Christine offers some other options that are allergy-friendly.
Kendra Tiedemann shared her son Norman’s journey with eosinophilic esophagitis.
If you’ve ever wondered if your baby can taste her food, then be sure to read this post from Mallory.
In this post, Nita helped to clear up some common confusions about what a failure to thrive diagnosis means and how it is treated.
Lorelei Alvarez, one of the founders of the Reflux Rebels group, shared her son Roland’s journey with FPIES in this guest blog.
Which blog posts were your favorite over the last year? Are there any topics you’d like to see us cover in 2011?
- Sarah
You may have noticed that allergies and asthma often go hand in hand. Roughly, 70% of children with asthma have some type of allergy[1]. So do allergies cause asthma? Or does asthma cause allergies? The answer to both questions is no; one does not cause the other but the two conditions do have a strong connection.
Allergies and asthma are both inflammatory conditions caused by dysfunction of the immune system. Sometimes they are referred to as “atopic diseases”. The immune system is the body’s defense to foreign invaders, such as bacteria, viruses, pathogens, fungi, etc. When the immune system detects these foreign invaders, it releases cells that seek out and destroy them. Inflammation is one of the first responses of the immune system to infection. Usually, the immune system keeps us healthy; however, a malfunctioning immune system can lead to illness. This is what happens with allergies and asthma.
With allergies, the immune system is hyperactive and produces an unnecessary inflammatory response to a traditionally harmless substance (such as a food protein). Asthma is a chronic lung disease characterized by episodes of inflammation and narrowing of the airway in response to certain "triggers." These triggers vary from patient to patient and may include infectious agents, exercise, stress, pollutants such as cigarette smoke, and common allergens such as cat dander, dust mites, and pollen.
There are approximately 9 million kids in the US who have asthma[2]. Of this 9 million, about ¾ have asthma that is triggered by allergies. Remember, we talked about different triggers for asthma symptoms (exercise, pollen, allergens, etc.). Patients whose asthma is triggered by allergens are often said to have “allergic asthma”. [3] According to the Asthma and Allergy Foundation of America, allergic asthma is the most common type of asthma, affecting around half of asthma patients.
Atopy refers to the genetic tendency to develop allergic diseases, such as eczema, allergies and asthma[4]. Someone with “atopy” produces certain antibodies associated with allergic disease. Genetics and environmental factors both contribute to whether a patient does or doesn’t develop atopic diseases. Not all people with atopy (that genetic predisposition) go on to develop allergic diseases because environmental factors play a role too; However, they are significantly more likely to. Likewise, not all people with atopic disease have atopy (but most do).
Genetics obviously plays a big role in the development of allergic diseases. If one parent has an atopic condition, their child has a 1 in 4 chance of having some form of atopic disease (not necessarily the same one as the parent)[5]. If both parents have an atopic condition, the child is more than 50% likely to develop an atopic disease.
Hopefully, this information gives you a better understanding of why asthma and allergies are so often seen together. While neither one causes the other, some people have a genetic predisposition which puts them at a greater risk for developing all forms of allergic disease (such as allergy, eczema and asthma). So if you have one allergic disease, you have a higher risk for developing other types of allergic conditions in comparison to the general population.
Have you found this to be true with your little ones? Be sure to share your experiences with us in the comments!
- Mallory
[1] World Health Organization. Global surveillance, prevention and control of chronic respiratory disease: a comprehensive approach, 2007.
[2] The Nemours Foundation/KidsHealth®© 1995- 2010. http://kidshealth.org/.
[3] American Academy of Allergy Asthma & Immunology.
[4] Atopic Diseases in Childhood. Gold MS and Kemp AS. MJA 2005; 182 (6):298-304. [5] The National Eczema Association. http://www.nationaleczema.org/.
Our post today is a special guest blog entry from Nicole Smith. Her blog is Allergicchild.com and she is also the author of the books Allie the Allergic Elephant: A Children’s Story of Peanut Allergies, Cody the Allergic Cow: A Children’s Story of Milk Allergies and Chad the Allergic Chipmunk: A Children’s Story of Nut Allergies. Nicole has also served as Treasurer for the non-profit organization, Kids With Food Allergies, Inc. and is currently serving on the Food Allergy Initiative (FAI) Advocacy Steering Committee. We would like to thank her for guest blogging for us.
Living with food allergies and eczema has become quite normal for our family. Our son, Morgan, is now almost 14 years old and has lived with food allergies his entire life. He is anaphylactic to peanuts, tree nuts, sesame, fish and shellfish. He is severely allergic to dogs, cats and other furry animals. His eczema is our ongoing battle. He is allergic to grasses, weeds and trees. He currently is receiving allergy shots in the hopes that his seasonal allergies will be minimized, and maybe he will be able to pet a dog in the near future!
From his first few months, Morgan had severe, weeping eczema across his body. It was everywhere – behind his knees, on his hands and feet, and even behind his earlobes. His skin was constantly infected, and I coated him with lotions and over the counter steroid creams to not much avail. 
Morgan’s eczema was helped by using Eucerin® lotion in the paste form, and by sparingly using Elocon® lotion (a steroid) when he was an infant. The Eucerin® is almost the consistency of lard. Wal-Mart sells a generic brand of this that costs about 1/2 the amount of Eucerin®, and we’ve found it to be equally as good. We slathered it on him every night. When he was a baby, we applied it every time we changed his diaper. The Elocon® lotion is a steroid cream, so we tried to use it only when his eczema got very severe.
The eczema moved around his body as he grew older, but it has never entirely disappeared. For a while, he had one finger that regularly sported an eczema spot if he ate any food with food dyes!
The use of heat in the winter time dries out his skin, as does swimming in chlorinated water in the summertime. So, there isn’t a season where he gets a break. If we forget to use the Eucerin® paste, his eczema will crack and fissures will form. He has been put on antibiotics, which ended up curing the fissures. However, we try to not allow the eczema to get this out of control. The Elocon® lotion will sting if put on eczema with fissures. He would cry in pain which hurt me almost as much as him – and made me more aware of staying ahead of his skin problems. Morgan’s eczema gets worse when certain foods are added to his diet. We notice that processed foods with yellow and red dyes made his skin much worse, so we removed these from his diet entirely when he was young. This helped the eczema to disappear, yet it would amazingly reappear for no apparent reason. When he was a baby he was severely allergic to eggs; when this allergy disappeared, we started feeding him foods containing eggs, only to find that his eczema flared up.
We live in Colorado Springs, which has hot, dry air in the summer. However, combining the heat with sun lotions is a recipe for disaster. We use titanium dioxide sun lotions since they seem to be kinder to his skin. Certain fabrics such as nylon bother his skin, creating eczema-like blotches. Long ago, I began using laundry soap that is free of all dyes and perfumes. None of this cures his eczema, but it helps it to not become worse. 
Now that he’s a teenager, he’s responsible for taking care of his skin. As with most teenage boys, hygiene is a difficult daily practice! For a while, the prescription medication Singulair® cured his eczema completely. Now it doesn’t work as well. Since he started allergy shots his eczema seems to be worse, yet he is also in the middle of puberty. Our allergist had told us that some patients experience worsening eczema with allergy shots, yet his environmental and pet allergies are much better. It’s a difficult trade off!
When he has a bad eczema breakout, we have begun wet wrapping his skin with CeraVe® moisturizing cream and Betamethasone steroid cream. (He also takes an antihistamine, such as Xyzal or Zyrtec once a day.) We apply the steroid first, then the moisturizing cream and then hot, wet gauze to wrap his skin sealing in the moisture. Adding socks or ace bandages over the top insures the gauze stays in place. Keeping the wet wraps in place overnight helps the worst eczema spots. Twice a day wet wrap treatments can do wonders for his skin!
We feel like detectives on most days, attempting to find the cause of the eczema. It might be food related, contact related (such as grass or clothing articles) or none of the above. We would love to find the magical cure to make his eczema disappear. In the meantime, we’ll keep searching for what works for today to ease the itch!
Nicole can be reached at:
Allergicchild.com
425 W. Rockrimmon Blvd, Suite 202
Colorado Springs, CO 80919
nicole@allergicchild.com
http://www.linkedin.com/in/nicoleshieldssmith
I often speak with parents of milk allergic babies and I hear a lot about rashes that appear on the baby’s face and body. It is heartbreaking to hear how much they itch and scratch uncontrollably. And for many parents it is hard to determine if their child has just a typical baby rash or if it is a symptom of something more serious – like a rash caused by an allergic reaction to cow’s milk. 
Atopic Dermatitis or eczema are two types of rashes that are commonly caused by a milk allergy. But without a diagnosis from the doctor of a cow’s milk allergy, how would a parent know that this is the cause?
You should always refer to your pediatrician to help you understand what is causing your little one’s eczema, but it’s also important to look at the big picture. Sometimes a baby with cow’s milk allergies, will also display other symptoms in addition to a rash. For instance, you may also see symptoms of diarrhea, vomiting, gassiness, wheezing, runny nose, and colic.
If you do see a rash accompanied by any of these other symptoms, make sure to keep detailed notes and share all symptoms with your doctor so that your little one can get diagnosed and treated faster.
Also, make sure to work with your pediatrician to come up with a plan for healing your baby’s skin – no matter what is triggering the rash, it is important to heal your baby’s skin as soon as possible. Some recommendations the doctor might suggest include:
Did your little one have a rash due to a milk protein allergy? Tell us about your experience and what you did to treat it.
-Christine
The other nutrition specialists and I often hear stories from parents about the (often too long) process of getting their child diagnosed and treated for a milk protein allergy. Some families even write up their experiences for us and allow us to share them with other parents. I just re-read one recently about a little boy named RJ (for the full testimonial, click here). By the time R.J. was four months old, he had a painful, itchy, red rash all over his body. He was miserable and in pain.
R.J.’s parents took him to several doctors who tried all these different treatments, but none of them worked.
After months of misery for RJ (and the rest of the family), they finally found a pediatrician who identified the problem as a food allergy and recommended Neocate, an amino acid based formula for the little guy. Within a week, the rash was cleared up and R.J. was a happy, healthy baby again.
This story is a reminder that eczema can be tough to figure out. Many doctors, like R.J.’s, think that eczema is always caused by a topical allergen. However, what many people don’t realize is that sometimes the cause of eczema is from the inside.
R.J. suffered from a severe case of eczema resulting from a milk protein allergy that caused not only him, but his whole family, to suffer. Something to consider if you notice a rash on your little one.
- Sarah
Last night, I was reading the June issue of Parents magazine and came across a pretty great article called “Forbidden Foods” by Jan Sheehan. Since this topic is my focus at work, I like to believe I know a lot of about it! And I have to say, this was a very informative article for allergy and non-allergy parents alike overall. However, it did leave out a few milk allergy specifics I think people should be aware of.
The article outlined the current “allergy explosion” and what parents need to be on the look-out for when it comes to allergies. One side bar I really liked was the “Is it really an allergy?” section. This is often a mistake parents make when deciding whether to take their children to the pediatrician. Just in case you’re not sure of the symptoms for each, here they are:
Food Intolerance
Upset stomach; Gas and bloating; Abdominal cramps; vomiting; Diarrhea.
Food Allergy
Skin redness and itching (a definite sign that is on the rise!); Rashes or hives; Red, watery eyes, Nasal congestion, runny nose, sneezing; Vomiting; Diarrhea; Swelling of lips, face, or throat; Wheezing; Severe breathing difficulty; Loss of consciousness.
As you can see, many of the symptoms overlap. To be on the safe side, I would take your child in to see the pediatrician if he/she is experiencing any of the above symptoms.
Now on to a few things it was missing. When speaking of the formula options available for children with food allergies, it only mentions soy formulas and hydrolysate formulas. Since children with milk allergies are often allergic to soy, the AAP does not recommend switching to soy if your baby is showing sings of a milk allergy. Click here to get more information on the possible risks with soy formulas.
Also, switching to a hydrolysate formula often isn’t enough for babies and kids with milk protein allergy – they need an amino acid-based formula like Neocate, which is made up of protein broken down to the absolute simplest form (amino acids), making it gentler on the tummy of a milk allergy baby.
So, some good info here. But just remember to talk about all your formula options with the pediatrician when you have a food allergy baby.
Here’s a link to a few more articles by the same author on the Parents website. Check it out!
-Sarah
I get a lot of calls from parents regarding their babies’ skin rashes and unfortunately, by the time a parent calls me, the baby has been suffering for quite a while. Eczema has so many triggers that most people don’t think a food allergy could be the culprit.
Here is a review of the basics of eczema…
It is most often characterized by dry, red, extremely itchy patches on the skin. Eczema is sometimes referred to as "the itch that rashes," since the itch, when scratched, results in the appearance of the rash.
10-20% of babies
Environmental Triggers
Our post today is a guest blog entry from Rachel Miller, Baby E’s mom. We’d like to thank Rachel for guest blogging for us.
Never could I have imagined that adding another bouncing baby boy to our family last summer would not only add extra snuggles and smiles, but that it would also add a seemingly long and sometimes stressful journey into the world of food allergies.
Baby E was born last August happy and healthy. He was welcomed home by mom, dad, and his two big brothers. Almost right away Baby E started showing signs of possible reflux. We had been down the reflux road before since big brother 2 had reflux when he was a baby. So when Baby E started sounding like something out of Star Wars (think Darth Vader), I mentioned to his doctor that I was concerned his nasal congestion was being caused by reflux. So, Baby E was put on reflux medicine and it seemed to help a little bit.
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Baby E Before
Then came the eczema. Baby E was like a snake (but way cuter). He started shedding away his soft newborn baby skin, and angry red baby acne took its place. The doctor said it was completely normal and likely caused by hormones. It was at this point that I started to consider the possibility that Baby E may be reacting to something in my diet. Refluxand terrible skin? But, I shrugged it off.
Then came the mucous-filled diapers. I knew from having been down the breast-feeding diaper route before, mucous is an uninvited guest. Seeds, yes. Mucous, no. He also had terrible tummy aches and painful gas. He would often cry and had a hard time settling down. Gas relief drops didn’t seem to help.
Then came the blood and green poops. There is really no way to shrug off lime green bowel movements with streaks of visible blood throughout. I immediately took Baby E back to the doctor where they took a stool sample and made sure Baby E didn’t have an infection. No infection. And so our journey began.
I knew I wanted to continue breastfeeding Baby E, so at the doctor’s recommendation I cut dairy out of my diet immediately. Baby E seemed to make slow improvement after only a few days. We then eliminated soy as well. After almost two weeks of being dairy and soy free, Baby E had “better” diapers but not normal.
This is where TED entered my life. Total Elimination Diet.
Unfortunately, my doctor was not able to offer much advice or information about TED, so I found most of my information from infantreflux.org and kellymom.com. Determined to get kick mucous out of this diaper party and to continue to breast-feed my “intolerant” child, I started eating nothing but chicken, turkey, rice, potatoes, apples, and bananas. Being on such a restrictive diet allowed me rid Baby E of mucous diapers, reflux, and his eczema. Then I slowly added foods back into my diet and waited for a reaction. This was how I was able to determine that Baby E cannot tolerate dairy, soy, eggs, and tomatoes. So now, I am still breastfeeding but avoiding these foods in my diet, and Baby E is doing great!
Baby E After
Our journey is still continuing. Since starting solid foods Baby E has had reactions to pears and infant oatmeal cereal. In spite of this, I feel lucky and blessed that Baby E is doing so well and that I am able to continue breastfeeding him.
-Rachel Miller