visit to new allergist--says baby\'s PA is nothing to worry about???

Posted on: Sun, 09/28/2003 - 12:40am
megans mommy's picture
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Joined: 08/26/2003 - 09:00

We just went to see a new allergist, who seemed very well-informed on food allergies.. Megan has multiple food allergies. She seems to have a delayed reaction (stomach cramps, throwing up, etc), not anaphylactic reactions (thank goodness!)

We have had Megan off peanuts/tree nuts all her life--she reacted through breastmilk with stomach cramps, lots of mucous in spit-ups/throw-ups. I took them out of my diet when she was 6 months old. Peanuts were by far her most allergic food, although she showed negative on RAST and slightly positive on skin tests. We have never allowed her to eat any peanut products. We requested an epi-pen and keep it with us, but we were told by this allergist we really didn't need one. She didn't discourage us from keeping it though. She said the worst thing that would happen if she ever did have a reaction was she would swell up, you jab her with the epi, and it's all over.....not sure I agree with that!!

I agree that we don't need to be concerned about it with the other food allergies....but I was not so sure about peanut. After all, she has never had peanuts....so how do we know how severe her reaction could be?? It also took very little for her to react through breastmilk(me eating a bite size PB snickers) and it was the only food she reacted to with mucous. The allergist said there are 2 kinds of reactions, immediate (anaphylactic shock) and delayed (stomach cramps, throwing up, etc). She said since Megan had never shown any signs of immediate reaction, we were safe...... I asked her how cautious we need to be (warning labels, may contain...processed at a plant that processes peanuts).... She said she had already had all those foods anyway. I was a little taken aback by this comment. We have been avid label readers since Megan was 6 months old. Since I was nursing, they were removed from my diet..and she has never been allowed anything with a nut warning on it!!

I am not too concerned about casual exposure. I don't think Megan is that sensitive. I don't know how she would react if she accidentally got peanut products somehow though. I am lucky that I get to stay at home for now, so I don't have that extra worry of daycare foods...

Does anyone else out there have only 'delayed reactions' to peanuts or other foods. Have they ever gotten more severe??? Do you worry about the risk of an anaphylactic reaction, even if you have never shown any signs?? How serious do you think I should take Megan's peanut allergy, since she has never shown any signs like swelling, trouble breathing... Do different people have different sensitivities to peanuts (someone can be set off by just touching, while others can tolerate eating a certain amount)??

My plan for now is to defintely keep her off peanuts/tree nuts until at least age 3. When and if we decide to introduce it, it will be at the allergist's office under supervision--whether they like it or not!!

Posted on: Sun, 09/28/2003 - 1:18am
Donna's picture
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Joined: 01/31/1999 - 09:00

If it were my child I would avoid foods that make her ill in any way, but I would NOT assume she is anaphylactic. If she has known food allergies I would not introduce any of the biggies--pnut, egg, milk, etc until she was at least 3 or 4 or even older. I would not worry too much about it. I have a dd 5 and we delayed introducing many foods but I did not worry too much. I was just careful and read labels. WE don't use many processed foods anyway. She has no known allergies at this time. She will not eat pnuts, nuts, or shellfish until she is much older since ds is ana and we have lots of allergies in the family. When she was smaller I was very careful with meds as well. Carrying an epi is a good idea if you are concerned. I certainly wouldn't worry about casual contact unless something indicates a severe problem.
But,I would find another allergist. My ds could have DIED from a delayed anapylactic reaction. I also have had severe delayed reactions.
There are different levels of reactions but for a dr to say such nonsense to you is an indication that they don't really understand allergies IMO. MAkes me a bit steamed.
BTW I had an allergist tell me my ds 'Wasn't that allergic' b/c he has not had an full blown ana reaction in a while. I returned to the office with pictures of ds last reaction and suddenly the doc changed his tune. Some docs just don't listen at all.

Posted on: Sun, 09/28/2003 - 2:17am
StaceyK's picture
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Joined: 05/06/2003 - 09:00

I would get a second opinion and possibly switch allergists. My allergist says that any nut allergy is all or none - you can't predict anaphylaxis by skin test or previous reaction. I think you should have an epi pen & probably a new allergist.

Posted on: Sun, 09/28/2003 - 3:00am
becca's picture
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Joined: 05/22/2001 - 09:00

Our allergist is also very serious, but not alarmist, about PA/nut allergies. He cautions us to be careful and continue with strict elimination diet and to not hold out any hope that she will ever outgrow it. This despite a history of very mild reactions and CAP RAST scores thet dropped dramatically in a year.
I might suggest another allergist as well. becca

Posted on: Sun, 09/28/2003 - 6:50am
Sandra Y's picture
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Joined: 08/22/2000 - 09:00

So what you are saying is Megan has had peanut protein only via breastmilk, and that she reacted with stomach cramps and vomiting w/mucus. And based on these early reactions, the allergist is assuming Megan will not have a severe anaphylactic reaction? I disagree.
When my son was a baby, he reacted to peanut protein via breastmilk the same way your daughter did. But then he actually ate a tiny bit of peanuts when he was 15 months old and he had a severe reaction which affected his breathing and I called 911. He has also had a few other reactions that were not as bad as that one.
You can't really predict what the next reaction will be like. I agree with you that it's prudent to avoid "may contain" products. Some studies have shown that up to 25% of these products actually do contain peanuts (sometimes in very small amounts that might not even cause a reaction, but you can never tell how much pn might be needed to trigger a reaction in a particular person on any given day).
I actually agree with your allergist that you shouldn't worry too much. Worrying is awful. But taking precautions is not the same as worrying. In fact, taking reasonable precautions means you don't need to worry as much!
I can tell from your post that you are inclined to take the allergy seriously and I think you've got the right idea!

Posted on: Sun, 09/28/2003 - 11:37am
Rae's picture
Rae
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Joined: 03/28/2000 - 09:00

My PA dd, the younger of 2 PA dd's, had what you referred to as delayed reactions when she was younger. The allergist also told us, when she was 3 and tested a "2" on the skin test, that if she hadn't had an anaphylactic reaction to peanut yet, she wouldn't be like her older PA sister. He didn't recommend an epi. She had an alaphylactic reaction to accidental exposure at 5 years old even though peanut had been totally avoided. Stay Safe.
Rachel

Posted on: Mon, 09/29/2003 - 5:29am
megans mommy's picture
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Joined: 08/26/2003 - 09:00

I would love to find a good allergist. I am thinking that is next to impossible!! Megan's pediatrician refused to believe she was reacting to foods--she even told me it was impossible to pass allergens through breastmilk! I switched pediatricians, and the new one didn't believe either, but referred us to a GI. The GI heard her story and asked why she was there, since this was obviously food allergies!! Her first allergist tested her, but was WAY more concerned with her environmental allergies (which she does not even react to!)
This is our 2nd allergist--she is supposed to specialize in food allergies and had lots of good information (most of which I already knew from researching). She said they could do a CAP-rast if we wanted--or we could wait. Megan had shown negative for peanuts on the RAST and barely positive on the skin test. She did say the only true test is oral challenge. But I don't think we'll do peanuts for a LONG time! And only at the dr's.
Yes, Megan has only reacted via breastmilk. I guess that is what scares me. It was our first clue to food allergies. And it was her worst reaction through breastmilk and I only had to have a small amount to get a reaction. After I was off peanuts, the mucous was gone. I always thought--if she reacts this way through breastmilk...what would happen if she actually ATE peanuts????
I would love to find an allergist who is on the same page as me....but until then, we'll just avoid peanuts, carry the epi-pen, just in case.....When we decide it's time, we'll do some more testing, and if all is clear, an oral challenge at the dr's. Megan is still so young and has been through so much already. She is 21 months old. We finally got her off all her allergens and happy and pain-free (and vomit-free!!) at 17 months old. She has been through a RAST test and skin test (which were actually not too bad!). Not to mention she was 5 wks premature and had to go through all kinds of tests then! But we are lucky she has always been healthy--other than food allergies. Now that we have those figured out....things are pretty good!
I don't worry too much. I only worry when I don't know the problem or how to fix it. Right now I know how to keep Megan healthy and happy. Thanks to great boards like this! I have learned more here than from any doctor!

Posted on: Wed, 10/01/2003 - 1:49pm
megans mommy's picture
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Joined: 08/26/2003 - 09:00

Donna--I am curious....what is a severe, delayed reaction exactly? I assume anaphylactic....how many minutes/hours after exposure did it happen? Sorry, but I am new to the world of anapylaxis....don't know many details, except that you have trouble breathing, need an epi-pen, and then go to the emergency room!!

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