Monday, September 1, 2014

Living without peanut butter

This a general call for advice and sage thoughts from anyone who has/ lives with someone who has a peanut allergy. My questions will be below, but first let me share with you our fun Saturday.

Being 11 months old age adjusted, the Beats are still in the middle of exploring new foods. To date, we have been surprisingly lucky with how this process has gone. Not only have both Beats been willing to try everything that is put in front of them (something I really credit their daycare for as the kids eat all there meals at a common table in community dinner fashion), but we've also been lucky that they've had zero allergic reactions. Reading stories in the blogosphere about kids being intolerant of diary, eggs, wheat and various types of fruits and vegetables as well as hearing stories about Lucas's kids (they believe his youngest has a corn allergy, which is a nightmare as corn syrup is in so many foods and meant resulted in the whole family having to modify their diet to prevent reactions), I've been cautious with what is introduced and how. Somehow we've been lucky. And with luck comes complacency.

So on Saturday, after doing some reading about when it is appropriate to introduce peanut better, Grey and I decided it was time to introduce the Beats to a childhood staple of ours: a peanut butter and jelly sandwich. At this point, the Beats had been eating soynut butter at school and both really enjoyed the jam we had been feeding them. In addition, though we had heard stories, neither of us knew anyone who had a peanut allergy. So though I knew that I needed to watch the babies, I didn't know what signs or symptoms to be on the lookout for.

He-Beat had zero issues. He happily eat his bites of sandwich, washing it down with the milk in his sippy cup. She-Beat was another story. After a few bites, she started to fussy, rubbing her face and eyes which blowing raspberries, a sign that she was irritated or not feeling well. After a couple of minutes, I noticed her left eye was turning red. I removed her from her high chair and took her upstairs to have Grey take a look at her. Initially he didn't think much of it, and then he noticed the rash on her neck. And a minute later that the whole left side of her face was swelling.

I've made calls to after hours nurse in the past. Usually for high fevers and babies who have suspected ear infections. Most times, the person answering the call will take your information and triage you, calling you back when the next nurse is available. This time, the mere mention of a peanut allergy immediately brought a nurse to the phone. And when they learned we did not have any infant Benadryl in the house, despite the fact that She-Beat was able to breathe without problem, they immediately put us through to 911, which resulted in 3 firemen and 2 paramedics in my condo in less than 5 minutes. And with that, She-Beat got her first ride in an ambulance to the local children's hospital.

I won't bore you with the details of the 2 hours that followed, only to say that He-Beat was a total awesome brother, being so patient in the ER when it was clear the poor kid was beyond bored. But we did learn a few things. First, She-Beat luckily only had an allergic reaction, which was readily controlled and reversed thanks to Benadryl (which we now stock). If she had anaphylaxis, which would have resulted in her throat swelling, potentially inhibiting her ability to breathe, as well as potential heart failure, nausea and a severe rash, they were prepared to inject her with steroids. Because she didn't display any of these symptoms and because she responded so well to the Benadryl, they sent us home after a couple of hours of observation without an EpiPen. That said, they did warn us about what to watch for and told us we need to follow up with her pediatrician this week for further preventative care.

As of yesterday, we are now a peanut-free household. Grey had been stocking peanut butter for our food stores, but returned most of it yesterday. In addition, we are now scrutinizing food labels, inspecting everything that is packaged for any trace of peanut products.

The question is, though, how careful do we need to be? To our knowledge, this is She-Beat's first exposure, but we know that peanut products are in other foods. In addition, we've had peanut butter in the house since she was born, with me consuming it without thinking during my pregnancy. Do we need to treat any peanut product like biohazardous material for the time being or is it just a matter of not allowing her to come into contact with it? The final thing is we've been told that it is likely she will outgrow this. When (if ever) do we try again? One year; 5 years, after I'm dead?

On the way home, Grey and I talked and talked (and talked) about all of this. And we've been reading. All of this is new to us and we're learning as we go. But we also talked about the fact that the doctors in the ER actually made a point to talk with us about the fact that how we had been introducing new foods was completely correct and they encouraged us to continue as the likelihood of food allergies is LESS in kids that have allergic foods introduced as younger ages. So as scary as all of this was, they wanted us to continue with these introductions. Looking at She-Beat in her hospital gown, which clearly showed how far her rash had spread, I wasn't (and still remain) not so sure. Hence my final question: for those with kids who have food allergies, what have you been told?

In the meantime, Grey wants to introduce shrimp in a few months (they've already had fish and did fine). My head hurts just thinking about it.  

16 comments:

  1. Oh Cristy, how terrifying for you guys. We've been lucky so far with no allergies, so I don't have any words of wisdom. But thinking of you guys! I'm happy to hear that she-beat is doing well and that she reacted so readily to the Benadryl. I need to go get some of this to cover my own butt!

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  2. This site just ate a response I took 20 min to type and now the toddler is up so I can't retype. Short answer: get several spi-pens so everyone who watch's her has one and treat peanuts as biohazard. Face swelling is in the class of reactions as anaphylaxis, so the next time benadryl might not work. Allergy reactions tend to get worse with exposure. I know several kids who can't breath dust of peanuts without anaphylactic reaction, so peanut allergies are a big deal.

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  3. Oh, and I'd start with a shellfish not shrimp, as shrimp has more reactions (I can eat crab, mussels, and oysters just fine, but my throat nearly closes with shrimp).

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  4. My grandson had a peanut allergy. I was amazed at how aware he was at 2-3 years about his allergy and refusing to eat peanuts if they were offered. In Canada all school lunchrooms are peanut free zones. There are a lot of products on the shelves that are certified peanut free so I was careful when buying foods intended for him. He was retested when he was four and found that he is now ok to eat peanuts. He tells us though that he doesn't like them. I'm not sure if he's still nervous or if he really doesn't like them.

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  5. I am so sorry for what you went through this weekend. Our pediatrician recommended that we wait until 8 or 9 before trying peanut butter for M and we are not entirely sure if he's allergic or not. Due to his other allergies we are being extra cautious. If it were me, I would treat peanuts as bio-hazardous material.

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    1. Yeah, I know you've been through the ringer with M's allergies. Actually was thinking of you on Saturday. Had a "what would KelBel do?" moment. Biohaz it is.

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  6. Oh wow, that is so scary. I can't even imagine how you must have felt in those moments. I don't have direct experience with peanut allergies, but we are peanut-free for other reasons so I know how to substitute pretty well (obviously not even close to the same thing). Have you thought about going to see an allergist to get her tested to see if she is allergic to other types of tree nuts/shell fish/etc? Maybe when you go see your Pedi, they can refer you? I am wondering if they could do more testing to see how allergic she really is to peanuts and give you more advice. Anyways, you did a great job handling that situation. I hope that you can get some real answers soon!

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    1. Yes please on the substitutions! We've already purchased some soynut butter for the peanut butter sub, but would love to hear what our other options are.

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  7. Wow how scary!! I'm glad it wasn't the worst kind of reaction, but that's got to be stressful!

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  8. Yep. Been there...minus the trip in the ambulance. Cadet has a peanut allergy...but it's just an allergy (topical), not the whole anaphylaxis route. First things first...see a pediatric allergist. Cadet's allergist isn't too concerned with his allergy. In fact, we still have peanut butter in the house for me (good protein). Get Epi pens and carry them with you. Get epi pens for their caretakers and family. You can get free epi pens too...https://www.epipen.com/copay-offer/.

    As for subs...sunflower seed butter is a favorite of mine. But almond is good too. I find that sunflower butter tastes better in baked goods than the almond butter, just a personal preference. Oh, allergy tags for your diaper bag and a med-alerty bracelet are also good ideas.

    Good luck. Sorry this comment is so scattered...

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  9. I second sunflower seed butter. No allergies in our household but that's what we introduced to X first before peanuts. It's more nutritious than pb so I keep buying it.

    Good luck and I would err on the side if caution until you figure it out for sure.

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  10. Holy moly! I'm glad she's doing okay. That must've been terrifying! I have no advice, I just wanted to give you a word hug.

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  11. I'm so sad you had to go through this. It's no fun at all. Don't panic! My 6 year old is allergic to strawberries and it's mostly a big pain in the neck but she has only had the rash/shortness of breath after a number of exposures so I guess my level of fear is low. My 18 month old we've been trying to expose to everything at a young age (that's what the pediatric allergy society or whatever it's called recommends based on the research, I read a bit of what that's based on and I'm on board with it) and haven't been scared off by a few bad reactions (she has a bad time with cow's milk and got a rash from orange juice once but not when we re-tried it a month later). Keep the Benadryl handy and you will do all right. The epi-pen wouldn't hurt since it's much cheaper than an ambulance ride and you can act faster. I'd also add that the allergic reaction may continue to cause trouble for a week or two after the fact so I'd wait that long to introduce any new foods to be sure you know what is really causing a reaction.

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  12. Uggg! So scary! I've got a good friend who was given an epi pen for her little guy early on, but his allergy has since been downgraded - so I think they can sometimes outgrow it? Your pediatrician will definitely have answers for you there, and I would imagine they will want to test her in office before ever giving you the go-ahead to try from home.

    As for how you manage, I have no advice. As a group, we all try to remain conscious of not bringing anything peanut related around my friend's little boy, and I know she stripped her house clear of peanuts as well. Realistically, it hasn't been the end of the world. There are good substitutes and even though most of us do love peanut butter, he doesn't know the difference because he has never had it.

    I think it takes a little time to figure out what you have to be most worried about, but that talking to a nutritionist would probably help. And hopefully, this is something she outgrows over time.

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  13. No serious food allergies here, but I have a few friends whose kids have had allergic reactions to food, and ALL of them have been told this same thing - "they encouraged us to continue as the likelihood of food allergies is LESS in kids that have allergic foods introduced as younger ages" -- so as scary as it is, I'd definitely keep introducing like you have been and watching. Stella reacted to strawberries for about a year, but no longer. Lots of food allergies they grow out of for sure. Good luck - I'm sure that was terrifying!

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  14. Awwww, so sorry little She-Beat had a reaction. :( I've had my own allergy issues with tomatoes as an adult (as you might remember from my blog) & that has been scary enough. I would definitely consult an allergist, & keep both Benadryl & an epi-pen on hand. I've just practiced avoidance & have not had a reaction in about four years now (knocking wood) -- and the last time I went to the allergist, I ate a tomato in her office. I actually managed to eat almost the whole thing (gradually, in increasingly larger pieces) before a hive popped out -- which I would say is an improvement. I'm going to try again in another year or so & see what happens then. But I think I will probably keep carrying both Benadryl & epi-pen with me for the rest of my life. I actually had people at work come to me when they'd had an allergic reaction because they figured I would have Benadryl, & I did!

    A friend's husband was allergic to peanuts for years, since he was a kid. In his late 30s he was retested and no trace of reaction was found, so he's happily resumed eating peanuts without incident. We filled his Christmas stocking that year with peanuts, Reese's pieces, etc. ;) So there is hope. :)

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