Baby's Eczema and Food Allergy

Egg Allergy and Eczema

What a difference a decade makes. Back in the day, parents of babies with eczema were advised of the food allergy march: itchy, angry skin, leading to food allergies and to asthma. I remember our doctor saying "eczema is linked to egg allergy". As a result, we were advised to told to postpone highly allergenic foods, such as eggs, milk and nuts, for several years.

So we did, and as later skin and blood tests confirmed those food allergies, avoidance, we were told, was key. 

In a recent Journal of Allergy and Clinical Immunology, Australian researchers pointed to a genetic link between allergies and eczema. The study, by Murdoch Childrens Research Institute in Melbourne, found that babies with changes to the filaggrin gene had a higher chance of a positive skin prick test to egg allergy.

Now here's the interesting part, those babies with the changed fillagrin gene and the positive skin test to egg allergy who were then given egg at an early age, had a decreased risk for developing a "ful-blown" egg allergy. Delaying the introduction of egg (which many of us were told to do) actually increased the risk of egg allergy.

It seems that there may be a skin sensitivity to food proteins, but not necessarily a gut sensitivity. Many doctors are now suggesting early introduction of egg, milk and other typical food allergens in order to develop tolerance.

What's a parent to do? Talk to your doctor. Make sure they are up on the latest research- this is new information. If your baby has eczema or you are concerned about food allergy, see an allergist sooner, rather than later.

New Discovery May Help Food Allergic

Research May Provide Clues to Food Allergy.

Science experiments can be a frustrating when expected results are not forthcoming. Sometimes, though, it's the unexpected results that can lead to the best findings. Dr. Rodney Newberry, a gastroenterologist at Washington University School of Medicine in St. Louis has come across something that may eventually benefit those with food allergies.

Dr. Newberry's team placed a video in the gut of a mouse to observe what they thought would be dendritic cells sampling food particles and then seeking out antigens to neutralize or attack if the samples were found to be threatening. However, what they discovered was an escort, called goblet cells, whose job it is to bring the food sample to the dendritic cells. This discovery leads researchers to believe that goblet cells play a much more important role than previously thought. If these escort cells could be trained to bring food samples to the dendritic cells and introduce them in a friendly manner, perhaps the body wouldn't over-react to an innocent egg or peanut protein.These findings may help scientists introduce a drug therapy to tame an over-active immune system, like that found in people with food allergies or celiac disease.

Aaahhh...if we could only get our cells to play nice and cooperate...

Check out Christopher Wajnek's article Special Gut Cells May Help Tame Food Allergies for more information on Dr. Newberry's study.

Food Allergies and Baking With Milk and Egg

As I've reported, we're adding tiny amounts of egg and milk in baked form to my egg and milk allergic child's diet. As all these food allergy transitions have been over the years, it's been challenging finding recipes that work. It sounds easy- just add an egg or some milk to any recipe.

It's not that easy. We're trying to stick to the guidelines of baking foods for at least 30 minutes at a minimum of 350 degrees. That eliminates most cookies and muffins and primarily leaves us with breads and cakes.

We've been eating an awful lot of chocolate cake in our house recently.

I'm in the routine now of having one baked good that contains one egg and one that contains a tiny amount of milk. My child eats egg one day and milk the next. The egg recipes are easier. Most cakes call for two eggs. For now, I use one regular egg and I substitute the other- usually 1 tablespoon flax seed mixed with 3 tablespoons water. The milk recipes take an advanced degree in chemistry with a minor in math. My childis off the scale allergic to milk so we're proceeding with extreme caution. I found a cake recipe that calls for 1/2 cup milk. I use 3 grams (our food scale comes in handy here) of dried milk powder mixed with an 1/8th of a cup of water. Then I add 3/8 cup of soy milk.  The plan is to gradually increase the amount of milk powder.

So, I'm certainly not complaining. Any time we can add more options to this food allergy diet is cause for great celebration, but I do see a need for a new kind of cookbook as more people are able to tolerate baked milk and egg.

In the meantime, we'll have to share.

Overprotective Parents and Increase in Food Allergies

I'm trying not to take offense with this article, but it's hard not too. I'm going to go with the idea that the writer was looking for a sensational headline to increase readership.

Yeah, that's it.

Here's the thing, medical doctors have been telling parents to delay introduction of certain foods and to read all labels to avoid any trace of highly allergenic foods. We've been told that our food allergic children could die if they eat even a tiny amount of their allergen. And people have died.

I realize that the latest research is beginning to show a different picture. Recent studies are showing that it may be better to introduce major allergens at a young age. This news article talks about a recent article in The Journal of Allergy and Clinical Imunology. A study involving 2500 infants showed a lower incidence of egg allergy for the babies introduced to egg before 12 months.No other major allergens have been studied.

For now, stay in touch with your pediatrician and allergist about what is best for your baby or child.

Overprotective parents...geeeesh...we're just doing the best we can with the information we have. We're just being the best parents we can be.

Flu Vaccine Recommendations and Food Allergy

The FDA has approved flu vaccine for 2010-2011 in the United States. Vaccine is expected to be available beginning in September 2010. This year's vaccine will protect against 3 strains of influenza, including H1N1, which last year required a separate shot. The brand names and manufacturers are:

• Afluria, CSL Limited;
• Agriflu, Novartis Vaccines and Diagnostics
• Fluarix, GlaxoSmithKline Biologicals
• FluLaval, ID Biomedical Corporation
• FluMist, MedImmune Vaccines Inc.
• Fluvirin, Novartis Vaccines and Diagnostics Limited
• Fluzone and Fluzone High-Dose, Sanofi Pasteur Inc.

As flu vaccine is cultured in egg, there are risks for those with egg allergies. I list the names and manufacturers here because the composition of the vaccine varies according to manufacturer. It may be helpful to contact your doctor's office to find out which brand they will use allowing you to check the manufacturer website and read the package inserts.

As stated in the recently released "Recommendations of the Advisory Committee on Immunization Practices", "

hypersensitivity reactions after receipt of vaccine are caused by the presence of residual egg protein in the vaccine). Although influenza vaccines contain only a limited quantity of egg protein, this protein can induce immediate hypersensitivity reactions among persons who have severe egg allergy. Persons who have documented IgE-mediated hypersensitivity to eggs might be at increased risk for allergic reactions to influenza vaccine, and consultation with a physician before vaccination should be considered.

A regimen, involving desensitization, has been developed for administering influenza vaccine to those with egg hypersensitivity.

This is a tough call for parents of egg allergic children and adults with egg allergy. There has been a lot of chatter on the topic on this blog and others.

Last year, our family got the vaccine, except for my egg allergic son. Instead, we chose to request a prescription for an antiviral drug (like Tamiflu®) to have on-hand in the event of the sudden appearance of flu symptoms. Another option is prophylactic use of antiviral agents, where antiviral drugs are taken over a period of time to protect against the flu.

This year...I don't know what we're doing. Recent reports indicate low risk of reactions when the flu vaccine was administered to those with egg allergy.

...uh huh, but this is my child....

Where are all of you with this decision?

Egg-free vaccines are available, but not yet approved in the U.S. Soon we may not have to make these tough choices.

Food Allergy Desensitization Programs

Okay, its controversial, but I'm keeping a close eye on this. Dr. Richard Wasserman, a pediatric allergist in Dallas TX, has been using desensitization to treat food allergy in his private practice. Some patients have had great success, others, not so much. Food desensitization is handled in much the same way as traditional allergy therapy. Someone allergic to cat, dust, mold or oak trees is given increasing amounts of their allergen in the form of an allergy shot. Over time, most people can better tolerate the allergen. In Wasserman's practice, someone allergic to milk or eggs can be given tiny doses of the offending food in increasing amounts.

Dr. Wasserman admits that many allergists find his food allergy treatment too risky. There are a few other practices throughout the U.S. who perform oral desensitization for food allergy. However, most desensitization studies are currently in clinical trials.

Wasserman reports that the program takes place over many months and costs about $5000. A few insurance companies cover the cost.

Does anyone have direct experience with this treatment for food allergy?  I'd love to talk to some food allergy families who've contemplated, or gone through, a program like this.

Baked Milk and Egg Food Challenges

We met with the allergist last week. At the top of my list was to talk about food challenges for baked egg and milk. What I found out was quite encouraging.

She told me they've done many challenges for these foods over the past few months and nearly all have been successful. There are now dozens of children and adults in their practice who are successfully eating foods that contain milk and egg that has been heated to a high temperature. The most recent research, she said, is showing that those who eat baked milk and egg on a regular basis may get rid of all milk and egg allergy.

Woot!

We're going to give it a go this summer. She wants to start with egg first, using the angel food cake recipe used at Mt. Sinai for these type of challenges. It contains 12 eggs and will be baked at 350 degrees for 40 minutes. I'm a little nervous after a nerve-wracking and unsuccessful egg challenge a year ago, but I am feeling hopeful.

I'll keep you posted!

Food Allergy Cure With an Apple a Day?

The Journal of the British Society for Allergy & Clinical Immunology reports on a promising study with implications for food allergy. Egg allergic mice were fed a polyphenol-enriched apple extract and then underwent a food challenge for egg. The results showed the apple extract reduced allergy symptoms. A polyphenol is an antioxidant that occurs naturally in some plants and tends to prevent or neutralize the damaging effects of free radicals.

The role of polyphenols is also being studied in peanut allergy.

I don't claim to understand it, but I like it. The hope is for human trials to be conducted after the positive results of the mice study.

Egg and Milk Allergy Lead to Peanut Allergy?

A recent study involving 500 infants seems to show a link between early milk and egg allergy to later development of peanut allergy.

The Consortium of Food Allergy Research (CoFAR), a major food allergy research program supported by the National Institute of Allergy and Infectious Diseases (NIAID) conducted the study and plans to follow the infants to age 5.

In light of this finding, researchers recommend parents of milk and egg allergic children speak to their doctor, or consult an allergist before introducing peanut in the diet.

Check out the full report. Interesting, huh?

Food Allergy Research

Professor Yoshinori Mine of the University of Guelph (Ontario Canada) has promising results from his study to provide a safer approach to dealing with allergies in children. In his clinical research using mice, Professor Mine found that mice ingesting only the peptide portion of egg protein, rather than the entire protein, were able to tolerate increasing amounts of egg. The body, over time, learned to accept the protein, rather than react against it.

looking ahead, the plan is to begin to introduce this technique in human clinical trials and develop a way the peptide can be administered orally.

“I would like to find a way to incorporate the peptide into foods such as cookies so it will be appealing to young children.” said Professor Mine.

I continue to feel confident that this path toward desensitizing our children to their food allergens will lead us to more answers and better solutions. The current medical advice of "avoid the offending food in all forms" isn't good enough. I am encouraged by Professor Mine and others who are trying to come up with better solutions for us.

Check out the full article for more information.

Food Allergy Research Findings Presented at Conference

The AAAAI (American Academy of Allergy, Asthma and Immunology) wrapped up its annual conference last week. Food allergy was the center of several prominent studies. Here is a re-cap of some of the big ones:

Oral Immunotherapy shows Promise for Egg Allergy- Early results from this study show that egg allergic children may be able to tolerate eggs following a course of ingesting increasing amounts of egg protein. Of course this has all been done in a carefully controlled setting and should not be tried at home. More about that in the video link at the end of this post.

Milk Allergic Children Tolerate Milk heated at high temperatures. The study shows that up to 80% of milk allergic children may be able to eat baked products like cookies and cakes containing milk. Something seems to change within the milk protein when it is heated at a high temperature. Research in this area continues.

Anaphylaxis to Meat is more common than originally thought. The message is that clinicians should investigate whether or not there is a meat allergy when there are unexplained allergy symptoms. In meat allergy, the allergic reaction is to the sugar in the meat, not the protein. This is the first food allergy to stem from sugars. The research shows that meat allergies tend to develop in adults who have tolerated meat all their lives, then, possibly due to a bee sting or tick bite, suddenly become meat allergic.

An Oral Immunotherapy for Peanut Allergy study revealed that children receiving increasing amount of peanut powder, could tolerate 20 peanuts after 10 months of treatment. A different three year study showed a significant number of children who were able to stop immunotherapy and can now eat peanuts successfully.

Check out this video from the conference about when oral immunotherapy may be ready to be used as a regular treatment for food allergy.

When you next visit your allergist, ask about these studies and how they may relate to your situation. I am glad to see that research is moving ahead, but I am also reminded that we have a ways to go before we can say food allergies are curable.

Egg Allergy Study Shows Postitive Results

This is big news!

We really are getting closer to a food allergy cure. AAAAI (American Academy of Allergy Asthma and Immunology) made an exciting announcement at their annual conference which began in New Orleans Feb. 26 and continues through March 2.

The announcement involved a multi-center trial including Duke, Johns Hopkins, Mount Sinai, National Jewish and the University of Arkansas. The trial involved 55 children between the ages of 5-18.

All had egg allergy- notice the word "had".

Some of the participants received a placebo. The other group received egg white solid oral immunotherapy. That means this group was given increasing amounts of egg protein in a controlled setting.

The results? After 44 weeks, both groups were tested and 21 of the 40 receiving the egg protein, are no longer egg allergic. The 15 who were in the placebo group continue to have egg allergy.

Here's the full press release from the conference.

We're making forward movement on this!!!

Guidelines for H1N1 Vaccine and Egg Allergy

Egg Allergy

The American Academy of Allergy Asthma and Immunology has come out with their guidelines regarding H1N1 vaccine and those with egg allergy.

I'm really torn about how to proceed with this. My son recently underwent an egg challenge in the allergist's office. It was not successful. Looking over the AAAAI guidelines, it appears that he would need several skin pricks (which he hates) and then if we proceed, he may require 5 vaccines at 15 minute intervals. If a medical issue arises, we face a shot of epinephrine and perhaps inhaled steroids. Ugh!

And that's just the H1N1 vaccine. This whole procedure is repeated for the seasonal flu vaccine. For the past few years, the rest of the family has received the seasonal flu vaccine. I get mine this afternoon. Our egg allergic son has not gotten the vaccine. Swine flu makes me more nervous.

What are the rest of you with egg allergies or egg allergic children doing? I know that I need to contact our allergist, but I'm not sure we want to go down the road that will be recommended...

Swine Flu Vaccine Safe for Those with With Egg Allergy?

The swine flu vaccine has been on my mind.

A post I read originally on Life With Food Allergies Blog has given me hope. Reportedly, drug company Novartis, has created a swine flu vaccine that will be safe for those with egg allergy.

I stil have a bunch of questions, though. It seems that other companies will be manufacturing swine flu vaccine that wouldn't be safe for those with egg allergy. How will distribution be handled? People who can't have the egg-based vaccine should certainly be the top priority for the new vaccine. Also, will the FDA cause this vaccine to hang up in the US? If it is available in Europe, can we go there to get the vaccine for our egg allergic family members?

It seems there are no clear cut answers to these questions yet.

Does anyone else know anything about this?

Check out the article here.