Adventures of an Allergist Mommy

With the awareness of food allergies increasing, there is expanded interest in the various methods of diagnosing food allergy. Of course, the skin test vs. blood test debate is ongoing. (I have more trust in the skin test, in case you're wondering.) There are also plenty of proponents of what I call "weird science". These are unproven methods that might make someone feel like they're getting an answer (and are certainly enriching the practitioner), but do very little to diagnose actual food hypersensitivity and, more often than not, lead to unnecessarily restrictive diets. However, there's decidedly less discussion about what is considered the most definitive way to diagnose food allergy- the oral food challenge. A food challenge is a test that involves giving a patient incrementally larger doses of a specific food by mouth over a period of time, all the while monitoring the patient for signs and symptoms of an allergic reaction. Because the risk of an acute ...

Just went a local restaurant to pick up lunch. As I exited my car, I was shocked to see a mother shielding her ~4 year old son with the car door while he urinated in the parking lot- in the spot directly in front of the restaurant entrance! I'm sorry, but this is inexcusable. You're not camping in the woods, you standing in front of at least fifty people behind glass walls. In a restaurant that has a bathroom, for goodness sakes! If your child cannot control his bladder, I understand- all children toilet train at their own pace. Sometimes, especially while you're learning, "I gotta go" means, "I gotta go NOW". But parental actions dramatically impact what our children learn to accept as appropriate behavior. People knock country music sometimes. but there are some lessons to be learned... I was listening to a Dixie Chicks album in the car yesterday, and was struck by the following lyrics: "Our children are watching us, they put their trust in u...

Those who know my children personally know that Son #1 is cautious and thoughtful, and Son #2 is impulsive and and fearless. So, the following conversation seems especially intuitive. Son #1: Mommy, I'm going on a trip to Mexico. Me: Ooh... mommy wants to come! Son #1: No, you can't come. It's a kids trip! Me: Will you be taking your brother along? Son #1: No- he can't come either. He's just going to run around all over Mexico and cause problems.

Warning: This post will be controversial. I have seen too many instances of terrified parents falsely believing that being in the same room as a peanut is going to kill their child. I have heard too much about 10 year old children being kept home from birthday parties, families being kicked off planes for requesting that peanuts not be served to anyone on board, of people demanding that high schools be peanut-free. I feel that something needs to be said. The bottom line is this: there comes a time when we need to sit down and come to terms with the actual risk posed by inhalant exposure of peanut allergen vs. the perceived risk. I do not need a double-blind placebo-controlled trial to tell me that the perceived risk of anaphylaxis to inhaled peanut protein far, and I mean FAR, outweighs the actual risk. The majority of parents whose children have experienced food-related anaphylaxis are understandably traumatized by the event, and would go to the ends of the earth to prevent a repea...

A Japanese study published in the European Journal of Allergy and Clinical Immunology (link: http://www3.interscience.wiley.com/journal/123251237/abstract?CRETRY=1&SRETRY=0 ) shows what many of us in the allergy world have suspected for a long time- mom's prenatal diet does have an impact of the risk of atopic manifestations in offspring at 16-24 months of age. The study evaulated over 700 Japanese mother-child pairs. A diet-history questionnaire evaluated maternal consumption of fruits, vegetables, and antioxidants during pregnancy (at week 17). Atopic symptoms were evaluated based on criteria from the International Study of Asthma and Allergies in Childhood (at aged 16-24 months). The study found that higher maternal intake of green and yellow vegetables, citrus fruit, and β-carotene during pregnancy was significantly associated with a reduced risk of eczema, but not wheeze, in the offspring. Maternal vitamin E consumption during pregnancy was significantly inversely relat...