Eat Like Your Life Depends On It
He broke out in hives. Anywhere that he'd touched the peanut butter - his fingers, the inside of his hands, around his mouth - turned deep pink and sprouted dozens of white bumps, no bigger than the head of a pin.
People frequently ask me how I knew my son was allergic to peanuts. Simple. At 10 months old, I gave him peanut butter, and he broke out in hives.
Two months later at his 1-year well child appointment, I mentioned the episode to his doctor. The hives combined with ongoing eczema earned us a referral to a pediatric allergist.
At that appointment, they covered his back with needle sticks laced with common allergens - peanuts, wheat, milk, eggs, soy, pollen, animal dander, mold, dust, and more. It was a grueling 20 minute wait while he sobbed and wailed but we couldn't put our arms around him for fear of cross-contaminating the samples. Growing welts confirmed what we already knew: he had spring and fall environmental allergies, and he was allergic to peanuts.
Peanut allergies are some of the most severe food allergies, and the least likely to be outgrown as a child ages. Somewhere between 1 and 3 percent of people in the Western world are afflicted with peanut allergies. And that number is rapidly growing. Research suggests a 21 percent increase in peanut allergies between 2010 and 2017. Nobody knows why it's happening, or how to prevent it. All you can do is limit exposure and carry an emergency dose of epinephrine, just in case.
When he was only a year old, it was easy to control his peanut exposure. Nearly everything he ate was given to him by family.
Around age 3, when my son was about to enter preschool, we had the allergist test him again. This time my husband held him down while nurses drew blood from his arm and he screamed. At least it was quicker than the skin test. This time his results showed allergy antibodies to peanuts plus two additional things we'd never knowingly exposed him to: pistachios and sesame seeds.
You never know how a person will react if exposed to an food allergen. It could be as mild as hives or as serious as anaphylactic shock, where the airway swells and the person begins to suffocate.
Now in an environment where others are providing my kid snacks and overseeing his lunchtimes, we had discussions with teachers and performed recon at every birthday party and family gathering. "Mixed nuts in a bowl on the kitchen island, 12 o'clock." "Chocolate chip cookies in the cafeteria appear nut free. We are a go for cookies." Hyper-aware became our new normal.
But I wasn't vigilant enough at the grocery store. After checking labels once, we neglected to keep checking if the item didn't obviously contain nuts. Too late I learned that nuts can be lurking anywhere. When his favorite cheese-and-club crackers changed recipes to include peanut flour (yes, this exists), I never noticed the warning. They had been a safe food. They were one of the few things he'd consistently eat, and I kept feeding them to him.
When I found out about the peanut flour, my first reaction was oh my god I almost tried to kill my child. How complacent I'd been! How stupid of me! When the fear and guilt wore off I recognized that he'd had no reaction, and felt that maybe I was doing an accidental, at-home food challenge. So I continued to let him eat the crackers and we became even more vigilant.
This summer, before entering kindergarten, we had his blood tested again along with some blood tests from his gastroenterologist (that's a different post altogether). Through five vials of blood he sat crying and screaming. He was traumatized, and I felt horrible, but it was necessary. By exposing him to small amounts of peanut flour the last few years, I hoped we had decreased his allergic response.
No luck. His antibody levels for peanuts were mostly unchanged. But his levels for everything else increased. Now he's got a 75 percent chance of having an allergic reaction to peanut in addition to cashews, hazelnuts, pistachios, and walnut; 50 percent chance for macadamia nut and pecan; and slightly less chance if exposed to almond and brazil nut. Basically all nuts readily available in the American diet, he is allergic to.
If that wasn't enough, his sesame allergy went through the roof - greater than 99 percent chance of reaction if he eats a Big Mac bun or a Stella D'oro bread stick. He could break out in hives, or throw up, or stop breathing. We just don't know.
Sesame allergies have also increased wildly over the past few decades. But unlike tree nuts or peanuts, it's not considered one of the Big 8 allergens that food manufacturers and restaurants are required notify consumers of. Unless we read all the labels and ask at every restaurant, we may never know where his top allergen may be hiding.
For the rest of the foreseeable future, my kid and anybody with him has to know exactly what's in his food, or he could suffer a life-threatening allergic reaction and possibly die. This is an overwhelming reality to live with.
The good (?) news is he's a terrible eater. He basically lives on snack crackers, bread, and dairy. He extremely reluctant to try anything new, so I'm less worried about him eating from a bowl of nuts or taking a bite of another kid's PB&J. And his teachers and principals will be very aware of his food limitations, so help keep him safe at school. In event of disaster, the school has emergency epinephrine injectors on hand.
The bad news is he's entering a phase where he's going to be around food and other kids and parents without me to protect him from these things that could kill him. And I'm completely terrified.
Twice last month he spent time without us playing at the homes of neighborhood kids. Both times I had to meet the parents beforehand and warn them: he has allergies, please no food. While I'm thrilled he's making friends and navigating the joys (and challenges) of other kids after spending several years as a fearful, shy boy, I'm also scared shitless that he's going to ingest an allergen and suffer a life-threatening reaction when I'm too many houses away to help in time.
Once he's out of view, he's out of my control. At 5, he's too young to be responsible enough to carry - let alone use - his epi pen. Asking each friend's parents to take a crash course in What To Do If My Kid Stops Breathing seems assumptive and overbearing, and not conducive to his making friends easily.
I feel like I'm trying to balance his safety in one hand with the freedom of his being a kid in my other hand, while I'm also riding a unicycle across a tightrope. I feel like all of the responsibility is on me at this point. All I can do is educate him, and educate his friends and their parents, and hope for the best.
That hardly seems enough when we're talking about eating like his life depends on it.
People frequently ask me how I knew my son was allergic to peanuts. Simple. At 10 months old, I gave him peanut butter, and he broke out in hives.
Two months later at his 1-year well child appointment, I mentioned the episode to his doctor. The hives combined with ongoing eczema earned us a referral to a pediatric allergist.
At that appointment, they covered his back with needle sticks laced with common allergens - peanuts, wheat, milk, eggs, soy, pollen, animal dander, mold, dust, and more. It was a grueling 20 minute wait while he sobbed and wailed but we couldn't put our arms around him for fear of cross-contaminating the samples. Growing welts confirmed what we already knew: he had spring and fall environmental allergies, and he was allergic to peanuts.
 |
| A big bowl of danger. |
Peanut allergies are some of the most severe food allergies, and the least likely to be outgrown as a child ages. Somewhere between 1 and 3 percent of people in the Western world are afflicted with peanut allergies. And that number is rapidly growing. Research suggests a 21 percent increase in peanut allergies between 2010 and 2017. Nobody knows why it's happening, or how to prevent it. All you can do is limit exposure and carry an emergency dose of epinephrine, just in case.
When he was only a year old, it was easy to control his peanut exposure. Nearly everything he ate was given to him by family.
Around age 3, when my son was about to enter preschool, we had the allergist test him again. This time my husband held him down while nurses drew blood from his arm and he screamed. At least it was quicker than the skin test. This time his results showed allergy antibodies to peanuts plus two additional things we'd never knowingly exposed him to: pistachios and sesame seeds.
You never know how a person will react if exposed to an food allergen. It could be as mild as hives or as serious as anaphylactic shock, where the airway swells and the person begins to suffocate.
Now in an environment where others are providing my kid snacks and overseeing his lunchtimes, we had discussions with teachers and performed recon at every birthday party and family gathering. "Mixed nuts in a bowl on the kitchen island, 12 o'clock." "Chocolate chip cookies in the cafeteria appear nut free. We are a go for cookies." Hyper-aware became our new normal.
But I wasn't vigilant enough at the grocery store. After checking labels once, we neglected to keep checking if the item didn't obviously contain nuts. Too late I learned that nuts can be lurking anywhere. When his favorite cheese-and-club crackers changed recipes to include peanut flour (yes, this exists), I never noticed the warning. They had been a safe food. They were one of the few things he'd consistently eat, and I kept feeding them to him.
When I found out about the peanut flour, my first reaction was oh my god I almost tried to kill my child. How complacent I'd been! How stupid of me! When the fear and guilt wore off I recognized that he'd had no reaction, and felt that maybe I was doing an accidental, at-home food challenge. So I continued to let him eat the crackers and we became even more vigilant.
This summer, before entering kindergarten, we had his blood tested again along with some blood tests from his gastroenterologist (that's a different post altogether). Through five vials of blood he sat crying and screaming. He was traumatized, and I felt horrible, but it was necessary. By exposing him to small amounts of peanut flour the last few years, I hoped we had decreased his allergic response.
No luck. His antibody levels for peanuts were mostly unchanged. But his levels for everything else increased. Now he's got a 75 percent chance of having an allergic reaction to peanut in addition to cashews, hazelnuts, pistachios, and walnut; 50 percent chance for macadamia nut and pecan; and slightly less chance if exposed to almond and brazil nut. Basically all nuts readily available in the American diet, he is allergic to.
If that wasn't enough, his sesame allergy went through the roof - greater than 99 percent chance of reaction if he eats a Big Mac bun or a Stella D'oro bread stick. He could break out in hives, or throw up, or stop breathing. We just don't know.
 |
| Two all-beef patties and anaphylaxis. |
Sesame allergies have also increased wildly over the past few decades. But unlike tree nuts or peanuts, it's not considered one of the Big 8 allergens that food manufacturers and restaurants are required notify consumers of. Unless we read all the labels and ask at every restaurant, we may never know where his top allergen may be hiding.
For the rest of the foreseeable future, my kid and anybody with him has to know exactly what's in his food, or he could suffer a life-threatening allergic reaction and possibly die. This is an overwhelming reality to live with.
The good (?) news is he's a terrible eater. He basically lives on snack crackers, bread, and dairy. He extremely reluctant to try anything new, so I'm less worried about him eating from a bowl of nuts or taking a bite of another kid's PB&J. And his teachers and principals will be very aware of his food limitations, so help keep him safe at school. In event of disaster, the school has emergency epinephrine injectors on hand.
The bad news is he's entering a phase where he's going to be around food and other kids and parents without me to protect him from these things that could kill him. And I'm completely terrified.
Twice last month he spent time without us playing at the homes of neighborhood kids. Both times I had to meet the parents beforehand and warn them: he has allergies, please no food. While I'm thrilled he's making friends and navigating the joys (and challenges) of other kids after spending several years as a fearful, shy boy, I'm also scared shitless that he's going to ingest an allergen and suffer a life-threatening reaction when I'm too many houses away to help in time.
Once he's out of view, he's out of my control. At 5, he's too young to be responsible enough to carry - let alone use - his epi pen. Asking each friend's parents to take a crash course in What To Do If My Kid Stops Breathing seems assumptive and overbearing, and not conducive to his making friends easily.
I feel like I'm trying to balance his safety in one hand with the freedom of his being a kid in my other hand, while I'm also riding a unicycle across a tightrope. I feel like all of the responsibility is on me at this point. All I can do is educate him, and educate his friends and their parents, and hope for the best.
That hardly seems enough when we're talking about eating like his life depends on it.
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