A Delicate Flower

When Lila was 2.5 months old she developed eczema from head to toe.  It wasn't awful, no cracking or seeping, but little red bumps all over and poor little birdie was always trying to scratch her head.  This wasn't really a surprise since her dad and I both have eczema and luckily some Hydrocortisone ointment and Eucerin Aquaphor got it under control.  She also had some mysteriously swollen lymph nodes on the back of her head and our pediatrician said the eczema and swollen nodes combined could be a sign of allergies.  She suggested we go slowly with introducing foods to Lila when the time came. 

When Lila was 6 months old, we gave her some rice cereal mixed with my milk.  She was pretty sure we were trying to poison her.

She had similar reactions to pretty much everything we tried to give her.  Finally she started to warm up to some purees and Cheerios.  One night we gave her a cracker and she seemed to like it.  She didn't want another one, though, and suddenly seemed tired and snuggly.  About a half hour after eating the cracker, she vomited for the first time ever.  At the time we thought this was a bit odd but sort of figured that she wasn't used to solid foods and maybe her tummy wasn't ready for it.  The next time I offered her a cracker (different brand than the pukey one), she made it clear that she was NOT interested.

Eventually she warmed up to some more foods.  Her favorites seemed to be peas, peaches, bananas, sweet potatoes, and Cheerios.  She was still very loathe to try any new finger foods other than her beloved Cheerios.  Sweet thing loves her pureed peas and began to want to feed herself.

We began to notice that many times after she ate, her skin would break out wherever the food had touched.

Not really hives but little red areas with whiter raised bumps.

I'd wipe her down after she ate and put some lotion on her and she'd be fine.  She also would get these irritated spots when the dog licked her.  Just being around the dog didn't seem to be a problem but when Tasha gave Lila kisses, then the rash would appear.  I have a pretty bad cat allergy and was pretty sure Lila did too.  She's never touched or even been in the same room with a cat but my in-laws have a cat.  Poor Zach is old and sick and hides from everyone and my mother in law does marathon cleaning before we arrive but dander and stray hairs are difficult to get rid of entirely.  When we visit there, Lila gets a runny nose and occasionally swollen and watery eyes, just like her mama.

Just after Christmas I had lunch with an old friend and Lila was grabbing for my root beer float.  I gave her some tastes and she seemed to like it.  I was so excited that she was willing to try something new!  About a half hour later, we were home and Stephen was holding her when she became fussy and broke out in hives.  Stephen had been in the attic and was covered in dust so we had no idea if she was reacting to dust or the milk in the float.  I thought it was more likely the dust since I have a dust allergy and the hives appeared right when she was exposed to that.  We did the usual wipe down and lotion routine and it cleared up.  (This next picture was during the hives and is a crummy iPhone shot but you can sort of see one of the welts.)

A couple of weeks later we were out to eat with my parents and Lila had a taste of Daddy's milkshake.  She had the tiniest taste and went into her whole cracker refusal routine, except even more adamant if possible.  Then almost immediately she broke out in hives all over her face.  We wiped her off and did lotion and they cleared up within an hour.  When we got home and were putting her to bed, we found more hives on her torso.  Up to this point, I'd been thinking and hoping that the rashes were due to food touching her sensitive skin.  But once she'd had the hives and in places where the food never touched, I knew we were dealing with an allergy.

At Lila's 12 month check up I discussed this with her doctor and she referred us to an allergist and said not to feed her any milk, eggs, soy, wheat, nuts, or fish until we'd had her tested since these are the most common and dangerous allergens.  This wasn't really an issue since Lila refused most of those things in the first place.  There was wheat in her Cheerios but she'd been eating those a while without any problems so we let her have them.

Last week we saw the allergist and brought in a very detailed questionnaire about all her symptoms.  I mentioned the rashes when she eats and the doctor asked what foods she reacts to.  For whatever reason, I thought of her three favorites and told her that she eats a lot of bananas, peaches, and peas, and it seemed like she almost always broke out.  The doctor decided to do a skin scratch test for the most common food allergens plus those three foods, dust, dogs, and cats.  She said there was no reason to test for any other environmental allergies because she hasn't had enough exposure yet to develop a reaction.

The nurse came in and instructed us that we had to hold Lila so neither she nor we could touch her back.  This meant holding her arms and not being able to really snuggle the poor little bit when she was upset.  And she was upset.  Can you blame her?

As if the initial scratches themselves weren't bad enough, sweet thing broke out in hives pretty fast.  We couldn't wipe off the serum they'd applied until 15 minutes had passed or put Hydrocortisone on it until the nurse had read the reactions after 20 minutes had passed.  She really did pretty well, all things considered.  I put some of her favorite music on my iPhone and let her hold it which helped distract her a bit.  The skin test reactions are ranked on a scale of 0-4.  Here's how Lila scored:

• 0: Fish mix, banana, negative control
• 1+: Soy, peach, dog, dust
• 2+: Pea
• 3+: Positive control (this means we got good, accurate results)
• 4+: Milk, egg, wheat, peanut, cat

I pretty much knew going in that Lila was going to have a milk allergy.  I wasn't terribly worried because we are still nursing and we'd just do soy milk and no cheese.  I wasn't counting on four severe food allergies.  Before we'd even seen the doctor again, the nurse (who did the testing and read the results) came in with a trainer epi pen to show us how to use it.  I really wish the doctor would have come back in first to talk to us before the nurse instructed us on the epi pen. 

In any case, then the doctor came back in and looked up from the results and said, "Oh boy," with a big exhale.  That's when it started to sink in how serious this was.  She told us we had to strictly avoid the four severe food allergies, not only Lila but me as well because we are nursing.  She wanted to do a blood test to check on the pea and peach reaction.  She said soy was okay since it was a mild reaction.  I still don't get why she wanted to double check peach but not soy since they had the same reaction.  We went to a building next door and had the blood drawn.  Thank goodness for the lab tech who was kind, quick, and accurate with little bit's tiny veins.  Thank goodness also that Stephen took a couple hours off work that day to be with us for all of this.  If he hadn't been there, I'm pretty sure I would have missed half the information and ended up crying at some point.  As things were, I made it to the parking lot before I cried.

In the last week we've adjusted.  Stephen has been amazing.  He loves a challenge and a project so this weekend he emptied our cupboards and sorted everything into safe and not safe foods.  Because her allergies are dangerous, we've decided pretty much to have an allergen-free home and I love Stephen so much for embracing this.  I find myself with so many questions that I know may never be answered.  Why has she been fine eating Cheerios up until now?  Is it my fault she's had eczema and swollen lymph nodes most of her life because of what I have eaten?  The fact that she's never had a really bad reaction makes it harder to believe.  The doctor instructed us that if we know she has accidentally eaten one of her severe allergens and begins to show sign of a reaction, even if it is just hives, to administer the epi pen and call 911.  She said many parents make the mistake of giving Benadryl and waiting to see how the child does which gives the reaction time to escalate.  But I have a hard time picturing myself giving her the epi pen for hives.  So the question is, how cautious do we need to be?  How scared?

Lila's eczema has flared up in the past week and after not hearing from the doctor for a week, I called yesterday to find out about the blood test.  She tested positive for allergies to peanut, egg, wheat, milk, pea, and peach.  Peanut, egg and wheat were "sky high."  Milk was "in the gray zone" which was a surprise.  Pea was positive but I don't recall if she said how bad it was.  Peach was positive but "very low zone."  She said eliminate them all.  I asked her if I should be worried about soy since she had a mild reaction and her eczema seemed worse in the last week when I'd switched to soy milk.  She seemed unconcerned and said something to the effect of, "six food allergies are enough."  I'm not sure what she meant by that.  Enough for us to cope with?  Sure, it's a lot, but I'd rather know if there are more allergies we need to worry about than find out when she has a reaction!  However, she did point out that I'd told her that Lila's eczema flares with weather changes and it has gone from frigidly cold to 60-70 degree temperatures in the last week.  She also has a cold which can cause a flare up.  She suggested we try eliminating these six foods and see how things go for a while.

So that's our plan.  We left the doctor's office with a few handouts and instructions to come back in a year for Lila to be retested.  I wasn't entirely happy with the doctor.  She was very professional and knowledgeable but not terribly warm.  She didn't really make any attempt to interact with Lila besides a quick examination and I know it's not her job to administer the test and check the results but she never even looked at Lila's back.  I already have a few recommendations for other allergists to look into so I'm thinking about that.

So, I'm focusing on the good things.  It's a very good thing that Lila was so resistant to new foods because it likely prevented her having a bad reaction to something.  It's a good thing that most children outgrow food allergies.  I was allergic to milk and eggs as a baby and outgrew both allergies.  It's a good thing that Lila is with my mom or Stephen while I'm working and so I don't have to worry about other environments she may be in or training other people to use the epi pen.  It's a good thing that Stephen is embracing the diet at home.  It's a good thing that I'm eating healthier and have already lost a couple of pounds.  It's a good thing that Lila isn't allergic to dogs.  She's a noisy, neurotic, nervous thing but the entire household is rather fond of Tasha.

And goodness knows she isn't one of those non-shedding, hypoallergenic dogs.  I brushed her last week and this was the result:

It's a good thing that there are so many products made these days for people with food allergies.  It's also a good thing that there are so many cookbooks for people with food allergies because those products are not cheap.  It's a good thing that Lila is suddenly willing to try new foods!

It's a good thing that she has decided she DOES like green beans and tortilla chips and freeze dried bananas and rice crackers since I was a little heartbroken on her behalf over the ban on peaches and peas.  And perhaps most important of all, it is a very good thing that Trader Joe's O's do not contain wheat.

(How cute are those teeth?!)