A Little Bit Can Hurt (4 page)

However Nikita's condition did not improve, and unfortunately one suggestion even proved harmful. Ranjna tried soaking Nikita in oatmeal baths which worsened her eczema because she had an undiagnosed allergy to grains including oatmeal.

During this anxious time, a family friend recommended Ranjna seek a second opinion. She took Nikita to another pediatrician who immediately suspected extensive food allergies. The new pediatrician replaced Nikita's existing formula with a hypoallergenic formula and promptly referred her to an allergist.

Two days later, Nikita was diagnosed with multiple food allergies to milk, egg, soy and grains by a board certified allergist. The allergist prescribed a steroid cream for Nikita's eczema and directed Ranjna to continue feeding Nikita the hypoallergenic formula while eliminating all other foods from her diet. Ranjna followed the allergist's advice and Nikita's eczema improved significantly.

While Ranjna was relieved she had an answer to Nikita's puzzling skin condition, she felt "very, very scared. I could not put her down for two days for fear that something [bad] was going to happen." Ranjna feared for her daughter's life because the only thing she had ever heard about food allergies was that people could die from ingesting foods such as peanuts. In addition, Ranjna felt guilty "that I had done this to her [because] I stopped breastfeeding her."

Nikita's allergist explained that allergies have a genetic component and that Ranjna's decision to stop breastfeeding at the direction of the first pediatrician was not a contributing factor. In hindsight, Ranjna recognized that her daughter's problems began before she stopped breastfeeding. Still, Ranjna wondered why her daughter had developed multiple food allergies while her son Rahul, born in India, had none.

Despite the stress of conflicting emotions and lingering questions, Ranjna learned to manage Nikita's extensive food allergies. She slowly introduced solid foods to Nikita and carefully monitored her health by keeping a meticulous diary of her diet and the condition of her skin. She prepared all Nikita's meals from scratch and kept her food and the utensils used to prepare it separate from the food and utensils used for the rest of the family. She also restricted the sharing of food in their home so each family member ate only what was on his or her plate. In this way, they taught Nikita by example not to share food.

Although Nikita's food allergies disrupted her family tremendously, Ranjna was determined to minimize the disruption and maintain a healthy balance in her family dynamic. For example, she continued to bake with Rahul for their mutual enjoyment.

With planning, Nikita's family continued to socialize and travel as they had always enjoyed doing. In fact, they planned a trip for a lengthy visit with family in India. Nikita's allergist thought the climate in India would help ease Nikita's eczema, and Ranjna nurtured the "wild hope" that in India, Nikita would be cured. In this hope, she made plans to consult a respected family doctor there regarding homeopathic treatment of Nikita's eczema.

Nikita's grandmother in India was baffled by her granddaughter's food allergies initially but was determined to be "on top of it." Though she usually employed a household cook, she learned to prepare Nikita's meals by herself in advance of the family's arrival. Ranjna packed Nikita's formula and food as an extra measure of safety during their stay in India.

Although Nikita's eczema has dramatically improved, her multiple food allergies remain. Ranjna admits, although she is now more knowledgeable about food allergies, "Every day is scary." She puts her fear into perspective by proactively managing Nikita's care and health.

Ranjna's hope for Nikita is that she will outgrow her food allergies. Ranjna laughs, "For her dowry, she is going to get eating logs from me...logs and logs of 'Mika ate this today.'" Hopefully, Nikita's food diary will be the only vestige of her extensive food allergies.

POSSIBLE NEXT STEPS:

1. Has your child suffered a serious or sudden reaction after eating a specific food? If so, seek emergency help
   immediately.
   If your child displays an array of symptoms, such as skin and digestive symptoms that may or may not result from food allergies, have you considered recording the foods your child eats along with any symptoms he or she exhibits? Share this information with your child's pediatrician.
   
2. If your child's pediatrician suspects your child may have food allergies, have you worked closely with the pediatrician or an allergist to learn what foods cause your child's allergic symptoms? Some pediatricians perform allergy testing and help manage food allergies, but if your child's pediatrician does not, consider requesting a referral to or recommendation for a board certified allergist.
   
3. If your child has been diagnosed with multiple severe food allergies, have you considered requesting a referral to a dietician or nutritionist to ensure your child is getting adequate nutrition and calories?
   
4. What can you do in your kitchen to eliminate possible cross contact with allergenic foods? Have you taken into consideration your pots, pans, cooking utensils and preparation surfaces?
   
5. Have you had a family conversation about why it's important
   not
   to share food and what emergency procedures should be followed if a sudden allergic reaction does occur?
   

2

SUSAN & JOSHUA

A Silver Lining

Susan is 36 weeks pregnant with her third child. She is already the mother of three-year-old Grace and 20-month-old Joshua. A happy boy with bright blue eyes, Joshua likes playing with trucks and climbing on his new playground set.

"J
osh had eczema and constant itching his first six months of life," his mother Susan explains. She was breastfeeding her son and asked the pediatrician if her diet might be affecting her son's skin, but the doctor doubted that was the case. However, after learning that some mothers were avoiding nuts while nursing, Susan decided to also avoid nuts. "So I stopped eating them because I ate a lot of nuts...Within two days, [Joshua's skin] completely cleared up." She reported this development to Joshua's pediatrician, and he recommended Joshua
undergo allergy testing. At seven months of age, Joshua was diagnosed with allergies to peanuts, tree nuts, milk, eggs, soy and chick peas.

Susan reacted with guilt to Joshua's multiple food allergy diagnoses. "Mostly, I felt really guilty at the time because I totally was eating all those foods that he was allergic to and I just felt like, 'How could I let this happen? I've read all the books.' I thought I was a mom who tried my best. So it was guilt and then fear for a few months. My husband helped me through it, and I really don't feel that anymore."

Although Susan has moved past her feelings of guilt, Joshua's multiple food allergies pose practical challenges that make day-to-day life stressful. Susan watches him carefully at play groups and doesn't feel comfortable leaving Joshua in groups where there are many more children than adults. In these situations, his big sister Grace often detects her mother's stress and becomes clingy in response.

Although Susan is beginning to teach her son about his food allergies, Joshua has little understanding of the seriousness or significance. He has suffered mild reactions after coming into contact with certain food allergens. For example, he once developed hives when Susan kissed him after she had eaten eggs.

As a means of coping with the fear and stress, Susan deliberately chooses to focus on the positives Joshua's food allergies have brought to her and her family. "The main thing is my relationship with God, learning to lean on God and look to Him for peace in this situation and protection for Josh, and I really feel that that's happening. It took a few months to feel that, after the initial shock of Josh's allergies, but I definitely feel that now." In addition, Susan says of her husband, "Had this not happened, I wouldn't have seen some wonderful aspects of his character. I love and admire and respect him more because of how supportive he's been, especially during those overwhelming first few months when I felt a lot of guilt."

Grace has blossomed in her role as Josh's big sister and protector. Susan says, "She's been protecting him since she was two-and-a-half years old. She has taken sippy cups away from him that he's found at the library. She's told the babysitter that he can't have certain foods that [the babysitter] wanted to offer him, and she's taken dangerous food away from him at play groups even before he touched them. She really gets it, and she's really learning to care for others." One of the specific ways Grace cares for Joshua's safety is to wait until he is absent before
eating those of her favorite foods to which Josh is allergic. With a smile, this three-year-old explains how she protects her little brother by saying, "I wrap my hands around him..."

The development of Joshua's food allergies has profoundly affected Susan's dietary choices during her current pregnancy. Susan consulted two allergists about avoiding food allergens while pregnant and received conflicting recommendations, so she is following her own instincts. "I'm doing it differently this time, and I'm not eating any nuts [or] fish. I'm eating fifty to seventy-five percent less dairy, less soy. I'm taking probiotics." Susan plans to continue probiotics while nursing and will avoid eating major food allergens in the hope of preventing her third child from developing food allergies.

Although Susan admits she has experienced stress and guilt over Joshua's food allergies, she asserts, "There are a lot of positives which you don't see when you're first going through it of course. But the bottom line is I'm just convinced that there's a reason for all this, and I just have to keep doing my best." She concludes, "My hope for [Joshua] is that he will not let allergies get in the way of enjoying his life, and I think that will probably be the case since he's so happy."

POSSIBLE NEXT STEPS:

1. Are you pregnant or nursing? Ask your allergist about current research and recommendations for avoiding allergenic foods.
   
2. Do you suspect a food you are eating may be causing your child to react via your breast milk? Eliminate the offending food from your diet and share the results with your child's physician.
   
3. In play groups, libraries and other areas frequented by children, are you cautious about the risks posed by other children's bottles, cups and snacks?
   
4. Are you able to recognize some of the positive aspects of living with food allergies and express those to your children?
   
5. If you or your child is having difficulty coping with the stress and anxiety caused by food allergies, have you considered professional counseling?
   

Section 2

CHILDREN - EARLY CHILDHOOD

1-4 years old

"Children are not things to be molded, but are people to be unfolded."

~Jess Lair

I
ncreasing independence and exploring boundaries are a normal part of development for toddlers. Their growing mobility with crawling and walking keeps them, their parents and other caregivers on the go! At this age, children expand their range of table foods and may be tempted to explore other children's food. When they enter daycare or preschool for the first time, they may be in close contact with many children in a new and uncertain environment. They are learning new rules including how to manage their food allergies in this setting. The combination of these factors with a child's desire to socialize with other children can be challenging and frightening for both the parents and the food-allergic child.

Section Two shares the enlightening stories of seven children, including a pair of sisters, and their families who navigate the challenges of food allergies presented by daycare, preschool, travel and siblings. You will meet:

• Reyna and Talia, young sisters who share extensive and limiting food allergies, the same medical condition that caused their uncle's sudden tragic death;
  
• Big sister Ariel who had a terrifying incident during a preschool party;
  
• Aidan, a very busy toddler, whose mother has created the ultimate tool to assist family and friends caring for him;
  
• Brynn, a frequent flyer, who had a surprising encounter with a fellow passenger;
  
• Grace, the baby of the family, whose two older siblings are fiercely protective and food allergy aware; and
  
• Robert whose recent multiple food allergy diagnoses have turned his family's life upside down.
  

3

REYNA AND TALIA

"Reyna Friendly Day"