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March 25, 2006

Thoughts on New Food Labeling Law

For those of you who have been reading labels for food allergies, are you frustrated now? The following excerpts are from FAAN’s website. They were written in the article Answers to Frequently Asked Questions About FALCPA by Martin Hahn, Esq., and Meg McKnight, Esq.

“The Food Allergen Labeling and Consumer Protection Act (FALCPA) of 2004 was passed to ensure that individuals, particularly parents of children with food allergies and others providing food to those children, could easily and accurately identify food ingredients that may cause allergic reactions. Under FALCPA, allergen declarations must be written in plain English…by placing the word “Contains” followed by the name of the food source…or…by placing the common or usual name of the allergen in the list of ingredients. The law applies to food products that are labeled on or after January 1, 2006.”

How much more excited can we be that it’s easier now more than ever to feel safe about the foods we’re feeding our children!

I have always used Ener G Foods as a reliable source for my wheat, egg, nut, etc. allergic child. According to their website, they are “a wheat-free, gluten-free, dairy-free, peanut free, kosher certified facility.” I’m in! But their previously nut free egg replacer powder (which works great for replacing eggs in certain recipes) now carries a nut warning. Bummer! So I called Ener G Foods to see if they were going to change their process so the egg replacer would be nut free again. I was directed to this on their website:

Ener G Foods Allergen Statement
”All products manufactured by Ener-G Foods, Inc. are subject to our HACCP program. …by being a HACCP compliant facility, all risks of cross contamination, or even any food safety issue will be completely eliminated.”

The Ener G Foods customer service rep told me that their manufacturing process for the product had not change. That basically it was still manufactured on a line that made a tree nut product, but that there was not a risk of cross contamination. OK, then why did they add the warning? Here’s my frustration: Do I use the product because I always have and never had a problem? Or do I avoid it, out of fear?

I understand it’s all about CYA for the businesses. But what about the consumers? We feel safer now with the foods we feed our kids, but the “safe-food-pool” seems to be dwindling. Even some of the pretzels I used to buy for my other food allergic daughter (only eggs and peanuts) now contain traces of peanuts. Is it a new manufacturing process, or are the companies just letting us know now how they really do things? Can my kids still eat those foods? Or did the risk all of a sudden go up just because my knowledge changed?

AHHHHH! Sometimes I just feel like screaming! It’s that rollercoaster ride again. So, for the time being, I go back to making things from scratch, wondering how long it will be until they find a cure!

Posted by Ann Marie at 6:18 AM | Comments (2)

March 20, 2006

Peanut Allergy Cure is Getting Closer

For peanut allergy sufferers, including 1.5 million U.S. adults and children who live each day afraid that one mistaken bite may cause a deadly reaction, a cure may be on the horizon. A new series of studies published in the July 2003 Journal of Allergy & Clinical Immunology indicates that scientists are closer to finding a cure for peanut allergy, according to The Food Allergy & Anaphylaxis Network (FAAN).

"Carefully reading labels, asking questions about ingredients at restaurants and carrying epinephrine are a way of life for peanut allergy sufferers," said Anne Muñoz-Furlong, founder and CEO of FAAN. "So is hoping that scientists will one day find a cure. The future looks promising."

The series of articles, the first of its kind for peanut allergy, covers topics including the latest information on causes, diagnosis and treatment of reactions, better understanding of who might outgrow peanut allergy and potential new therapies to desensitize patients. One study also has immediate ramifications for asthma sufferers, linking food allergy as a significant risk factor for life-threatening asthma.

The findings are critical for school administrators, child care providers, the food industry, restaurants, airlines and physicians and other health care providers. "We must continue to improve education about food allergies, symptom recognition, the use of epinephrine and other emergency responses," said Muñoz-Furlong. "Today, improved knowledge and quick response times are the best cures against deadly reactions."

Allergic food reactions, particularly peanut allergy, are on the rise. Peanut allergy is believed to be the leading cause of severe or life-threatening food-induced anaphylaxis, causing an estimated 15,000 emergency room visits each year and nearly 100 deaths. Peanuts, along with milk, eggs, tree nuts (walnuts, almonds and pecans, for example), fish, shellfish, soy and wheat account for 90 percent of all allergic reactions in the United States. Food allergy-induced reactions are estimated to account for tens of thousands of allergic reactions each year and 30,000 emergency room visits.

"When someone is diagnosed with a food allergy," added Muñoz-Furlong, "they can't just go home and avoid milk, eggs or peanuts. To avoid reactions they must learn the technical names for these foods, read ingredient labels and teach others -- including restaurant staff, educators, babysitters and coaches &endash; how to recognize and treat reactions when they occur."

In spite of best efforts at avoidance, reactions will occur. "Every time a food-allergic individual puts something in their mouth, they must be ready to treat a reaction. Some people say a silent prayer that the food they are about to eat won't kill them."

Each year, peanut allergy causes nearly 100 deaths, more than 15,000 emergency room visits, and tens of thousands of milder reactions handled at home. For the 1.5 million Americans who are allergic to peanuts, reading labels, asking questions about ingredients at restaurants, and carrying epinephrine is a way of life.

The studies provide hope. Hope that scientists will one day find a cure for peanut allergy. Based on the findings, the future looks brighter for the millions of patients and their families who live each day in fear that one bite of a food containing peanuts may cause a deadly reaction.

Still, the best practices for now are avoidance and the immediate administration of epinephrine if a reaction occurs. And most importantly, we must continue to educate. Educate patients, health care professionals, school personnel, businesses, and the population at large on the dangers of food allergy reactions.

We still have a ways to go. Most people ask themselves, "What's the big deal? Why can't these people just not eat peanut butter and take care of themselves?" Believe me, they wish they could.

When someone is diagnosed with a food allergy, they can't just go home and avoid milk, eggs, or peanuts. To avoid reactions, patients must learn the technical names for these foods and read ingredient labels. Would you know that peanuts are also called monkey nuts? ground nuts? mandelonas? Additionally, one company listed them by the type of peanut -- Valencias.

Then, there are instances where the peanuts are found unexpectedly -- reactions have occurred in restaurants from peanuts or peanut butter in hot chocolate, chili sauce, spring rolls, enchiladas, egg rolls, pie crusts, as well as a variety of desserts.

Patients must teach others, including restaurant staff, educators, babysitters, and coaches, how to recognize and to treat reactions when they occur.

In spite of best efforts at avoidance, reactions will occur. The majority of reactions occur outside the home, often in restaurant settings and sometimes in schools. Always unexpected.

If a waiter, waitress, or member of the kitchen staff in a restaurant doesn't take food allergies seriously, his or her mistake can land someone in the hospital or worse. For example, one woman died, even though she'd informed the waiter about her peanut allergy. The cause? The lamb chops she ordered had been marinated in a mixture containing peanut butter.

A young man died and another had a near fatal reaction after eating cookies from a vending machine. Although years apart, in both cases, the company had large amounts of undeclared peanuts in the cookie dough.

It's not just about peanuts -- other food allergies call for the same type of caution and can cause severe or fatal reactions.

And finally, while FAAN members report improvement in the management of food allergies at school, reactions continue to occur when food, particularly peanuts, are used as part of a craft project or when food is brought in from the outside for special class celebrations.

As you can see, food allergy avoidance is not easy. Peanut allergy reactions continue to rise. Food allergy, particularly peanut allergy, has become a public health and food safety concern whose wake has been felt by everyone -- from the government, to food industry, restaurants, schools, health professionals, and patients.

The studies show us that there is hope, but we must not let our guard down. FAAN will continue to take the lead on education, awareness, advocacy and research. But until there is a cure, education and proper diagnosis from an allergist is the key to preventing reactions.

source: The Food Allergy & Anaphylaxis Network

Posted by David at 7:18 PM

March 18, 2006

Decorating Easter eggs the allergy free way

How do you keep the tradition of decorating Easter eggs alive if you have a child who is allergic to eggs? For the first several years it bummed me out so much I couldn’t even think about an alternative. Do I let the other kids color eggs so they get to experience the smell of vinegar and the magic of swirling colors? I concluded that it would make my daughter feel horribly left out. So, could she dye eggs too? Would it give her hives or a worse reaction? I felt sad for my child who has to live with an egg allergy. I felt angry that she even has allergies. I felt uncertain if I was being overly protective or cautiously safe. And I was mad at myself for having so many feelings! With all of these overwhelming emotions, I chose to skip this tradition. And each Easter, thinking of my childhood, I felt a little pang of sadness. Then, over the years, I chilled out and wised up!

I decided to make a new family tradition, including both the tried and true favorite of coloring eggs and the avoidance of the dreaded protein. We first tired coloring fabric eggs. It certainly was a fun activity, but the end result didn’t give ME that family tradition feeling that I was looking for. Instead of sitting them out in a basket, we ended up playing football and shooting hoops with them. The ceramic eggs were out because I had 4 kids under the age of 6! I wanted to decorate as a family. Enough said. I finally found plain wooden eggs at our local craft store. We had fun as a family painting our eggs with marvelous colors and patterns! We all signed and dated our creations. Now each year, I put out our special basket, fill it with fake grass, and carefully place each egg in one at a time. To every other eye, it looks like a cute Easter decoration made by little kids. But for me, it’s so much more. It marks my passage from a world where food allergies controlled my feelings (and life, I guess) into a world where I feel more in charge, more confident and more at peace with living with food allergies.

It may seem really obvious to decorate “fake” eggs instead of real ones. I guess I needed to YET AGAIN experience that emotional rollercoaster of parenting-a-child-with-food-allergies. Then I come to that peaceful, “it’s really not that bad” state, and all seems happy again. It’s not only Easter eggs that have thrown my emotions into a whirlwind, it’s the everyday things too; a classmate bringing in donuts unannounced, a party invitation involving something your child can’t do without A LOT footwork by you, a friend at the park eating a peanut butter and jelly sandwich with lots of peanut butter smeared across their face. The list goes on and on.

I guess this part of our lives won’t change until there is a cure for food allergies. But with each trip on the rollercoaster, I am learning that I am a strong person and I do have the knowledge and confidence to raise my children safely in a world filled with allergens. I realize that I can create our own family traditions that have as much meaning for my children as my childhood traditions have for me.

Posted by Ann Marie at 11:19 AM | Comments (1)

March 15, 2006

Potential herbal formula solution for peanut allergy

source: Reuters Health

Treatment of peanut allergic mice with the Chinese herbal formula known as FAHF-2 completely blocks peanut-induced allergic reactions for up to 6 months following therapy and full protection is restored following a second course of FAHF-2, investigators report.

These observations, if reproducible in humans, suggest that this Chinese herbal formula may be a highly effective treatment for peanut allergy, study investigators say. The findings were presented Tuesday in Miami at the American Academy of Allergy, Asthma and Immunology's annual meeting.

Following treatment with FAHF-2 for 7 weeks, peanut-allergic mice were completely protected against peanut-induced reactions following oral challenges administered up to 34 weeks after treatment, lead investigator Dr. Kamal D. Srivastava from Mount Sinai School of Medicine in New York reported.

Subsequent challenges at week 40 and 50 showed "only modest declines" in protection, the team reports, with 1 in 10 mice reacting to peanut challenge at week 40 and 3 in 10 at week 50.

Full protection was restored with re-treatment with FAHF-2; no mouse reacted to oral peanut challenge administered at week 66.

"This is a significant finding in terms of the duration of protection with a single course of treatment that can be taken orally, making it an effective and convenient treatment that can be administered at home," Srivastava told Reuters Health.


Posted by David at 11:41 AM

March 13, 2006

Playdough at Preschool

My daughter has had a wheat allergy from infancy. Long before she was born, playdough was a favorite activity in my house. Being the (overly?) careful mother that I am, we got the playdough out only when my allergic daughter was napping. She was none the wiser! Over time, her reaction to wheat began to lessen, so she also partook in this favorite pastime.

I had become pretty good at managing the wheat allergy and felt confident sending her to preschool. Her nut and egg allergies definitely got way more attention! I remembered to discuss making bird feeders with lard instead of peanut butter, not using eggshells for art projects, and choosing wheat and nut free cereals and candy for counting activities. It was very clear that my daughter would only eat food sent from home. All was good.

Then I got the call from the school that my daughter’s arms and hands were covered in hives and she was miserable. We quickly determined that it was the playdough she was playing with. Our preschool makes their own playdough, both to save money and because it’s more pliable for the kids. Upon further discussion, I realized that it was basically wheat flour, salt and water. Apparently, not the best combination for my daughter!

I brought her home from school and gave her Benadryl and a bath. She was fine. She learned not to play with the playdough at school. And I learned that no matter how many precautions we take, life happens. So I learn from it. And hopefully, by passing the information along, other people can learn from it too!

Posted by Ann Marie at 11:18 AM | Comments (2)

March 10, 2006

Waiting for Mr Goodbar to Clear

Peanut allergic individuals need to be careful of contact they have with those who have eaten products with peanuts, especially peanut butter. Allergens can linger in saliva for hours, meaning that people who are peanut allergic should be extremely with a kiss. So, hold off Auntie Deb, on that big kiss on your niece after enjoying your Peanut Butter Pattie cookie.

"A concern that becomes more pressing as peanut-allergic individuals enter pre-adolescence and adolescence is the concern about kissing, and especially with passionate kissing there is a risk for allergens to be transmitted in saliva," said Jennifer Maloney, M.D., of Mount Sinai Medical Center in New York.

Peanut-allergic patients can indeed suffer severe allergic or anaphylactic reactions when they come into contact with the oral fluids of a peanut eater. Dr. Maloney and her colleagues conducted a two-part study in which they measured levels of peanut antigens in saliva at various time points, and then evaluated various methods for washing them away.

They first asked 10 healthy volunteers to eat a sandwich containing two tablespoons of peanut butter. They then investigated which if any of several interventions might help to wash the allergens away. These included brushing teeth for two minutes, brushing plus rinsing twice with a "swish-and-spit" technique, rinsing twice alone, or chewing gum after waiting for thirty minutes post-peanut butter. The chewing gum intervention was delayed because the oils in peanut butter can break down the gum's consistency, which is why it's used to remove gum from hair.

"What we found, and this is a little bit surprising, three out of our 10 participants actually did not have measurable peanut in their saliva at five minutes after eating the sandwich," said Dr. Maloney.

Of the remaining seven volunteers, six cleared the allergen out of their saliva within one hour, and in the one person in whom Ara h 1 was detectable at the one-hour mark, the allergen had cleared by 4.5 hours.

"From this point of our investigation we can conclude that peanut is detectable in the majority of subjects after eating a meal with peanuts, and secondly we can conclude that it does leave the saliva over several hours," said Dr. Maloney.

When they looked at the intervention, they found that no single intervention was uniformly successful at removing peanut allergen from saliva, although in eight of nine gum chewers the peanut was removed from their saliva.

The best approach? Have boyfriends or girlfriends completely avoid the peanut foods. Dr. Maloney states, "However, if this isn't possible, we think that waiting several hours, possibly eating a meal in between would reduce levels below what would be a clinical problem, and that most likely would be a safe approach as well."

source: American Academy of Allergy, Asthma & Immunology

Posted by David at 8:36 AM

March 8, 2006

Peanut Kiss Did Not Kill Quebec Girl

When a Quebec girl with peanut allergies died recently after kissing her boyfriend who had eaten a peanut butter snack many hours before, it was widely reported, including here on ChildFoodAllergy.com, that she died from anaphylactic shock. We have now learned that the coroner has determined that anaphylatic shock was not the cause. The 15 year old girl instead died from cerebral anoxia, coroner Michel Miron said.

He did not specify what caused the lack of oxygen but Miron said he was speaking out now to head off an allergy association from using the case as an example. "The Canadian Association of Food Allergies intended to use the Desforges case to launch an education campaign," he said. "I had to tell them the cause of death was different than first believed."

source: AP

Posted by David at 8:43 AM | Comments (1)

March 7, 2006

Flying peanut safe

In recent years, some airlines have replaced peanut snacks with less-controversial pretzels. For updates to the list of peanut free airlines, visit the The Food Allergy & Anaphylaxis Network's website www.foodallergy.org.

For example, American, United, Northwest, JetBlue, Spirit and ATA are peanut-free. We usually fly US Airways-America West who serve both peanuts or pretzels. What? We actually fly an airlines that serves peanuts? Are we crazy? Well, hold on a minute. Let's discuss our decision.

First, we have become comfortable that our kids will not react from airborne peanut allergen. So, if there is "peanut dust" in the ventilation system of a plane, it hasn't affect our children. Second, we clean our seats when we board. Families with kids usuallly board early, so that gives a chance to wipe down the seats, arm rests and tray tables with antibacterial wipes. We also bring our own food every time. I know, its tough to pass up that fine airline cuisine but we do it.

Finally, we pack injectable epinephrine (Epi Pen) just in case. We "don't leave home without it." Our kids have racked up some frequent flier miles, so we've gained some good experience in flying with child food allergies. It can be done safely, so take heart.

Posted by David at 7:25 AM | Comments (1)

March 2, 2006

What about babies, food introduction and food allergies?

OK, my very non-medical opinion is that children are wired for food allergies, well before they make their first appearance into this world. A study published in Pediatrics, February 2006, states, “Delaying the introduction of solid food beyond 6 months of age does not protect against the development of allergic dermatitis, the results of a new study show. However, delayed introduction of solid food for the first 4 months of life ‘might offer some protection.’" Isn’t it common sense and standard pediatric practice not to introduce solid foods before 4 months of age? I guess some parents might still add rice cereal to formula or breast milk for various reasons.

Years ago, when I became pregnant, I thought I was well aware of the food allergy do’s and don’ts because I already had one child with food allergies. It was mostly the “don’ts” I listened to: don’t eat peanuts or tree nuts, don’t eat shellfish, don’t eat eggs, don’t consume dairy when you’re breastfeeding, don’t supplement with formula, don’t laugh too much (OK, I just threw that one in!). I thought if I avoided so many allergens, my child would grow up allergy free. WRONG!

This same study reports, “There was also no evidence to support a protective role of delaying the introduction of solid foods on the development of allergic dermatitis and sensitization in children who had parents with allergies.” So, unless I changed my baby’s mother and father (right!), then she was destined to have allergies. And she does. Lots of them! And eczema. Lots of that too!

I’m not suggesting that people introduce allergens into an infant’s diet because it doesn’t matter, I just think people shouldn’t get their hopes up. Our genetic make-up is what it is. So, we should educate ourselves and surround ourselves with a knowledgeable support network. You know, people who actually LIVE with food allergies, not those who are quick to offer advice but don’t really get it!

In a state of frustration at a time when ALL of my children were suffering rather intensely from respiratory allergies, I once asked my allergist if it could be the house we lived in. She looked at me rather empathetically, and said, “No, dear. It’s your genes.”


Posted by Ann Marie at 5:44 PM