Food Allergy Challenges for Baked Egg and Milk

I just baked a cake. It has an egg in it. A real egg for my egg allergic child! Last night I baked bread in the bread machine. I put 15 grams of dried milk powder in it. Real milk for my milk allergic child!

I haven't shared anything about this nearly 3 month journey because like all journeys, it's had plenty of bumps in the road and wrong turns. Frankly, I feel like we've stepped off the road and we're ploughing our way through uncharted territory. It's scary. It's exciting. We continue to move forward.

This food allergy journey began in July 2010 when we made an appointment to do a baked egg challenge in our allergist's office. As instructed, I baked an angel food cake with 12 eggs. My egg allergic child needed to eat one piece to get roughly one egg. There was much anxiety leading up to the appointment. It's hard to convince a child to eat something after telling them for 10 years to never eat it. The anxiety made the appointment difficult. Physical symptoms were hard to separate from symptoms of anxiety. The challenge was not completed. We left the office not knowing if there had been an allergic reaction.

Over the next few days, we, the parents, decided to use egg in baked products- just one egg in a whole cake for example. Our allergist was aware and not totally comfortable with the plan, but acknowledged that we had the tools to handle a reaction if there was one.

There wasn't a reaction.

For several months now my egg allergic child has been eating baked goods containing one egg that have been baked for approximately 30 minutes.

So, we decided to tackle baked milk. We wanted to use a small amount of dried milk powder in a batch of muffins. For the first serving, we decided to go into the allergist's office. This wasn't a traditional food challenge as technically we weren't using enough of the allergen, but the reassurance of having a doctor close by was helpful. My milk allergic child was able to eat a whole muffin that contained 0.33 grams of dried milk powder. As per the allergist's instructions, we've continued to keep milk powder in the diet over the past week.

This experience has been fraught with anxiety for all of us, but we hope we're doing the right thing in the long run. Our efforts are two-fold: get missing nutrients into the diet and begin to introduce the allergen slowly to allow the body to recognize it as okay.

There continues to be moments of, "I think my mouth is tingling" and "What if I can't breathe after I eat this?". We work through each situation as it comes up with as much confidence as we can muster. We're just parents trying to do the right thing by our child.

I certainly can't recommend this method, but I can recommend an open dialogue with your allergist. The research is coming in quickly and it's hard to keep up with the latest recommendations. Talk to your doctor and make a plan that is best for your child and your family.

I'll keep you posted on ours and hope you'll keep us posted on yours. We can all learn from one another.

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Food Challenge: A Distress Signal

I'm still feeling damaged as I write this post. The trauma of Monday’s food challenge still lingers. It began innocently enough with the allergist saying, “Let’s do a food challenge for egg.”

Great idea, thought the parents. Our nine-year old called the scheduled challenge “the day I’m going to die”.

It’s hard to explain to a child that they should eat a food they’ve been told could make them very sick. We really worked hard to manage his anxiety. We’d been through food challenges with him before, but he’s too young to remember. We explained, and the doctor re-explained, the process. A tiny amount of egg would be given, with increasing amounts over five ingestions. We would wait 20 minutes between each ingestion to see if there would be a reaction.

The hard part was separating the anxiety symptoms from physical symptoms. The first level- no problem. After the second ingestion, he asked if his tongue was swelling. We said no, doctor said no, we proceeded. On to level 3. He asked if there was something on the side of his lip. He thought it felt funny. Nothing there. Proceed to level 4. He said it was hard to breathe. We called the nurse. Breathing fine. His heart rate was up, but everyone thought that was due to anxiety. For the final ingestion, he had to eat the rest of the egg. There were tears and “I hate this. I don’t want to do this.” Doctor came in and said that all was going really well and she expected he’d be able to eat eggs on a regular basis. He forced it down and we waited. A minute later, he vomited a little. Everyone studied the projectile and determined it was mucous. No problem...for a few minutes.

Things began to go downhill and then gathered a fierce pace for a fast descent. He started scratching his back. A little red, no problem. A few minutes later, there was a hive. We wait. Soon, another hive on his stomach. The nurse brought in Benadryl. We wait. Soon he began scratching furiously- all over- and said he felt like he was going to be sick. His skin turned bright red and become rough. Eczema everywhere. He looked really bad. Is there anything more painful than watching your child suffer?

The doctor gave him Zyrtec and a steroid. Minutes later, violent vomiting. The egg came up, but so did the medicine. Apparently the Benadryl had enough time to start to work because over the next hour the skin symptoms started to recede a bit. After four hours with strict instructions to avoid egg, we went home. We had more steroids and antihistamines to give throughout the next 12 hours.

Amazingly, he looked like himself again the following morning.

“That was the worst day of my life,” he said the next day. I remember a few rougher days in his early years, but for him, I agree, this was the worst.

We did learn some things, though:

He now really understands what an allergic reaction is and how he feels when it happens.

I would do a single or double blind challenge IF we ever do a challenge for him again. With an older child who is anxious already, it would be best if the child did not know if they were getting the food or a placebo.

We know without a doubt, that eggs need to be avoided.

He was already dealing with spring allergy symptoms, so we also learned not to schedule a challenge during a season of allergy symptoms.

So, I lost some faith in medical science this week. When it comes to food allergies, we know that skin tests results are often unreliable and that blood test results have a lot of false positives. The true test is a food challenge, but isn’t there a better way to do this? No one should have to go through this- especially our children. I’m still upset, but I know over time this sadness will turn into action. We need better diagnostic tools for food allergy. We must keep pushing education and awareness which will result in more funding and more research. We can do better. I know we can.

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