>My daugher was diagnosed with milk/wheat allergies in February
>and now it appears she is also reacting to peanut butter? Does
>anyone know how this works, she isn't reacting with vomiting,
>but with irritability and stomach aches. Can additional allergies
>appear and how does one keep track of this?
>
>I am thinking of having blood tests done on her instead of
>scratch tests (she is 18 months old) - any advice as to if we
>shoudl do this? I thought the blood tests might be able to
>pick up more allergens.
>

Yes, it is possible. And yes, it is frustrating. To develop a food allergy,
it typically takes 1) the propensity to become allergic to that substance,
and 2) exposure to that substance. In some cases, exposure (becoming
"sensitized") occurred in-utero. What Mom ate passed through to the fetus,
and the fetus was sensitized. In other cases, it takes consumption of the
food, sometimes in great quantities. Since the child is not born with a
printout of what s/he will (eventually) react to, and since exposures
happen at different times, it's nearly impossible to get a sense of where
the child will eventually end up, and to what items the child will
eventually and always be allergic to. Add to that the leaky gut hypotheses,
and you've got a complex and anxiety-provoking picture of parenting the
highly atopic child.

What you're left with is coming up with a strategy for introducing new
foods. For us, it was a matter of avoiding all things that Josh reacted to
or tested allergic to, and also those items that were known to be highly
(and dangerously) allergenic, as long as they are avoidable/dispensible
foods. This also included challenges to new foods, which we did carefully
and always with medications at hand and an ER close by. For those highly
allergenic foods that we need to try for a first time (for reasons of
nutrition or because avoidance is difficult) we prefer to do oral
challenges at the doctor's office or as an in-patient. If those foods are
ok, we watch for a week or so of eating a fair amount of that food,
watching for increasing symptoms. We know that sensitization can be slow,
so if Josh developed a sensitivity to some incorporated food item, we
sometimes had to strip back to a known, minimally symptomatic diet and
re-search for the culprit. It's terribly complicated, but do-able.

If you decide to test, take the tests with a grain, and do them repeatedly
over the next several years. Josh tested negative to milk for several
years, eve though he was anaphylactically allergic to it. For many other
items, he showed symptoms years before his skin reacted with a positive. Do
the tests anyway, for the positives that you might get, to help you figure
out a good strategy. But you won't be "done" and know the whole picture for
quite a while.

Hang in there - over time you'll get a sense of what your child can eat.
Josh is now 11, and he's eating quite a lot (although he can't eat eggs or
milk products and has never eaten a nut or shrimp). With a positive
attitude and some creativity in searching out new special foods, your child
may even grow up feeling nearly "normal."

Good luck

Mark

Mark Feblowitz                  GTE Laboratories Incorporated
[log in to unmask]              40 Sylvan Road, Waltham, MA 02154-1120