Well, shoot: Todd has a peanut allergy!
It all started on Friday, May 1st. I sat Todd in his chair for lunch, and I gave him some cantaloupe slices to start with. It was really sweet and juicy. He’s such a good eater, so of course he loved it. He’d had slices the day before, and 2 days before. Two weeks prior to that, he’d eaten his first cantaloupe.
About 10 minutes later, I quartered a banana and smeared some peanut butter (PB) on it. It was a thin enough layer to not pose a choking hazard, but the amount of PB was more than he’d been exposed to in the past. Before this peanut exposure, Todd had handled and tasted some pancakes made with banana and peanut butter. Probably very little was ingested, though. He’d also had some small smears of PB applied to his lips, and he’d been fed tiny amounts of frozen banana with PB from a spoon. Obviously, he’d had no reactions to these initial exposures.
As a side note, Todd slurps/eats about 1/4-1/3 cup of green smoothie every morning. This nutritionally dense smoothie contains frozen banana, along with orange, kale/collard leaves, frozen celery, canned pineapple chunks, frozen blueberries, avocado, pea protein and hemp protein. So– Todd’s banana consumption is frequent.
After I gave Todd the banana with PB, he chomped and munched and licked it right up. Because his hands and tray were already wet from the juicy melon, his face and arms were covered with everything. His bib and clothing were getting soaked through, too. Everything seemed fine, though. When Todd was finished with what he wanted, I started cleaning him up.
I typically start by picking up a hand to wipe his forearm. That’s when I noticed the large, red circular “welt” underneath his wrist. I continued wiping and immediately noticed that both arms had multiple red spots with white centers. My heart sunk, as it was a blatant food reaction. I took off his clothing and noticed more spots on his chest and neck. Fortunately, he wasn’t showing the severe symptoms of facial/throat swelling or difficulty breathing. Other than the spots, he seemed fine.
I phoned the pediatrician’s office, and the outcome of that was the recommendation that I take Todd to the ER. They knew that the hives were already fading, but they said that was the standard protocol since we were still within 2 hours of the reaction. (Apparently it could have still gotten worse.) I thought about it, I monitored Todd, I spoke with family, and I ultimately decided not to go to the ER. My gut said it just wasn’t warranted.
The next morning, I felt quite confident that I could feed Todd his usual smoothie, and he was fine with it. The banana was easily ruled out, I felt. I doubted that the melon was the culprit, but I decided to withhold cantaloupe, just in case. Obviously, I wasn’t going to expose Todd to any peanut.
On Tuesday, May 5th, the pediatrician’s office called me for a follow-up. The MD referred Todd to an allergy doctor, and we were able to get seen the next day, May 6th.
Todd was tested via scratch test for the 7 “primary” foods (i.e. high risk foods: chicken, corn, egg, milk, peanut, soybean, and wheat), plus banana and cantaloupe. Of note, the doctor said that a negative test is more significant than a positive one, because there’s a high false positive rate (did he say 45%?). The false negative rate is very low.
The doctor also confirmed that current data suggests that it’s good, from an allergy standpoint, to give an infant his/her first exposure to peanut in the first year of life. (So, I did the right thing by exposing Todd).
The test administration involved marking Todd’s back with pen, dripping the test liquids in the set distribution, then scratching the spots to allow the test liquids to penetrate the skin. Then, wait 15 minutes. There were 3 controls including a saline drop (S), nothing at all (I), and histamine (H).
Anything less than 3 mm isn’t considered significant, so even though Todd had a small hive from the soy (2 mm), they didn’t consider that cause for any concern about soy. Todd’s reaction to peanut was 8 mm. Nothing else caused a reaction.
Note: being vegan, I had considered declining testing for the animal products, but I ultimately decided to go along with it just in case Todd is accidentally exposed to those animal products in the future, without our intent. We certainly don’t plan to give him any animal products.
The recommendation given to us from the doctor is to avoid peanut for 1 year. Todd will get a baseline blood test during his 9 month well baby appointment (in 2 weeks), and then a repeat blood test in 1 year. We’ll see the allergy doctor again in one year, and based on Todd’s blood work, there’s a possibly of peanut re-introduction.
For now, we have an EpiPen Jr®. 2 pack and a bottle of children’s Benedryl (diphenhydramine) in case we need to treat any future severe or mild symptoms. (The dosage for a mild reaction is 1.5 ml, which isn’t much!) I assembled our “peanut allergy travel pack” to include the Pens, the diphenhydramine, a sterile syringe, and the information leaflets so that we can easily bring it with us wherever we go…exciting!
And so we wait a year!