Allergy and Asthma Resources

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The Food Allergy Network (FAAN)
10400 Eaton Place, #107
Fairfax, Va 22030-2208
1-800-929-4040
http://www.foodallergy.org/

American Academy of Allergy Asthma and Immunology
611 East Wells St.
Milwaukee, WI 53202
1-800-822-ASMA
http://www.aaaai.org/

American College of Allergy Asthma and Immunology
1645 Oakton
Des Plaines, IL 60018
1-800-842-7777
http://www.acaai.org/

American Dietetic Association
216 West Jackson Boulevard, Suite 800
Chicago, IL 60607
1-800-366-1655
http://www.eatright.org/Public/

The Asthma and Allergy Foundation of America
1125 15th St., NW, Suite 502
Washington, DC 20005
1-800-7ASTHMA
http://www.aafa.org/

Allergy and Asthma Network / Mothers of Asthmatics
3554 Chain Bridge Rd. Suite 200
Fairfax, Va 22030-2709
1-800-878-4403
http://www.aanma.org/


Kids with Food Allergies - formerly Parents of Food Allergic Kids (POFAK)
http://www.kidswithfoodallergies.org/index.php

Read about the Food Allergen Labeling Laws in this article entitled, Food Allergies What You Need to Know

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Food Allergies?

The way to manage severe food allergies is to strictly avoid the foods to which which you are allergic. Knowing how to read a label will help you avoid foods that contain these ingredients.

Read the label on all foods every time you shop! It is important not to rely on any one brand as ingredients can change without warning. Accidents are never planned. Always carry your medicines with you and wear your medic-alert bracelet.

A registered dietician can help you plan a diet that is well-balanced.


You can use Allrecipes.com to find recipes. If you use the ingredient search, you can specify which ingredients you want and which ones you don't want! This is not an allergy site, just a recipe site. So be sure to double check all recipes for allergens.

I am not a doctor. Please verify information with your doctor.

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Milk Allergy?


*see more extensive list at the end of this thread*

Ingredients that indicate the presence of milk protein include:

artificial butter flavor
butter (fat, solids)
buttermilk
caseinates (ammonium-, calcium-, magnesium-, potassium-, sodium-)
cheese (curds)
cream (half and half, sour cream)
custard
hydrolysates (casein, milk protein, whey)
lactalbumin, lactalbumin phosphate
milk
pudding
rennet casein
whey (in all forms)
yogurt


These ingredients on labels MAY indicate the presence of milk protein:

caramel coloring/flavoring
chocolate
high protein flour
natural flavoring


"D" on a food label next to a "K" or "U" may indicate the presence of milk protein or cross contamination of food by equipment used for other foods that contain milk. "Parve" or "pareve" means a food product does NOT contain dairy.


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Do these ingredients contain milk?(from FAAN)

We frequently get calls about the following ingredients. They do not contain milk protein and need not be restricted by someone avoiding milk:

Calcium lactate
Lactic acid (however, lactic acid starter culture may contain milk)
Calcium stearoyl lactylate
oleoresin
Cocoa butter
Sodium lactate
Cream of tartar
Sodium stearoyl lactylate

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If your child is breastfed, the food allergens can be passed through breastmilk and the mother should also avoid milk protein in her diet.

If your child is formula fed, then soy, hydrolysate, or elemental formulas may be recommended:

Soy formula: Isomil, Isoyalac/Soyalac, Nursoy, Prosobee

Casein or Whey Hydrolysate formula (contains protein that has been extensively broken down): Alimentum, Nutramigen, Pregestimil

Elemental formula: Neocate

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My own personal suggestions:

Many margarines also have milk products. But some of the light margarines are 100% vegetable oil.

In recipes, you can pretty easily substitute equal amounts of water or fruit juice for milk, in most circumstances.

For ice cream, I use fruit sorbet instead.

There are a variety of soy and rice products available at health food stores to use as substitutes.

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*I am not a doctor. Please verify information with your doctor.*

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Egg Allergy?

If your child is breastfed, the food allergens can be passed through breastmilk and the mother should also avoid egg protein in her diet.

Ingredients that indicate the presence of egg protein include:

albumin
egg (dried, powdered, solids, white, yolks)
egg substitute
eggnog
globulin
mayonnaise
meringue
ovalbumin
ovomucin
ovomucoid
ovovitellin

Avoid baked goods with a shiny glaze or yellow color (usually from eggs).

Egg substitutes: (works up to 3 eggs in a recipe)

A) 1 teaspoon baking powder
1 Tablespoon water
1 Tablespoon vinegar

B)1 teaspoon yeast dissolved in
1/4 cup warm water

C) 1 Tablespoon apricot puree

D) 1-1/2 Tablespoon water
1-1/2 Tablespoon oil
1 teaspoon baking powder

E) 1 packet of plain gelatin mixed with
2 Tablespoons warm water.


*I am not a doctor. Please verify information with your doctor.*

[ August 16, 2005, 10:33 PM: Message edited by: BlueEeyore ]

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Peanut or Tree nut Allergies?

If your child is breastfed, the food allergens can be passed through breastmilk and the mother should also avoid peanut and/or tree nut protein in her diet.

Ingredients that indicate the presence of peanuts include:

arachis oil
beer nuts
cacahouète, cacahouette, cacahuète
mixed nuts
goober nuts, goober peas
ground nuts
mandelonas
"Nu-Nuts"
peanuts
Valencias
peanut butter
peanut flour
cold pressed peanut oil (usually found in gourmet or health food stores), refined peanut oils usually are OK

These foods MAY contain peanut protein:
baked goods
candy/chocolate
chili
egg rolls
Ethnic foods: African, Chinese, Thai, hydrolyzed plant or protein or vegetable protein
nougat

Don't forget some fried foods are cooked in peanut oil. Chik fil A, for example, cooks all their fried food in peanut oil the last time I checked. This is a problem for some peanut allergic people but not others, depending on the sensitivity and how the oil is processed.

Tree Nuts
Thanks to Becka, we can add tree nut terms to look out for.

Ingredients that indicate the presence of tree nuts include:

almonds
Brazil nuts
cashews
hazelnuts (filberts)
macadamia nuts
pecans
pistachio nuts
walnuts

Other names they might be hidden under:
Anacardium nuts
mandelonas, Nu-Nuts (peanuts that have been altered to look and taste like tree nuts)
marzipan (almond paste)
nut meats
Pinon

Nutmeg and coconut are not nuts.

For additional informations, the following links may help.
http://www.aboutkidshealth.ca/News/Peanu...=news-type]Link 1[/url]
http://www.calgaryallergy.ca/Articles/English/treenuthp.htm]Link 2[/url]


*I am not a doctor. Please verify information with your doctor.*

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Soy Allergy?

If your child is breastfed, the food allergens can be passed through breastmilk and the mother should also avoid soy protein in her diet.

Ingredients that indicate the presence of soy protein include:

miso
soy (albumin, flour, nuts, milk protein)
soybean
soy sauce
Tamari
Tempeh
textured vegetable protein
tofu

These foods MAY have soy protein present:

hydrolyzed plant, vegetable, or soy protein
natural flavoring
vegetable (broth, gum, starch)

NOTE: Soybean oil and soy lecithin are considered to be safe.


*I am not a doctor. Please verify information with your doctor.*

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Wheat Allergy?

If your child is breastfed, the food allergens can be passed through breastmilk and the mother should also avoid wheat protein in her diet.

Ingredients that indicate the presence of wheat protein include:

hydrolyzed vegetable protein
natural flavoring
soy sauce
starch (gelatinized, modified food, vegetable)
vegetable gum


*I am not a doctor. Please verify information with your doctor.*

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From Food Allergy News Volume 15, Number 3 , Feb- March 2006. The full text is not available online, but a synopsis can be seen at www.foodallergy.org


quote:
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When evaluating for food allergy or other allergic problems, it is not uncommon for an allergist to test for foods that a patient has never knowingly eaten or is eating without problems. This is especially true in children with moderate to severe atopic dermatitis (eczema) or asthma, where acute symptoms may not be readily apparent following eating, or in children with a known food allergy.

For example, infants with milk or egg allergy develop other food allergies in about 35% of cases, and children with peanut allergy will develop allergy to at least one tree nut in about one-third of cases.

Negative tests are very reassuring that the food can be ingested safely, except in allergic disorders that are not due to IgE (allergic) antibodies, such as certain types of food allergies that cause symptoms limited to the gut (abdominal pain, vomiting and diarrhea). The problem arises when a child tests positive to a food that he or she is eating with no apparent problem.

Although no diagnostic test in medicine is 100% accurate, nowhere does the discrepancy between a positive laboratory test and the absence of clinical symptoms seem more apparent than in the various tests used to diagnose food allergy. In large part, this stems from a misinterpretation or "over-interpretation" of what the test can actually do.

A positive prick skin test to egg or milk simply indicates that a person has IgE antibodies to milk or egg - that the patient is sensitized to milk or egg. The positive prick skin test does NOT necessarily mean that the patient will experience and allergic reaction to milk or egg.

Overall, less than one half of individuals with a positive skin test to a food will develop allergic symptoms if they eat that food. The larger the skin test wheal (raised area), the more likely it is that someone will react to a food, but no skin test is 100% definitive.

When determining whether someone is likely to react to a food, the allergist must weigh a number of factors, including a detailed history, prick skin test results, and food specific IgE antibody levels. Even after considering all these factors, the allergist may still not know whether a patient will react to a specific food, and a food challenge may be recommended.

Many parents wonder how their children can have positive skin tests or blood tests to food that they have never eaten, since you cannot make IgE antibodies against something that your immune system has never seen.

Because many foods are made up of related proteins (i.e., botanically related, such as legumes - peanuts, peas, green beans, lentils etc), the skin test or blood test may not fully discriminate between various members of food families. Consequently many of the tests will appear to be positive even though the patient will not react when the food is eaten.

The tendency for IgE antibodies to bind to several different related foods is called "cross-reactivity". About 90% of peanut allergic children can ingest all other members of the legume family without allergic symptoms, even though most will have positive skin test results to these foods. About 90% of milk or egg allergic patients can eat beef or chicken, respectively, even though a majority of their skin tests will be positive to both.

Grass pollen allergic patients almost always test positive to grains such as wheat, oat and corn, but they can eat those foods with no problem in the overwhelming majority of cases. Certain pollen proteins are similar to food proteins (such as ragweed pollen and melons and bananas or birch pollen and apple, plum, carrot, kiwi etc.) Consequently birch pollen allergic ("spring hay fever" or allergic rhinitis) or ragweed allergic (fall hay fever) patients will overwhelmingly test positive to the above mentioned foods although they can eat them without problem.

In addition, it is possible that infants become exposed to food proteins form inevitable and unsuspected places in our environment. Researchers have suggested a number of possibilities: processed foods contaminated with other foods, inhalation of food protein in vapor particles from cooking or in house dust, small amounts of food proteins passed in breast milk, residual food on parents or siblings hands contacting the skin of babies with eczema and possibly by contact with good protein in the mother before the child is born.

As noted above, many of these exposures are inevitable, and researchers cannot agree whether some of these exposures - for example, food protein in breast milk or the mother's system prior to birth - may be protective rather than harmful.

IgG antibodies are typically made by the immune system to help protect us from infections; however, IgG antibodies also are made against the foods we eat and are normally found in most individuals. Levels of food-specific IgG antibodies may be higher in some individuals who have various gastrointestinal disorders, but this does not necessarily signify an allergy to the specific food.

A variety of other tests are used to "diagnose" food allergy, but at this point, they must be considered unproven until well-controlled clinical trials demonstrate their value in identifying specific food allergens.

Although certain allergy test are very accurate at detecting and quantifying IgE (allergic) antibodies, they must be interpreted by someone who is highly skilled in the diagnosis of food allergy and who understand the significant clinical limitations of these tests.

Over the past decade, research has enabled the allergist to diagnose more accurately which patients will actually react to a food and when they have likely "outgrown" their food allergy, but in may cases, the physician supervised food challenge is still necessary to provide the patient with the correct diagnosis.

Positive skin test or blood tests to a food that someone is eating regularly with no allergic symptoms, including chronic eczema, hives, or asthma, are never a good reason to eliminate a food from the diet. Only by considering the patients history and allergy test results can the physician decide what foods should be removed from the patients diet.

Hugh Sampson, M.D., Professor of pediatrics and head of the Jaffe Food Allergy Institute at Mount Sinai Medical Center in New York City.

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More extensive list of foods containing dairy allergens (thanks to Gypsy and kidswithfoodallergies.org)


Butters: artificial butter, artificial butter flavor, butter, butter extract, butter fat, butter flavored oil, butter solids, dairy butter, natural butter, natural butter flavor, whipped butter

Casein & caseinates: ammonium caseinate, calcium caseinate, magnesium caseinate, potassium caseinate, sodium caseinate, hydrolyzed casein, iron caseinate, zinc caseinate

Cheese: cheese (all types), cheese flavor (artificial and natural), cheese food, cottage cheese, cream cheese, imitation cheese, vegetarian cheeses with casein

Cream, whipped cream
Curds
Custard
Dairy product solids
Galactose
Ghee
Half & Half

Hydrolysates: casein hydrolysate, milk protein hydrolysate, protein hydrolysate, whey hydrolysate, whey protein hydrolysate

Ice cream, ice milk, sherbet
Lactalbumin, lactalbumin phosphate
Lactate, calcium lactate, lactate solids
Lactyc yeast
Lactilol monohydrate
Lactoglobulin
Lactose
Lactulose

Milk: Acidophilus milk, buttermilk, buttermilk blend, buttermilk solids, cultured milk, condensed milk, dried milk, dry milk solids (DMS), evaporated milk, fat-free milk, fully cream milk powder, goat's milk, low-fat milk, malted milk, milk derivative, milk powder, milk protein, milk solids, milk solid pastes, non-fat dry milk, non-fat milk, non-fat milk solids, pasteurized milk, powdered milk, sheep's milk, skim milk, skim milk powder, sour milk, sour milk solids, sweet cream buttermilk powder, sweetened condensed milk, sweetened condensed skim milk, whole milk, 1% milk, 2% milk.

Milk fat, anhydrous milk fat

Nougat
Pudding
Quark
Recaldent
Renned, rennet casein
Simplesse (fat replacer)
Sour cream, sour cream solids, imitation sour cream

Whey: Acid whey, cured whey, delactosed whey, demineralized whey, hydrolyzed whey, powdered whey, reduced mineral whey, sweet dairy whey, whey, whey protein, whey protein concentrate, whey powder, whey solids

Yogurt (regular or frozen), yogurt powder

Possible sources of milk:

Natural Flavoring
Flavoring
Caramel Flavoring
High Protein Flour
Lactate
Lactic Acid (usually not a problem)
Non-Dairy products may contain casein.
Rice cheese
Soy cheese

Milk derivatives that should be safe for most individuals with milk allergy, but check with your doctor before using:

Lactoferrin
Tagatose (Naturlose)

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Easy 2 page (printable!!!) info sheet you can EASILY share with daycare, family, friends etc

http://www.enjoylifefoods.com/cart/PDF_files/allergen_free_bro.pdf

More links:

http://familydoctor.org/340.xml

http://biz.yahoo.com/prnews/060601/cgth032.html?.v=56

http://www.northjersey.com/page.php?qstr...nFlZUVFeXkxNQ==

http://www.theledger.com/apps/pbcs.dll/article?AID=/20060530/NEWS/605300302/1326

http://allergies.about.com/od/anaphylaxis/a/aa011501a.htm

http://www.kitsapsun.com/bsun/fe_health_fitness/article/0,2403,BSUN_19073_4731388,00.html

http://www.wcnc.com/news/local/stories/wcnc-052406-al-peanut_allergies.1ae5bec4.html

http://www.app.com/apps/pbcs.dll/article?AID=/20060521/LIFE10/605210321/1006/LIFE

http://www.smh.com.au/news/allergies/when-food-is-fatal/2006/05/19/1147545489550.html

http://www.upi.com/ConsumerHealthDaily/view.php?StoryID=20060512-040611-9648r

http://www.foodnavigator-usa.com/news/ng.asp?n=67525-milk-allergies-nestle

http://today.reuters.com/news/newsArticl...;archived=False

http://www.kansascity.com/mld/kansascity/living/14474088.htm

http://www.fankids.org/FANKid/Basics/FoodAllergyBasics.htm

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Top 8 Allergen Free Brownies


Dry Ingredients
1 1/2 C whole barley flour
1 C whole oat flour
1 C sugar
1/4 C cocoa powder
4 tsp egg replacer or tapioca starch
2 tsp baking powder
1 tsp salt

Wet Ingredients
2/3 C canola oil
1/4 C maple syrup
2 tsp vanilla extract

Additional Ingredients
1/2 C rice milk (I use water, but you can use any liquid you want, cows milk, soy milk, coconut milk)
1 C chocolate chips

Preheat oven to 350
Spray a 12X9 baking pan with cooking spray
Mix dry ingredients together and set aside
Put wet ingredients in a bowl and set aside
Put the chocolate chips and liquid of choice in a microwave safe bowl and melt on medium heat stirring frequently until all chips are melted and mix well with liquid of choice.

Add wet ingredients to chocolate mixture and stir well.

Pour wet mixture into dry ingredients and stir gentle until just mixed.

Spread into pan and bake 40-50 minutes until top has crusted over.

Allow to cool and serve

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Breastfeeding when baby has food allergies
http://seattletimes.nwsource.com/html/living/2003226186_nursing27.html

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otes from the 2007 FAAN conference

Food allergy prevalence is increasing and it’s becoming harder to outgrow.

Only 60-70% outgrow milk allergy now (if RAST was EVER over 50 for milk you only have a 10% chance to outgrow milk).

Only 20% of egg allergy is outgrown by age 5, but 80-90% egg allergy outgrown by age 16.

A study showed that 8% of kids who outgrew peanut allergy had the allergy return, but that was because they avoided peanuts after they outgrew the allergy. For those that ate peanuts on a regular basis, they maintained the ability to consume peanuts, allergy did not return.

Sesame is now added to FAAN common food allergy list. Dr. Wood feels it’s number 4 on the list: milk, egg, peanut, sesame, then tree nut in terms of ranking. FAAN is working on collecting information about sesame allergy. It will take some time, but they CAN add sesame (and other foods) to FALCPA in the future. When this will happen is unknown. More studies on prevalence have to be done but they are working on it. If you have sesame allergy or concerns you might want to contact FAAN to find out more.

Food allergens are passed thru breast milk, the very allergic can have a major reaction. They showed a slide (photo) of a breast feeding child whose mother was on an elimination diet for child’s allergen, mom caved on her b-day and ate the allergen, child had a severe reaction.

40-50% of children with eczema have food allergy as the cause. Egg is most common cause, followed by milk, peanut, soy, wheat, fish.

Eczema is harder to control than asthma.

We often hear people say that kids with food allergies commonly develop more food allergies. Statistically it’s >30% develop more food allergies. On a personal note, I asked Dr. Wood during a break if my son was a ticking time bomb and do I need to worry that a sudden eczema flare is a new allergy. He said no. He said if we knew which food allergy my son developed 1st, and let’s assume it was milk, then his egg, peanut, and tree nut allergies are the “other” food allergies they are talking about. Even though there were all diagnosed at the same time. And once kids are around 3, we don’t expect to see more food allergies developing – except possibly shellfish which tends to develop in adults.

90% of hives will occur within 30 minutes of food ingestion if they are going to happen. 100% within 2 hours of food ingestion. And yet 20% of anaphylaxis cases do not present with hives at all and 80% of fatal anaphylaxis cases did not have any hives. Don’t depend on hives as a sign of trouble, they may not be there.

ONLY respiratory symptoms are more likely to be caused by environmental/seasonal allergies. If respiratory symptoms were ONLY thing you are seeing then food allergies would not be the 1st, 2nd, or even the 3rd thing they would look to as the culprit.

Oral allergy syndrome is not included in the food allergy prevalence rates. The rates would be much higher if they did so.

You have a 50% chance of having OAS if you have a high tree pollen allergy, but cooking the fruit or vegetables allows you to eat it without symptoms.

When eosiniphils are found in GI tract they think first and foremost about underlying food allergy as the cause.

It is possible for some kids to be perfectly fine until adolescence and then they develop EE.

You can have allergic EE caused by environmental allergies, it’s not always from food.

Consider oral challenges for milk, egg, peanut when RAST is a 2 or lower. That is when you have 50/50 chance of passing. For tree nuts, look to challenge when RAST is between 2-5; for soy 10-20; for wheat 10-30.

On elimination diet to see if food makes a difference, Dr. Wood suggests keeping food out of diet for 3-4 weeks.

There may be some use for probiotics in preventing allergy. They are still researching this. This would only work for pregnant and breastfeeding mothers to help lessen chance of child being born with/developing food allergies. It would not help a 2 year old who already has a food allergy. Probiotics are still being studied and they do not recommend pregnant or breastfeeding mothers take these at this time because studies are not clear on benefits/risks.

Under FALCPA an item can be labeled “non-dairy” and still contain casein. READ THE LABELS.

Consider “processed on same equipment with” as another version of a may contain statement. They are trying to tell you something. The allergy statements of may contain, shared equipment, same facility etc are VOLUNTARY and mean different things to different companies. If they put one of those t on the label they are trying to warn you of something. Pay attention, don’t take risks.

They showed a label for popcorn that contained fish and wheat in addition to milk. Seriously folks! and it’s a common brand. READ THE LABEL.

Don’t go by allergen statement alone. It’s voluntary. Just because you don’t see a statement doesn’t mean the food doesn’t contain allergens. READ THE ENTIRE INGREDIENT LABEL.

I will say it one more time: READ THE INGREDIENT LABEL EACH AND EVERY TIME.

Itchy mouth is often the 1st sign of allergic reaction and usually happens within seconds of food hitting the mouth. Risk of pre-treating with antihistamine is you could lose this early warning sign that otherwise would have told you to stop eating a food. (personal note on this, it does not happen to my son – he has happily consumed his allergens without an itchy mouth only to have a severe reaction follow).

Antihistamines have NO LIFESAVING CAPABILITY. Only EPINEPHRINE has life saving capability.

One more time: Antihistamines have NO LIFESAVING CAPABILITY. Only EPINEPHRINE has life saving capability.

It is common to have skin, GI, respiratory reactions in children but rare to have cardiovascular system involved (shock) in kids. Not impossible, just rare. Kids cardiovascular system can take a lot and bounce back.

Reason to go to ER after EpiPen is NOT because EpiPen is dangerous in any way, it’s because they want to monitor you for a bi-phasic reaction which can have more severe symptoms than initial reaction. Epinephrine is not dangerous and won't hurt if you use when you don't need it.

Prior reactions do not predict future reactions. The sensitivity of the individual and the amount of the allergen are the biggest determinant in how bad a reaction will be.

Those with peanut and tree nut allergies hit their peak PN TN sensitivity during the teen years.

Vast majority of deaths had a delay in getting epinephrine by 30 minutes or more.

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CONTINUED FROM ABOV


MYTH: Anaphylaxis is easy to avoid if you avoid the food you are allergic to. False. You need an EpiPen for food allergies. It’s not if you react, it’s when. 50% of kids with peanut allergy will have at least one reaction in a 5-year time period. 75% of peanut allergic kids will have a reaction in a 10-year time period.

Usually only ONE dose of steroid is needed. It is given in ER to help prevent a bi-phasic reaction.

Recommend having 2 doses of epinephrine available. 2 EpiPens or 2 Twinjects. Recommend 2 Twinjects because the second dose in Twinject can be difficult to access in the heat of the moment. You cannot save this second dose. Once Twinject is activated you either use second dose or give to EMTs to dispose of, you do not save it until you can refill Rx. An air chamber is activated in the Twinject and epinephrine is not stable for more than a couple of hours once that happens.

Rabbit studies in Canada are looking at sublingual epinephrine administration. No other info given aside from this statement.

General guidelines for when to give EpiPen: Get a plan in place with your doctor specific to if X happens then do Y… Also, look at prior reaction history. Bad reaction history with small exposure of allergen, you probably should be advised to give EpiPen immediately upon known ingestion. Give immediately if there is co-existent asthma especially if reaction is getting worse. And look at symptoms. Are they localized or generalized? Systemic/generalized reaction is anything more than localized hives. Give EpiPen for ANY respiratory symptoms and/or for any repeated GI issues such as vomiting.

Majority of reactions at school happen in the classroom, not in the cafeteria. Usually from food trading or class projects with food. A no food trading rule is important. If class/school won’t go for it then YOUR CHILD needs to have this rule and follow it.

Educating schools/teachers about food allergies is not a one time deal. You have to continue education throughout school year.

At 1st meeting with school ask what school will do if there is a teasing or bullying situation. Get a plan in place BEFORE it happens, don’t accept a wait and see approach, then you will be playing catch up.

Empower your children to speak up and to honor and recognize early reaction signals. Most children don’t speak up because they don’t want to believe they are having a reaction. This will delay them getting help. Teach them to tell the teacher or some other adult if they are having a reaction and if they aren’t believed or being responded to then they should find another adult and another until they get someone to respond.

If you get a call from school saying “your child is having these symptoms, what do you want us to do?”… You should answer that they need to LOOK at your child’s written emergency plan and do what it says. Tell them to look at the plan and implement it. They should not call you and describe symptoms over the phone for you to try and evaluate the seriousness of the situation.

Laws about keeping medication under lock and key do not always mean a physical lock and key. Often a child lock that an adult can work easily is enough to meet the law.

Go into school every few weeks and ask to see the EpiPens. Make sure they know where it is and can get to it fast. This is part of the continuing education you need to do.

Cafeteria people should be trained about EpiPen use and allergic reaction symptoms. They see and hear a lot that happens during lunch and can be of great value.

If you can limit food in classroom in early grades (K-2) it’s good. By 3rd/4th grade, kids can better advocate for themselves. Their friends in middle school and high school are very important. They can help keep kids safe -- they are their safety net. Kids have to be independent by college because they will be on their own. Start teaching them how to handle their allergies while they are young, don’t wait until they are teens.

As kids get older don’t single them out with a big sign on the front of the classroom door about their allergies. Most kids don’t want designated seating as they get older. Try not to isolate them. Kids can choose to eat elsewhere than cafeteria or can choose peanut free table but under 504 a school cannot make them sit elsewhere/isolated.

Under Federal law if a school says only nurse can administer EpiPen then they better have a nurse. If they don’t have a nurse then they have to hire one. If they say they don’t have the budget then they have to find the money somewhere.

Parents cannot sign away the rights of their child by signing a waiver – under 504 there is “no provision” for a school to make “free/appropriate education contingent upon release of liability from parent.”

TNX-901 will not be studied further.

Xolair has had major issues trying to get it approved for anti-IgE therapy study. Among problems are safety concerns (cancer) and cost concerns (over $1K a dose). Hopeful that Xolair studies will one day resume.

Chinese herbal medicine is looking promising. In peanut allergic mice who received this treatment they had no reaction to peanut and effectiveness of treatment seemed to last up to a year. Human studies of this will hopefully start in next 3 years. An asthma study with the herbal formula is to start in 2007 and if it proves safe then hopefully it will move to food allergy group.

1st human trials for peanut vaccine will begin as a safety study sometime in 2008 (Hopkins and Mt. Sinai). Safety study looks to see if vaccine is safe, not if it protects against peanut allergy. Have to prove safety first.

Some studies show that oral or sublingual therapy for inhalant allergies are as effective as allergy shots but with fewer reactions.

Which test? SPT or RAST? You get more information from RAST in the long run. Without RAST you are missing a piece of information. You should follow the numbers for an important part of the picture.

Benadryl or Zyrtec for allergic reaction. Fast melts should work as well as liquid but there haven’t been any studies to look at this.

Claritin is slowest acting antihistamine – it takes 1-2 hours to start working. Claritin ready tabs dissolve fast but the medicine doesn’t start to work fast. Do not use for reaction.

Dr. Wood prescribes EpiPen Jr. for children starting around 15 pounds. Under that it would be vial and syringe.

Albuterol won’t do a thing for the upper airway swelling that kills people in anaphylactic reactions.

Don’t need to avoid coconut if you have a tree nut allergy unless you have a problem with coconut. You should avoid shea nut if you have a tree nut allergy.

If you want more information on Hopkins allergy studies call 410-502-1711 or email pediatricallergy@jhmi.edu

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CAKE!!!!!!!!!!!!

INGREDIENTS:

* 1 1/2 cups unbleached all-purpose flour
* 1 cup sugar
* 3 tablespoons unsweetened cocoa (or leave it out for white cake)
* 1 teaspoon baking soda
* 1/2 teaspoon salt
* 1 teaspoon vanilla
* 1 teaspoon vinegar
* 5 tablespoons canola oil
* 1 cup cold water

PREPARATION:
In a large mixing bowl, mix flour, sugar, cocoa, soda and salt. Make three wells in the flour mixture. In one put vanilla; in another the vinegar, and in the third the oil. Pour the cold water over the mixture and stir until moistened.


Pour into 8 x 8-inch pan. Bake at 350°F. oven for 25 to 30 minutes, or until it springs back when touched lightly.


Coconut Cream Frosting

INGREDIENTS:

3 cups confectioners' sugar
1/2 cup shortening
1/2 cup Nucoa Margarine
1 teaspoon vanilla extract
1 to 2 tablespoons coconut milk
FOR CHOCOLATE FROSTING ADD 1/4C Cocoa

PREPARATION:

Put all shortening, margarine & vanilla extract in bowl & blend. Add confectioners sugar and mix on low speed until well blended and then increase speed to medium and beat for another 3 minutes.

Add coconut milk and continue to beat on medium speed for 1 minute more, adding more coconut milk if needed for spreading consistency.

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These do contain some soybean oil, but I'm sure it can be adapted, and it is wheat, dairy, nut, egg, corn (check the vanilla!)-free.

1 C shortening, melted
2 C sugar
2 tsp molasses (more or less)
2 Tbsp vanilla
2 Ener-G egg replacers
1 3/4 C white rice flour
1/2 C potato flour
1 C oats
1/3 C sunflower seeds
1 C dairy-free chocolate chips
1 tsp pumkpin pie spice
2/3 C dried cranberries (w/o corn syrup)
1 1/2 tsp baking soda
1/2 tsp cream of tartar


Mix it all together. You can half the amount of rice and potato flour and add one cup of gluten-free baking flour instead. If the mixture is way too dry, add a little extra liquid of your choice. Pat into a greased 13x9 dish (may be messy, because it is too thick to spread well with a spoon) and bake at 350 for around 35 minutes. It is crunchy and chewy and very yummy.

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ORANGE SPICE PANCAKES AND SYRUP

These are light and crunchy, and a perfect sweet snack at any time.

1 C buckwheat flour (this isn't wheat, despite the name)
2 Tbsp sugar
1/2 tsp salt
1 C rice milk or orange juice
1 tsp grated orange peel OR orange extract
1 egg replacer
2 tsp allspice OR cinnamon
1/3 potato starch or tapioca starch
1 tsp baking soda

Heat a frying pan with enough canola oil to coat the bottom. Mix all ingredients with a mixer till well-blended. Drop by tablespoon into the hot frying pan, turn when bubbles have formed. Add more canola oil as necessary to keep them crispy. They taste almost like funnel cakes.

Corn-free syrup

Boil 1 1/2 C sugar with 1 cup water. Add a tsp molasses and vanilla. If desired, add some orange peel or extract for a delicious flavor.