Baked Milk Challenge

Last week we had E retested for her dairy, egg, and peanut allergies.  It’s been six months since her last blood test when her allergist was hopeful she was starting to outgrow her dairy allergy.

I already knew the peanut allergy was still going strong.  A month ago E had a reaction from cross contamination.  I gave her a piece of toast with cashew butter that was fresh ground in a machine right next to a peanut grinder.  Never again.  This pic was taken about six hours after exposure:

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I also expected we were still dealing with an egg allergy since we’ve had some suspected cross contamination reactions there as well.  I was correct in both of my suspicions–egg and peanut are both too high to do anything but retest again in six months and see if the IgE numbers have decreased any.

E’s milk numbers dipped low enough, though, that her allergist allowed us to try a baked milk challenge in the office.  They gave me a recipe for muffins (we still had to use an egg substitute) and we set up an appointment to monitor E after she ate them to see if she had any reactions.

Our appointment was at 8:45, almost an hour later than E’s normal breakfast time.  She would have to eat two muffins for the challenge, so I had to starve the poor child until we got to the allergist’s office.  By the time the challenge began, she was so excited to be presented with the 1/4 of a muffin she was allowed to start out with.  When she finished, we waited 20 minutes and monitored for a reaction.  There wasn’t one.

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Next she got half of a muffin and we watched her for 20 more minutes.  There was still no reaction.  I texted updates to B about every 15 minutes.  The last leg of the challenge was for E to eat a whole muffin, and we would monitor her for 45 minutes.  After the whole muffin, I texted B and we were both so thrilled that E wasn’t reacting.

No sooner had I texted him that last update than I noticed it:  all of my excitement and hope and optimism melting away as a rash appeared on her left cheek.

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I stepped into the hallway and summoned the allergist, who came in and examined E’s face.  He noted the rash and asked me to step out and let him know if it spread or got worse.

Over the next 20 minutes, the rash began to fade, but then more began to appear on other parts of her face–the other cheek, below her eye, in between the eyebrows.  I knew what this all meant but I refused to believe it until the allergist said the words himself: that E hadn’t passed the challenge.

What this means:  despite E’s super low IgE numbers for dairy, she can’t completely tolerate baked milk.  What this doesn’t mean:  that there’s no hope and we’re not making progress.  Though E reacted, it was mild enough that her allergist wants to continue exposing her to very small amounts of baked milk regularly in the hopes of building up a tolerance.  For the next six months, we’ll give E half a muffin, three times per week.  When we retest at her second birthday, the hope is that her numbers will have come down significantly and we can redo the challenge and pass with flying colors.

What THIS means:  I’ll be baking.  A lot.  Every single week.  The muffins need to be fresh, so there’s no batch baking and freezing here.

What THAT means:  I picked a good time to get back into running.  Mmmmmmmm muffinsssssss.

I had a nice little cry after we left the allergist’s office.  It’s a step in the right direction and for that I’m grateful.  But it’s tough, knowing that on your child’s second birthday she will still be unable to tolerate so many foods in a world that is awfully insensitive to dietary needs.  It’s a hard thing to accept.  But we will keep fighting and I will continue to hope.

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