I'LL KEEP this one short(ish) and not very sweet. You've no doubt heard of Alpro, one of the leading purveyors of soya stuff, from milk to yoghurts, cream and custard. For kids battling dairy allergy their calcium enriched products are a staple part of their daily diet. In fact, Alpro is on the list of brands recommended to dairy allergic kids by specialist dieticians and allergists.
After quite a journey, we as the parents of allergybabe, are happy to finally have reached a “steady state” (as the chemistry profs would say) in managing our son’s food allergies. We know what foods are safe for him, where to shop these items and what to cook with these foods. We developed a soothing routine in dealing with his food allergies in our every day life.
So I did not worry to much when I started to look into several options where to celebrate allergybabe’s third birthday. Keeping in mind it will be mid-november, and that our 2b2b London apartment would barely cope with more than a handful of guests, we opted for an indoor location. There are lots of options for little ones to celebrate their special party. E.g., a museum just a stone throw away from where we live offer lots of packages, they have a great indoor play area, a party room, and catering. Yes, they do cater. THEY cater. They are so proud of their catering standard, that they have ridiculous demands for anyone wanting to bring in their own (SAFE) foods:
I have had another conversation with our catering team regarding your request to provide your catering yourself. It could be possible but there is quite a process that would need to happen to be approved. We would require you to have £2 million public liability insurance as well as references for 2 previous grade 1 listed venues that you have provided catering for. Also you would need attend an interview with our catering manager. This I imagine will not be possible option for you but if you know of a caterer who is suitable for your son’s needs, I would suggested they may be able to provide the above. There would also be a facilities charge of around £100. If you are interested in this option, I can put you in touch with the relevant people to get the ball rolling.
And no one else can bring in foods (they allow you to bring in the birthday cake, though). After trying to explain our unique situation (highly food allergic three year old to 7 of the big eight, apart from other food allergies), they still did not want us to bring in the food. I then suggested a couple of foods their catering could provide if they would avoid cross contamination (a certain brand of crisps, sliced veggies and fruit, juices, a certain brand of biscuits). This is the reply:
I have now had feedback on your request with regards your menu below.Our catering team will not be able to provide the catering on this occasion for the following reasons:They cannot guarantee an allergy free environment and are not willing to take the risk of providing the catering on this occasion. Also as this request is not our standard pre-priced offer and will take time to plan and order the end cost would be far higher than our regular offer.
The only option would have been not to have catering at the party. Do we as parents of a food allergic child demand too much? Too much understanding, too much trouble, too much compassion?
All we want is that at his special day, our food loving son should not worry about foods around him. Just this one day he should be able to enjoy himself, eat, drink and have fun.
I understand that the above – in extracts- mentioned conversation could have taken place with 90% of the catering industry. This conversation was not an exception. That is the sad truth. I understand that people do not want to take any risks. I understand they are scared to make a mistake. Every kitchen staff is trained in maintaining hygiene standards. Why is it so hard for them to confidently state that they can avoid cross contamination? Is it the lack of knowledge?I demand (and I will repeat this like a mantra for the rest of my life!) that every single person in the industry who ever has the responsibility to cook or cater for any human being, is to be trained properly to be able to accommodate food allergic individuals. I demand proper training.
I believe in Confidence through Knowledge.
PS: I also experienced lovely and very thoughtful staff everywhere on this lovely planet, and especially in the UK. The general rule is: the more expensive the restaurant, the better they are with food allergies and other food related disease. But, there is a growing number of other restaurants (especially chains), that are getting better and better in dealing with special dietary requirements.
Every 20th of the month, 20 questions will be asked. To whom? Amazing people who deserve to be in the spotlight. Allergy friendly people. People, who truly make this world a safer place.
Look who is first-
Fantastic Nia from Nia’s friendly foods. Never in my life have I met a more enthusiastic, commited and motivated business woman.
And here they are, the twenty questions:
In reference to yesterday’s #allergyhour on twitter, the topic of the influenza vaccination came up and I got inspired to post the latest developments in regards to the flu vaccine’s application, safety and allergenic potential.
In the UK, the flu vaccine is currently administered to high risk children (kids with comorbidities such as severe asthma) only and requires an intramuscular jab. From 2014, an annual influenza vaccine for all children will be introduced into the UK immunisation schedule, to reduce the morbidity and mortality associated with this disease. This new vaccine, known as LAIV (Live Attenuated Intranasal Vaccine) is given by a spray into the nose and has been successfully used in the US for a couple of years. You can see the results of a NEJM study here. The new vaccine is grown in hen’s eggs and contains egg protein, and there are NO existing data on the safety of LAIV in egg- allergic children. To prove the safety of the intranasal vaccine for egg allergic children, the SNIFFLE study will be performed in a multicentre setting shortly. The new application sounds very promising and I am looking forward to the results. Will keep you posted.
Among the allergy community, there is a lot of doubt and uncertainty about the safety of the MMR vaccine in egg allergic children. This post sums up the latest research and recommendations.
What is the MMR?
The MMR Vaccine protects from measles, mumps and rubella. It is given around 12 month of age and again around 3 to 5 years of age. It is an active virus, consisting of weakened forms of the viruses.
Why is there a concern about giving the vaccine to egg allergic children?
The vaccine is cultured on embryo chick fibroblasts.
Though, it does not contain any hen’s egg protein. If traces of hen’s egg protein are detected, they are highly processed and their concentration is very low.
a danish study published in 2013, investigating 32 children with egg allergy who had been referred to get their mmr vaccination (Priorix MMR) at hospital. None of the children had severe reactions
Published in September last year, the authors claim their study being “one of the largest studies looking at childhood vaccinations performed in a hospital setting for children who are ‘at risk’ of allergy, anaphylaxis or hypersensitivity”. A total of 374 patients (with a medical history of anaphylaxis, allergic reaction or strong suspicion of a severe adverse reaction against egg) contributed to the findings. All of the children received their vaccinations in a hospital setting. “Only six patients (1.3%) experienced an immediate reaction to a vaccination. All reactions were minor”. The authors conclude that “A significant number of referrals were unwarranted and the majority could have been safely managed in the community”.
Latest expert opinion (BSACI, 2007):
The MMR has an excellent safety-record and may be administered to all egg-allergic children in a primary care setting. As with any other immunisation, adrenaline should be readily available in case of rare and unpredictable anaphylaxis. MMR should be postponed if child is unwell. A hospital based application is necessary after a previous severe reaction to a vaccination (MMR or other) after a specialist assessment. It might be possible that the reaction occured due to an allergy to other components of the shot (gelatine (beef and lamb allergy) or antibiotics (neomycin or other)).
Other vaccinations and egg allergy:
Flu vaccine: updated every year, the content level of ovalbumin, varies every year, some jabs do not contain egg. A split dose (1/10 of single dose, than 9/10 of dose) of the vaccine might be an option. Consult your GP or specialist for up to date advise.
Yellow fever vaccine: unsuitable for children with egg allergy
So what is the verdict?
Latest research suggests that the likelihood for an egg-allergic child to react to the MMR vaccine is about the same as to any other non-egg containing vaccine. Reactions are rare but non predictable due to other substances like gelatine and antibiotics.
Even though the MMR seems to be a safe shot, it is always recommended to seek advise from your specialist if in any doubt. Every child reacts differently and the risk profile of your allergic child can be best assessed by your trusted allergist.
Sources: the anaphylaxis campaign, nhs choices, pubmed, bupa, bsaci
Please note that this post does not imply any medical advise. Please always consult your specialist.
Every 10th of the month, we will take the opportunity to refresh the basics in case of an emerging anaphylactic reaction.
So we got out our emergency kit, checked all bottles and pens, their expiry dates and contents. And, every family member had a go at demonstrating the others how they would administer the Epipen. All did a really good job:
“Blue to the Sky, orange to the thigh”: reminds you what part is the top and what is the bottom (containing needle):
Take off the blue cap, form a fist around the pen, and apply the orange end which contains the needle firmly in the outer part of the upper thigh:
Hold the pen tightly for 10 sec (one elefant, two elefants…, 10 elefants), remove the pen and rub the thigh.
If the patient is lying down, do not move him.
Call 999 and wait for the ambulance. If no improvement within 5-7 min, apply another epipen to the other thigh.
So, when will you give it a shot?