Beware of the Headlines

The recent news explosion in the allergy world titled:

Landmark Study May Change How We Feed Peanut Butter To Infants

High-Risk Infants Fed Peanuts Developed Allergy At Lower Rate Than Other 

Babies - Study May Pave Way for New Prevention Strategies

http://community.kidswithfoodallergies.org/blog/landmark-study-may-change-how-we-feed-peanut-butter-to-infants-to-prevent-peanut-allergy

Reading these headlines, one may think that the allergy problems have been solved. But when we read the article further we come across the following sentence.

“First, every child in this study underwent skin prick testing and physician -supervised oral challenge towards peanut before eating it at home for the first time. About 10% of possible study participants were deemed too risky to enroll due to the large size (greater than 4 millimeter) of their skin test,” he noted.

So yes, the results are great and very encouraging for the children who are either negative (i.e. were not allergic to peanuts in the first place, but had eczema and perhaps another dietary allergy) or those who were moderately positive and hence at risk of developing a full on peanut allergy. However, for the children who already had an allergy this is not the right way to go.

There is current research work underway by certain exceptional people to try to solve the allergy problem for the children who have an allergy from the time they are born. Something myself as well as many other parents unfortunately have seen since birth. When my daughter was born, she was exclusively breastfed, but she started having reactions and I started noting what I eat. So by the time she was eligible for an allergy test at 6-months, I already knew what her allergies were and the test results were just a confirmation. By then, I've already eliminated all of those triggers from my own diet. This is not a unique story, this is a story that I've heard from a number of other moms.  This really points to the fact that we need to re-write all of our books when it comes to feeding.

However, something that we did was when my daughter got a bit older, I can't recall the exact age, but would guess about 11-12 months. What I started doing is introducing one food item at a time to my diet for a week. If all goes well, I would give it to her directly the following week. She did outgrow a number of her former allergies, but there are still certain ones that had given her the most severe reaction, which are still an issue.  The next step is trying them in cooked form. But of course, this is all under supervision both my own and her allergist.  There are also more tests available today that can help break down the components further.  I think slowly but surely, we'll tackle them one by one. But it is not a simple process and nothing is guaranteed.

Some truly inspirational work that I've come across has been done by Dr. Kari Nadeau, a must-read NY Times article:

http://www.nytimes.com/2013/03/10/magazine/can-a-radical-new-treatment-save-children-with-severe-allergies.html?pagewanted=all&_r=0

Link to her Research Page:

http://nadeaulab.stanford.edu/research.html

She truly is my hero. And has been my inspiration in the whole process. She is very open about the difficulty of Immunotherapy to foods both on the medical as well as financial / political side.  Dr. Nadeau went without salary for 3 years to conduct her studies, because funding for research was minimal compared to the typical drug company-sponsored research. 

Just to give you a sense of the magnitude of her undertaking and the precision of the allergen doses required for immunotherapy, I'm posting this excerpt:

Nadeau experimented with blood samples of allergic patients and was encouraged to see that the allergens seemed not to interact with one another. She consulted with senior colleagues in the field to see if anyone would collaborate on a multiallergen study, but no one was interested. Scientifically the results would be harder to interpret than single-allergen trials. Moreover, each allergen would require getting separate F.D.A. approval, and it was difficult to get even one application approved. When she found herself home sick in bed with a virus for a few days in 2011, she decided she would “knock them all out” and wrote 13 Investigational New Drug Applications, each 90 or so pages long, and soon received F.D.A. approval for each one.

Even more daunting was the question of how to finance the study. Each child would cost between $20,000 and $30,000 to treat annually, and treatment could take several years. Flour would have to be manufactured from the proteins of each allergen to prepare precisely measured, minute doses, and it would have to meet the high purity standard for drugs.

Simple Joys of Life

It is amazing how when you're faced with feeding an allergic child and you yourself have no dietary restrictions, you're initially in a panic of "what am I going to feed them so that they'll actually enjoy the food?!" I have to note that I am a foodie. But then as you educate yourself, you realize that one can have just as much variety of tasty meals and treats as a person without allergies. And it comes with a bonus - they are much healthier!

Recently our daughter turned three and for her third birthday, I decided to surprise her with a very special treat. A rich Chocolate Cake.  She currently has the following food allergies: dairy, egg white, nuts and seeds, and legumes. So initially one might wonder, how you make a rich chocolate cake without things like cream and butter e.t.c. and especially the frosting?!

I have to say a huge thank you to the minimalist baker for giving me pretty much the whole recipe that I just had to slightly modify:

http://minimalistbaker.com/one-bowl-vegan-chocolate-cake/

The only thing I swapped out was Soy milk (next time I'll do Coconut milk) for the Almond Breeze that they have in their original recipe.  It was absolutely one of the best chocolate cakes I've had and all of the family and friends that tried it at the party were simply shocked that it was allergen free!

Finding the Trigger

Any parent of an allergic child or a child with eczema will agree that life is always an adventure. You never know what the next trigger is and where it will come from.  You've done the skin tests, you've done the blood work, but even it all of those tests they still don't capture every possibility. As an example, there are hundreds of varieties of mold, so even though your test may have come in negative for the common three, you still have plenty more potential triggers to discover.  The food tests are getting more finite, where you can do Component testing for a number of common food allergens. But when it comes to environmental exposures (i.e. where I'm defining the environment as the conditions that surround someone or something : the conditions and influences that affect the growth, health, progress, etc., of someone or something). Therefore, the environment is both inside your home and outside.

As you've learned, our previous adventure has been linked to our mattress selection. So now that we're back to peaceful sleep with our daughter resting on the all-natural organic Berkeley mattress that is cozily resting on an all-wooden bed, we introduce the wardrobe.... the STUVA system from IKEA. What we loved about it is how modular it is! It's basically a custom closet / toy storage / play area all in one and you can build it out to be 100 inches high to take advantage of the high ceilings of a charming pre-war apartment - all at an affordable price.

After bringing it home, we decided to only assemble one section of it to start.  As we began the assembly a sneaky thought passed - will our daughter be ok living with it in the same room?  From my online research that I've done, IKEA adheres quite high standards for their particle board / fiberboard furniture as they manufacture the same inventory for all of the markets they operate in, so it doesn't vary from market to market. This means that this wardrobe has passed higher EU standards for emissions from material / glues / coatings e.t.c. They are also amazingly transparent when it comes to product information on the materials used (quoting the product description verbatim):

Product description

Frame:
Board on frame: Honeycomb structure recycled paper filling, Particleboard, Fiberboard, Foil, ABS plastic, Foil
Side panel: Particleboard, Honeycomb structure recycled paper filling, Fiberboard, Foil, ABS plastic, Foil
Back panel: Fiberboard, Foil

Door/ drawer front:
Fiberboard, Acrylic paint

Drawer without front:
Main parts: Particleboard, Foil
Drawer bottom: Fiberboard, Acrylic paint

Shelf:
Particleboard, Honeycomb structure recycled paper filling, Foil, ABS plastic

Clothes rail:
Clothes rail: Steel, Pigmented epoxy/polyester powder coating
Support: Polypropylene

Wire basket:
Steel, Pigmented epoxy/polyester powder coating

The only question remaining is - will we be sleeping tonight?  Well, it turned out we didn't.... But at least we know the drill by now - i.e. remove the item in question.  Our daughter's room returned back to it's original "steady state". A wooden bed with the Berkeley mattress. A wooden toy organizer (by the way it is from IKEA - but it's all solid wood), a wooden doll crib, a wooden chair, and a wooden book stand with books. Back to the minimalist state to see if sleep can now resume again and windows open for a couple of hours to air-out any remnant odors, bed sheets changed just in case moving the wardrobe resulted in any fiber dust on her sheets, and floors and surfaces wiped with a damp cloth.  Sure enough - sound sleep returned the following night.

We're back to the drawing board on the solution for the wardrobe.  We know we need to stick to solid wood at this point, we know we need to pay close attention to the stains that were applied to that wood and the recency of application.... Let the search begin!

Sweet Dreams: is the secret in your mattress?

If you're a parent of an allergic child you know that sleep is the most valuable commodity in your life! Sleepless nights don't ever seem to end. Even when your child is a toddler, there are numerous nights that you spend scratching and comforting your little one so that they can sleep in peace. Sometimes you know the triggers, some times you don't..... which brings me to the topic of mattresses.

When our daughter was a few months shy of being three, she was growing out of her toddler-bed-from-crib conversion and ready for a big-girl bed. She was thrilled to upgrade and so were we.  We picked out a Maxtrix bed (http://www.maxtrixkids.com/), which is awesome of city living. They are made out of  wood and super adjustable. We totally love it! 

Of course we also needed to get a mattress to go with it. So after looking at the mattresses available at the store and explaining to the shop attendant that our daughter has allergies, he recommended we go for the EverTrue Grand (http://evertruemattress.com/). It comes with an impressive resume, an adorable picture of a happy baby on the front page and a line up of certification, including international recognition, which means higher bar and stricter testing criteria than if it was US alone.

Quoting the EverTrue Collection description followed by a sweet adorable and happy baby:

"Introducing the EverTrue Collection, a beautiful and modern line of crib mattresses, handcrafted from the highest-quality materials. The new line consists of five innovative foam mattresses, with exceptional features and designs. Each EverTrue model uses our exclusive SecureCore Technology™, a sleep system engineered to enhance air circulation for sound sleep, proper development and safety. EverTrue products not only meet, but exceed the industry’s highest safety standards, each earning the coveted Greenguard® Gold seal of approval giving expecting parents the peace of mind to sleep like a baby."

That's the mattress we purchased. We were excited to get the delivery, but then unexpected events followed. Week one, we were loosing sleep, our daughter took forever to fall asleep and started waking in the night and not just to use the potty and took longer and longer to fall back asleep. We initially explained it as an adjustment period for the new bed, even though she totally loved it. Week two, we were exhausted and I couldn't stop questioning the somewhat sweet smell of the mattress (note: I've got a very sensitive nose). We re-read the labels and re-confirmed that VOCs should technically be minor if any as it claims "exceed the industry's highest safety standards". By week three, I grew more and more determined that it was the mattress. I started reading about the mattresses and polyurethane and visco elastic foam and became convinced that we need to consider alternatives. We've done an experiment and moved our daughter to our bed once she fell asleep and she slept better. Not perfect but better. As typical for children her age, they tend to think of their bed as sleep time but their parent's bed as play time, so having her fall asleep on our bed would not be a good idea. We tried a few more nights just to be sure it wasn't a fluke and she was calmer. Of course we still weren't getting all that sleep :).

I've fully plunged to investigate the simplest of mattresses, not VOCs, no memory foam, no polyurethane, no plastic, no fire retardant soaks, e.t.c. And I came across the Berkeley mattresses (http://berkeleyergo.com/). I liked how simple it was, some German coils, an inch of latex for firmness, wool, and organic cotton cover. No flame retardants (wool is a natural fire retardant), no toxins. I also was so lucky to actually find a retailer in NYC who sold it. I was thrilled, my husband was still not fully convinced. He felt that I had it out for that EverTrue mattress! Regardless, after almost four weeks of total sleep deprivation we set out to the store the next morning and bought it.

And then, a miracle.... our daughter slept "like a baby" again! First night we agreed that it could be a fluke... but it continued...

I just want to be clear that I'm not in any way connected to any of the products that I've mentioned here, I'm just sharing our experience and perhaps there is another mom or dad out there who is pulling their hair out wondering why their little one is itching the night away when they've ruled out every possible trigger.... perhaps it's the mattress!

I hope you find this helpful and I am so grateful that there are still companies out there who manufacture truly clean products, clean of man-made material and of toxins.

We know where we are buying our crib mattress for baby #2 :)

Beware of the "Green" labeling

It's quite natural to think that when something is considered being "green" it is safe for both the environment as well as it's inhabitants. However, this is not always the case.

The other day I was researching the Spray Polyurethane Foam (commonly known as SPF) that is widely promoted as a "green" building material for its ability to improve energy efficiency. It insulates better per inch than fiberglass or cellulose, which can mean major energy savings on heating and cooling for the home owners.  However, it the impact on the environment whether during the manufacturing of the raw material or the installation process does not turn out to be quite so "green".

SPF is a formed by combining two parts, side "A" and "B" side materials. The "A" side is known as polymeric methylene diphenyl disocyanate (PMDI) and consists of approximately equal amounts of monomeric MDI and higher molecular weight oligomers of MDI. The "B" side is a polyol blend which typically contains base polyols, catalysts, blowing agents, surfactants, flame retardants, and other additives.

Even though once the compound is mixed and cured it is supposed to be inert and safe for building re-entry after 24 hours in general but depending on the manufacturer, the Environmental Protection Agency (EPA) believes that the material is still very new and not yet well understood. They believe that the potential long-term-off gassing is not fully understood.  Furthermore, they recommend that individuals with a history of skin conditions, respiratory allergy, asthma, or prior isocyanate sensitization should fully understand the product information and consider safer alternatives. That is, if the installation is done properly by someone who is an expect in this area.  So there is still a wild card where the safety of the product is further compromised by the skill of the installer, the quality of the foam, thickness of the application, and ability to properly inspect post-installation.  Furthermore, the EPA also suggests that any maintenance or repair work that disturbs the cured compound (cutting / heating e.t.c.) is a potential health hazard.  Considering this, it is quite unsettling that this is marketed as a "green" building material that is being used during construction on weathering modifications to existing constructions.  

References:

http://www.epa.gov/dfe/pubs/projects/spf/spray_polyurethane_foam.html

http://www.sprayfoam.org/technical/faqs

http://www.greenbuildingadvisor.com/blogs/dept/musings/spray-foam-jobs-lingering-odor-problems

http://polyurethane.americanchemistry.com/Spray-Foam-Coalition/Guidance-on-Best-Practices-for-the-Installation-of-Spray-Polyurethane-Foam.pdf