Speaker 1: Welcome to Katie's Crib, a production of Shonda Land Audio
Speaker 1: in partnership with I Heart Radio. Hi everybody, and welcome
Speaker 1: back to Katie's Crib. Today we are discussing bump bump
Speaker 1: bomb allergies. When you have a new baby, you're super
Speaker 1: scared of an allergy attack, just always, and not even
Speaker 1: like a baby, even when they're like older. You're just
Speaker 1: constantly scared of allergy attacks always from the get go.
Speaker 1: People are giving you advice of what diapers, detergent, to use,
Speaker 1: body lotions, and then forget about it when they start
Speaker 1: eating food. Um, once we get into nuts and eggs
Speaker 1: and shellfish, and you hear stories about kids throats closing,
Speaker 1: and it's basically just complete alarmist, insane fear all the time,
Speaker 1: or at least that's how I felt. Also, my husband
Speaker 1: is literally allergic to everything, like when you do those
Speaker 1: little prick things, the fifty things on your back, forty
Speaker 1: eight of his rise up, but none of his are
Speaker 1: the death ones, but they're all all like, he's basically
Speaker 1: allergic to every single fruit and vegetable and whatever. So
Speaker 1: I was convinced when I had my son, like he
Speaker 1: was going to be the most allergic kid on the planet. Um,
Speaker 1: so here to bless us with their expertise and ease
Speaker 1: my anxiety and hopefully some of you all out there
Speaker 1: listening is Dr Tricia Lee and my dear friend and
Speaker 1: fellow mom and lawyer, Julie Feldman, Um Doctor Triciallie is
Speaker 1: an adult and pediatric allergist and immunologist. She's board certified
Speaker 1: with the American Board of Pediatrics and the American Board
Speaker 1: of Allergy and Immunology. Her research has included clinical trials
Speaker 1: and asthma and food allergy, and she has published articles
Speaker 1: and presented at national meetings about immune deficiency, food allergy,
Speaker 1: and infectious disease. Julie is a super fancy entertainment lawyer
Speaker 1: who has two little girls who do both face serious
Speaker 1: allergies and um she's been in this world as a
Speaker 1: mom for a few years now. Um So, Julie, let's
Speaker 1: start with you talk to me about your two daughters,
Speaker 1: their ages differences, and what they're allergic to and what
Speaker 1: were their initial symptoms which I can repeat those questions
Speaker 1: back if there were too many of months. Okay, So
Speaker 1: I have two girls. Alexandra, who we call Ali, is
Speaker 1: my older one, and she's three now. And my baby
Speaker 1: Isabella we called Izzy, is sixteen months and they're cute.
Speaker 1: Not that that matters, but let me tell you, getting
Speaker 1: the picture of the two of them anytime is a gift.
Speaker 1: So what are they both allergic to? Doctor Tresuali is
Speaker 1: Julie's doctor allergist who has saved her life, who has
Speaker 1: saved my life on so many occasions, and my emotional
Speaker 1: stability on so many occasions. So they are both allergic
Speaker 1: to eggs and peanuts, and Isabella is also allergic to oats.
Speaker 1: Oh my god, I can't. But they're also which makes
Speaker 1: it more complicated allergic differently so my older one Ali.
Speaker 1: Her allergies are kind of what you think of your
Speaker 1: throat closing anaphylaxis, typical allergies UM that most people are
Speaker 1: afraid of. Isabella has a what I understand to be
Speaker 1: like pretty uncommon or you know, more rare digestive but
Speaker 1: very serious allergy where when she eats her trigger foods,
Speaker 1: she'll start throwing up to the point where her body
Speaker 1: kind of may not be able to balance itself, so
Speaker 1: she needs UM. She would need so many boose thumps
Speaker 1: right now. Even with this I mean, this is crazy.
Speaker 1: So if she throws up that much, it's like rush
Speaker 1: to the hospital. Situation exactly called doctor Lee, go to
Speaker 1: the emergency room. I was in an ambulance, right, I
Speaker 1: was want to say two weeks ago, I was in
Speaker 1: an ambulance. I don't think I even told you this
Speaker 1: wasn't what My eyeballs just became saucers. I was an
Speaker 1: ambulance on the way to the er because Izzy had
Speaker 1: a bad reaction. And this is when we confirm that
Speaker 1: she is also has this allergy. The acronym for it
Speaker 1: is f pies um, but she has an allergy to
Speaker 1: peanuts as well, and so her her allergy is also
Speaker 1: it happens it's a delayed reaction. So Ali's happen immediately
Speaker 1: after you eat the food Izzy as are about two
Speaker 1: hours after starting to name than what it is, because
Speaker 1: you in movies it's like the kid eats the peanut
Speaker 1: and it's like we're in the emergency room. We're dying.
Speaker 1: But like for her to have a delayed reaction, that
Speaker 1: must be hard to do an elimination sort of diet
Speaker 1: and figure out what the triggers, especially since there's no
Speaker 1: testing for this type of allergy, so you can do
Speaker 1: skin tests and blood tests for the anaphylactic type allergy.
Speaker 1: So when you think you might have something, you go
Speaker 1: to doctor Lee. She tests them all, she figures it
Speaker 1: all out, and then she tells you what to avoid.
Speaker 1: For f pies, there's no test. You basically have to
Speaker 1: eat foods trial it for depending on the food like
Speaker 1: a you know, several days to a few weeks to
Speaker 1: see if you start having an issue from it. And
Speaker 1: the other thing for that is that some of the
Speaker 1: more common foods for f pies allergies are not ones
Speaker 1: that you would think about. So chicken and rice and
Speaker 1: banana and not a hat out are all an oats
Speaker 1: are all really high risk foods, so they don't fall
Speaker 1: into the dairy, eggs, peanuts category. You normally think of, um,
Speaker 1: what was um the first symptom you saw with UM,
Speaker 1: I'm trying like which way do we want to go first?
Speaker 1: I'm like, you're older or you're younger, which, by the way,
Speaker 1: when you had Izzy, I was like, this kid isn't
Speaker 1: gonna have any allergies because she was put through such
Speaker 1: a ringer with your first and I was like you, like,
Speaker 1: you're done you're like, you're done. You did it, like
Speaker 1: you survived. And now we have number two who has
Speaker 1: a lot of allergies and they're different, right, So so Alie,
Speaker 1: it's funny because we went to we sat at a
Speaker 1: coffee shop across the street from an emergency room to
Speaker 1: give Alie peanut butter for the first time. Because I'm
Speaker 1: just type a anxious person. That makes you a great lawyer, well,
Speaker 1: thank you, and it also makes me, you know, a
Speaker 1: difficult wife and you know a mom like so sitting
Speaker 1: across this room leaving peanuts for the first time exactly, sorry,
Speaker 1: dragged my husband with me. Didn't give her a whole lot,
Speaker 1: but she was fine, like it was everyone just that
Speaker 1: I was up. That's Julie. And she overreacted and then
Speaker 1: a few you know, she had that a few more
Speaker 1: times and things seemed to be okay. We introduced eggs.
Speaker 1: She seemed to be okay with eggs. She then had
Speaker 1: a few hives or like like of a rash that
Speaker 1: we're like, h what is this And again it wasn't
Speaker 1: the first time she had had eggs, so we didn't know.
Speaker 1: We gave her egg whites, thinking that egg whites were
Speaker 1: less you know, allergic allergy complete opposite. Most people who
Speaker 1: have egg allergies are more allergic to the egg white
Speaker 1: than to the egg yolk, So hell knows that. We
Speaker 1: just learned that here on Katie's grip folks exactly. So
Speaker 1: there you go. I messed that up, and that's when
Speaker 1: Ali's face started blowing up, her eyes were getting swollen,
Speaker 1: her lips were getting swollen. So we rushed over the doctor,
Speaker 1: got that agil. She kind of settled down from there,
Speaker 1: But after that was when I went over to doctor Lee.
Speaker 1: We also had been avoiding dairy just because she had
Speaker 1: had some digestive issues and really bad reflux, and so
Speaker 1: we didn't know if she had a digestive allergy to
Speaker 1: dairy or if there could also be something more of
Speaker 1: an anaplaxis dairy allergy. Ali did outgrow her dairy allergy
Speaker 1: right before she turned three. Now, Dr Tricia Lee, do
Speaker 1: you normally meet moms and their kids when we're at
Speaker 1: this sort of crisis mode? Um? Does it vary when
Speaker 1: do they come to you? So normally it's after the
Speaker 1: first reaction, and for some of those families that takes
Speaker 1: them in to the emergency room, and the emergency room
Speaker 1: physician will say okay, now you need to see an allergist,
Speaker 1: or if it not even taken them to the emergency room,
Speaker 1: just to the general pediatrician's office, then they will be
Speaker 1: referred to the allergist. UM. Very rarely am I seeing
Speaker 1: um sort of a new diagnosis before the first reaction. UM. Nowadays,
Speaker 1: with sort of new recommendations and pushed to get children
Speaker 1: in tested early introduction, a lot of these high risk
Speaker 1: kids meaning moderate to severe egma will be sent before
Speaker 1: they've even eaten anything I see, right, So there's also
Speaker 1: the kids that are having crazy skin stuff happening before
Speaker 1: they've even eaten solid foods. And sometimes I'll see four
Speaker 1: eight week olds and then we're not really doing food
Speaker 1: testing at that time. UM, it's really probably not acuratetil
Speaker 1: close to four months old, UM, but sort of following
Speaker 1: along there. So sometimes we're capturing it before they actually
Speaker 1: eat it. UM. But most of the time my suggestion
Speaker 1: is to to eat the food and then sort of
Speaker 1: go from there. The problem with skin testings it's not perfect.
Speaker 1: You can get a lot of faults positives. For example,
Speaker 1: if you go to local mall tore that people have
Speaker 1: a positive test of peanut, they eat it and they're
Speaker 1: fine with it. So testing is just not accurate, and
Speaker 1: so you can end up with a lot of false positives.
Speaker 1: UM sort of unknowingly unfortunately. I feel like when we
Speaker 1: were kids, they would wait awhile to test it. Now
Speaker 1: there's all these new stuff saying like give them small
Speaker 1: doses before even the age of one, exactly, and that
Speaker 1: was actually UM. Probably part of the problem in the
Speaker 1: United States when food allergy increased in the United States
Speaker 1: was when the ap had recommended delay an introduction of
Speaker 1: these foods for that reason. Part of the reason is
Speaker 1: UM more from a choking hazard perspective in the sense
Speaker 1: of like nut, you're not going to feed a four
Speaker 1: month old nut. But nowadays, with nut butters and nut powders,
Speaker 1: it's much easier to accomplish. UM. A lot of times
Speaker 1: I'm hoping to even capture that family before the first introduction. UM.
Speaker 1: So now there's some data to support sort of moisturization.
Speaker 1: So from day one of life to moisturize head to toe. UM.
Speaker 1: Every day I'm imagining a one week old being slathered
Speaker 1: in peanut butter. That's not what you mean. I'm glad
Speaker 1: you clarify, So what do they do somewhere like a
Speaker 1: cream or vasselin just what you would moisturize your skin with.
Speaker 1: And the concept is the or the hope even is
Speaker 1: that if we can prevent sort of eggs ma starting
Speaker 1: and progressing, then maybe we could prevent this progression into
Speaker 1: UM food allergy. UM even to the extent of UM
Speaker 1: a little bit of data to support that if you
Speaker 1: touch an allergy with your hands, like if you were
Speaker 1: eating a peanut butter and jelly sandwich, to then not
Speaker 1: directly touch your kids skin. UM. There is a hypothesis
Speaker 1: out there that UM, these kids are seeing allergens through
Speaker 1: their skin first as opposed to through their gut, and
Speaker 1: then they're forming an abnormal reaction so in the reverse
Speaker 1: sance as well not putting foods on the skin. So
Speaker 1: UM in England, UM, some of their food allergy increase
Speaker 1: after they started using things like coconut oil and the egsma.
Speaker 1: So until the kids eating the food. I don't really
Speaker 1: prefer food products on the skin, got it, But from
Speaker 1: there with food introduction, I think early what first like
Speaker 1: I vasoline. Vassoline is like one product and no one's
Speaker 1: allergic to it. Y, Seravey, Vanning cream or good brands um.
Speaker 1: Even Aquifer though has vanolin in it. I'm so glad
Speaker 1: on this podcast because I'm switching it up. I feel
Speaker 1: like vascaline is like what we used kids like a
Speaker 1: head to toe grease the kid up every single diaper change. Um.
Speaker 1: But then you know, close to four or five months,
Speaker 1: and this is going to pin a lot on the
Speaker 1: child developmentally speaking in the sense of can they hold
Speaker 1: their head up and are they thrusting their tongue out?
Speaker 1: But just starting eating, we just don't know until you
Speaker 1: eat it, like you just got to eat um. And
Speaker 1: so starting sort of early with fruits, vegetables, and then
Speaker 1: pretty quickly going through sort of those top eight allergens
Speaker 1: um all so, milk, egg, wet fish, shellfish, peanut, tree, nuts, sesame,
Speaker 1: soy um and generally speaking in in order of like
Speaker 1: weed and then milk and then egg um and then
Speaker 1: obviously peanut very soon. And they also now have it
Speaker 1: in pouches. So there are brands where you give your
Speaker 1: baby like these, like many pouches that have these different
Speaker 1: allergens in the pouches. So even though they can't eat
Speaker 1: a nut or an egg or like soy like things
Speaker 1: like that they can be exactly. So that's what we
Speaker 1: started doing for Isabella because we were trying to introduce
Speaker 1: everything early. I mean, when you say, what point do
Speaker 1: you to Dr Lee start seeing patients for Isabella, I
Speaker 1: was like, I'm pregnant, now tell me what to do.
Speaker 1: It's like she's born, now tell me what to um.
Speaker 1: But so we gave her all of these pouches as
Speaker 1: early as we could. You know, when she was having
Speaker 1: a symptoms of Isabella with being allergy is different, right,
Speaker 1: So when we gave when we gave her one of
Speaker 1: the pouches that had egg in it, she was fine.
Speaker 1: We put her down for a nap. We well, first
Speaker 1: we had tested everything on the skin testing with Dr Lee,
Speaker 1: so we felt okay trying it at home. Then two
Speaker 1: hours after she threw up and it was she's a
Speaker 1: baby baby, so you're kind of like this a spit up?
Speaker 1: Is it? Like? So you're kind of like, as a
Speaker 1: second kid, is it a coal qualifying? So I called
Speaker 1: Actor Lee and she's like, okay, well, I don't want
Speaker 1: to say that. We're not going to try egg again.
Speaker 1: We'll see, like let's just like let's be aware of it.
Speaker 1: So and she didn't even tell me what f pies
Speaker 1: was or anything like that. She hit it from me
Speaker 1: and so then there's like nobody this is. Yeah. So
Speaker 1: the next time we gave her egg, we gave her
Speaker 1: the same page and we tried to do it at
Speaker 1: a time when she wasn't sick. She's like, they're like
Speaker 1: that we kind of knew her baseline of where she was.
Speaker 1: And she threw up again about two hours later. So
Speaker 1: I called Dr Lee again. I'm like, what do I do?
Speaker 1: And that's when she said, Okay, Isabella has f pies
Speaker 1: and here's what we do. And PIES stand for food
Speaker 1: protein induced innercalitis, which is why I say F pies.
Speaker 1: Is that like what it's called F pies? No, that's no.
Speaker 1: I feel like that's there's an I C D tinko
Speaker 1: for the diagnosis of f pies. It's like a I
Speaker 1: feel like it's a rare group of people who know
Speaker 1: what it means. But among the people that have this allergy,
Speaker 1: that's what it's called or how we refer to it. UM.
Speaker 1: So a lot of times you think, oh, my kid
Speaker 1: is sick and I have a virus. You also don't
Speaker 1: think when you're giving your baby bananas or wheat cereal
Speaker 1: or these foods, and they're throwing up two hours later,
Speaker 1: and you're giving it to them at multiple times. That
Speaker 1: they're throwing up multiple times, you don't realize that it's
Speaker 1: related or an allergy. Almost think it's acid reflux or something.
Speaker 1: Right like at first, like the vomiting is so bad,
Speaker 1: you do go into the emergency room, especially as like
Speaker 1: a first time parent, um, and sort of time and
Speaker 1: time again, Um, the emergency room is not connecting it
Speaker 1: as well because it's so delayed in the sense of
Speaker 1: its two hours later, and a lot of times it's
Speaker 1: not within the first even a few ingestions. I've seen
Speaker 1: it within the first ten ingestions, for example, So like
Speaker 1: the first five times, like okay, you sort of marked
Speaker 1: that food off your list, You've done it. You don't
Speaker 1: even think about it. You're now then combining it with
Speaker 1: other things. You know, the kids thrown up a few times.
Speaker 1: You go into the emergence room. Just seems like a
Speaker 1: virus every single time. So I felt really lucky that
Speaker 1: we had is about throw up twice and Dr le
Speaker 1: knew exactly what it because you already had it all
Speaker 1: in place. I had my system in places, so I
Speaker 1: was like, Okay, now I'm calling our nutritionist because we
Speaker 1: started working with a nutritionist for Ali because she being
Speaker 1: allergic to eggs at the time. Dairy. You want to
Speaker 1: make sure it's getting the food exactly and the nutrients
Speaker 1: she's supposed to be and she's tiny and so she
Speaker 1: wasn't gaining weight, so we needed to really be on
Speaker 1: top of it and make sure that she was going
Speaker 1: to thrive despite her food restrictions. So and it was
Speaker 1: funny because the day before I had a conversation with
Speaker 1: the nutritionist and she was like, Isabella is not Ali.
Speaker 1: You have to like take steps and start feeding her
Speaker 1: more proactively and not be so afraid of things. And
Speaker 1: then I called her back. You were like you were wrong,
Speaker 1: and and then I called her back the next day.
Speaker 1: I'm like, so Isabella has f pies and she's like,
Speaker 1: oh boy, She's like, now we need a whole new
Speaker 1: game plan. So at least felt fortunate that I had
Speaker 1: that support system in place, because it's when you find
Speaker 1: out about it at first, and you don't know anything
Speaker 1: more than just kind of the stuff that you're afraid of.
Speaker 1: It's very overwhelming. Oh, I want to ask you, um,
Speaker 1: so do you recommend Dr Lee, do you recommend when
Speaker 1: people start introducing foods like the sort of thing where
Speaker 1: it's like you do the same thing every day. I
Speaker 1: also know women who like wrote like they did the
Speaker 1: same food every single day for lunch and then they
Speaker 1: moved that food tonight and then they introduced a new
Speaker 1: food in the lunch time. Is that ye know that
Speaker 1: it has to be so I was like, this is
Speaker 1: making me nuts, especially for like fruits, vegetables, and meats,
Speaker 1: because generally they're not going to be an issue. Um
Speaker 1: for some of those highly allergenic foods, you know, I say,
Speaker 1: start with a small amount gradually increase. Doesn't necessarily have
Speaker 1: to be in consecutive days. Not really doesn't have to
Speaker 1: be at the same time. No, so maybe day one,
Speaker 1: day three, day five, day seven. The goal is just
Speaker 1: to get to a full serving, which generally I would
Speaker 1: say with peanut, it's like to teaspoons of peanut butter
Speaker 1: peanut powder, and you've done it multiple times. So normally,
Speaker 1: and I'm taking a history from a patient, that threshold
Speaker 1: for me is five times. The problem, particularly in a
Speaker 1: four six month old, is they're not getting that much.
Speaker 1: They're not getting anywhere close to two teast, So you've
Speaker 1: really got to push the amount because a lot of
Speaker 1: times that allergy is not going to be obvious until
Speaker 1: we've had enough to make it obvious, which is probably
Speaker 1: why for Ali, we didn't realize that at first because
Speaker 1: she had had so little, like a little tiny of
Speaker 1: eggs and peanuts, so it wasn't until later on that
Speaker 1: we saw her reactions. My next question for Julie is
Speaker 1: do you ever get like judge moms about because I know,
Speaker 1: as a mom of someone who's dealing with some pretty
Speaker 1: scary allergies, I've seen you as a mom in action
Speaker 1: and you have to be the advocate for your child,
Speaker 1: meaning you're asking all the other mom's questions, who are around,
Speaker 1: what's in it? Did Ali grab it? Like all that
Speaker 1: kind of stuff? Because it's on you? Um and so
Speaker 1: have you had issues with that kind of thing we have?
Speaker 1: I have to say I've been really lucky with close
Speaker 1: friends and our community who understand that you know, this
Speaker 1: is serious and important, and especially our close friends who
Speaker 1: know everything that kind of we go through regularly, they're
Speaker 1: more apportive about it. It gets harder as there's school
Speaker 1: and birthday parties and things like that where and I
Speaker 1: try very hard to not feel like I have to
Speaker 1: control what everyone else is doing, but do what I
Speaker 1: have to to protect the girls. So you know, now
Speaker 1: they can eat pizza as long as I make sure
Speaker 1: it's from a place that doesn't have egg in the dough,
Speaker 1: because sometimes they do. When we get a birthday party invitation,
Speaker 1: I'll respond yes, so excited, and then I also say,
Speaker 1: are you planning to do pizza or other food? Ali
Speaker 1: has allergy, so just let me know so I can
Speaker 1: plan accordingly. Like I don't, I don't expect everyone else
Speaker 1: to make an accommodation for us. I mean, if you
Speaker 1: tell me that you're gonna have a peanut butter birthday cake,
Speaker 1: then we're not going to go because then I can't
Speaker 1: do it. And if it's brunch and you're having eggs
Speaker 1: and like that's your scrambled eggs is your meal, then
Speaker 1: I'm not going to go. But if you're having something
Speaker 1: that has you know, eggs in it or things where
Speaker 1: you know, I kind of have to balance the balance
Speaker 1: it and also educate Ali as she gets older, because
Speaker 1: she's gonna be responsible for herself and so not that
Speaker 1: I would ever leave her to her own devices at
Speaker 1: this point. But she's she's pretty good. I mean, she
Speaker 1: just turned three, and she knows what she's allergic to.
Speaker 1: She knows what Isabella is allergic to. She knows there's
Speaker 1: a song that she sings that has her rules of
Speaker 1: what to do and liked her this song Did you
Speaker 1: write this? Daniel Tiger? Daniel Tiger and three? Or what's
Speaker 1: the song? Can you sing it for us? Is a good?
Speaker 1: Oh my god? No? Is it like I can't eat um?
Speaker 1: What are her ones again? Eggs and dairy and she
Speaker 1: can do darry now. I grew out a dairy and
Speaker 1: I can have that now. But she has these, she
Speaker 1: has the tools and Daniel Tigers. It's basically the song
Speaker 1: in Daniel Tiger has three rules in it, Um, don't
Speaker 1: eat the food that you're allergic to, ask before you
Speaker 1: eat something new, and if you don't feel well till
Speaker 1: a grown up. And so Ali knows those rules and
Speaker 1: so she will be somewhere, you know. She was talking
Speaker 1: to her other best friend who turned three the other
Speaker 1: and her friend was like, Ali, I'm going to have
Speaker 1: a frozen cake at my birthday, like so excited, and
Speaker 1: Ali goes, that sounds great. Does it have eggs and peanuts?
Speaker 1: Because I can't have eggs and peanuts And her friend
Speaker 1: was like, I don't know. Like her friend was like,
Speaker 1: but so I have in my freezer a bunch of
Speaker 1: cupcakes and cookies that are safe for Ali that I
Speaker 1: will defrast And I always tell Alle, I say, oh,
Speaker 1: today So and So's birthday, there's gonna be cupcakes. She'll
Speaker 1: say did they have eggs and peanuts? And I say
Speaker 1: they do, so we can't eat them, And then say
Speaker 1: I'm going to bring one for right And she's excited
Speaker 1: by that. So she's she's really good about it so far.
Speaker 1: And I love Daniel Tiger. Oh my god. Yeah, we
Speaker 1: are big fans of Daniel Tiger. Now, UM, I was
Speaker 1: going to ask you are there chances of these kids
Speaker 1: growing out of these allergies? Like what do you see
Speaker 1: as far as especially for Izzy from an f PIS perspective, A,
Speaker 1: there's never been any documented DUTs UM and then be
Speaker 1: most kids. I'll l so right now, the nation recommendation
Speaker 1: is UM eighteen to twenty four months after the last reaction,
Speaker 1: you should try it. UM. The recommendation right now is
Speaker 1: to do that within a hospital setting, though hopefully that
Speaker 1: tide will will try. You have to go do this
Speaker 1: so for three foods. When we get to that timetable,
Speaker 1: we'll see if those are still the recommendations. The other
Speaker 1: thing for her you said, we probably will just because
Speaker 1: she has small veins and they've had trouble getting i vs,
Speaker 1: so they want to have the i V in already
Speaker 1: if she needs medicine. Wow wow wow wow wow wow.
Speaker 1: Now is there any link to like my husband parents,
Speaker 1: like why is why does a kid have allergies? And
Speaker 1: why does a kid not have allergies? Why does this
Speaker 1: as the question of the decade are people asking me about?
Speaker 1: Like why? Um? So you know, we have realized some
Speaker 1: of these answers through research in the sense of early introduction.
Speaker 1: And that's probably the greatest study. It's called the Leap study,
Speaker 1: done a few years ago in England. And the reason
Speaker 1: why it was done is because we realize as Israeli
Speaker 1: kids eating bomba, the peanut puff um, and so they
Speaker 1: seem to have less peanut allergy than the rest of
Speaker 1: the world. Um. And so that study looked at sort
Speaker 1: of early introduction between four and eleven month olds for
Speaker 1: high risk kids, meaning monitor to see eggs and or
Speaker 1: egg allergy. UM. So certainly early introduction I think sort
Speaker 1: speaks to that. UM. There's a lot of study of
Speaker 1: medicine nowadays sort of looking at the microbiome in the
Speaker 1: sense of the good or back bacteria or whatever the
Speaker 1: bacteria is, whether it's on your skin or in your
Speaker 1: gud and how are we affecting that. That concept of
Speaker 1: like if you have UM exposure to farm animals are
Speaker 1: living on a farm and having less allergy has certainly
Speaker 1: been validated. So I think one thing moms she says
Speaker 1: always like I don't know where she pulls this out,
Speaker 1: but she'll just be like, it's always good for a
Speaker 1: house to have a dog because then your kid won't
Speaker 1: be allergic to dogs. Like she says stuff like this,
Speaker 1: And I'm like, where are you getting these facts? UM,
Speaker 1: But I guess that that is true. Well, it's also
Speaker 1: speaking to UM sort of going back to that microbiome
Speaker 1: in the sense of the more sort of viruses, bacteria,
Speaker 1: germs you're exposed to, the greater variability that you're going
Speaker 1: to have, And that's what we're realizing, is the variability
Speaker 1: is sort of what is protective? Um, But it's one
Speaker 1: of a million questions. It's one of a million probably reasons.
Speaker 1: They're probably a some genetic component going from the first
Speaker 1: child to the second child. Is the seven percent chance
Speaker 1: of having food allergy? It's not, But that's not because
Speaker 1: we were saying they're allergic to the same food, but
Speaker 1: their reaction and the treatment and what I have to
Speaker 1: look for completely different. Like it's actually think she's my
Speaker 1: only family who there are two kids with food allergies.
Speaker 1: That's not necessarily rare, but like two kids with different
Speaker 1: types of reactions. Um. So I was stilling around the
Speaker 1: look and that is how special her genes are. So
Speaker 1: are you guys, like on speech? How often do you
Speaker 1: see Dr Julie? Um? I feel like pretty regular because
Speaker 1: we do a bunch of food tests. We do because
Speaker 1: in trying to see if she can, if you know,
Speaker 1: Alie at this point can outgrow them. We've had tests
Speaker 1: every year for her and then to outgrow her dairy allergy.
Speaker 1: We had to start with dairy baked into food, so
Speaker 1: it's like baked milk in muffins, and then it was
Speaker 1: milk in like um crackers or and like then it
Speaker 1: was cooked cheese, and it was pizza, then it was
Speaker 1: a glass. And so depending on kind of where we
Speaker 1: feel she is, we have to do multiple food challenges
Speaker 1: in Dr Lee's office, which is like a four to
Speaker 1: five hour challenge every time. And so we've done that
Speaker 1: for eggs, We've done that for peanuts, We've done that
Speaker 1: for skin test saying I feel like we've done that
Speaker 1: for a lot. So were you allergic to anything? Nope? Nothing,
Speaker 1: So this is like new to you. It's my Nope,
Speaker 1: neither of us hill eat anything. I'm weird and picky
Speaker 1: about food, but not allergic. Um, but it's really just
Speaker 1: this generation so I wouldn't need nearly say. It's hard
Speaker 1: to think gets worse than ever. Oh yeah, it definitely
Speaker 1: is roast peanut butter, for example, and it was introduced
Speaker 1: into Australia. You know, there was an increase in their
Speaker 1: food allergy. We've always had roasted peanut butter, and we're
Speaker 1: probably doing you know, other things to our foods as
Speaker 1: well to sort of change it's allergenicity of it in
Speaker 1: the how we make the food. Oh my god, this
Speaker 1: is so and I talked to it. Actually I'm like, okay,
Speaker 1: So is there anything that I did while I was
Speaker 1: pregnant with Ali that I shouldn't do, but then I
Speaker 1: should do differently with Easy? I'm like, we're doing it again,
Speaker 1: and I ate less. I ate a lot of peanuts
Speaker 1: and eggs when I was pregnant with Alley. I ate
Speaker 1: much less if it when I was pregnant with Easy
Speaker 1: because I obviously couldn't have it in the house. So,
Speaker 1: you know, neither neither works. Can you take me through
Speaker 1: when you meet a baby or something and you're testing
Speaker 1: them for allergies, is it the same as with an adult, Like,
Speaker 1: is it those pricks? Yeah? So the way I described
Speaker 1: it to older chilling some mouse how to fork, this
Speaker 1: is what he would used to eat with. It's dipped
Speaker 1: into liquid and then pricked on top of the back.
Speaker 1: It's not a needle, there's no blood. We wait fifteen minutes.
Speaker 1: I expect a readit chey bump. So very similar adults. Obviously,
Speaker 1: we're doing you know, many more with kids. Specifically with food,
Speaker 1: you try to be very targeted because you're not wanting
Speaker 1: to get those false positives and avoid foods for no
Speaker 1: good reason. Um, so it should be you know, specific
Speaker 1: in the sense of what have you had a reaction to,
Speaker 1: what is associated with that food. So, for example, if
Speaker 1: you come into me and you've had a peanut reaction
Speaker 1: up to pen allergic, kids are going to be allergic
Speaker 1: to tree nuts. So I'm going to skin test those
Speaker 1: tree nuts before you know, we try them. It's so
Speaker 1: crazy that it's worse now than ever. I mean, I
Speaker 1: feel like that's even a thing. There's preschools that are
Speaker 1: no nut schools, so our school is not a nut
Speaker 1: free school, but Ali's room is a nut freedom room,
Speaker 1: and so this is like a real thing, you guys.
Speaker 1: And I feel bad because, like my husband is really
Speaker 1: allergic to a lot of things. But I'm always like, Okay,
Speaker 1: it's fine, like get over it because his aren't. His
Speaker 1: aren't like ones and their life rereatening. And they're like,
Speaker 1: he gets a scratchy throat for a walnut and he
Speaker 1: gets a scratchy throat and like sneezy if the apple
Speaker 1: is really ripe, like all of those things, um and
Speaker 1: sneezing a lot. And he's like, but you don't understand
Speaker 1: how uncomfortable this is. Like this is terrible, like it is,
Speaker 1: but it's so much lower risk to progress. Get over it.
Speaker 1: It's like, so I'm so, I'm so mean about it,
Speaker 1: Like can't, So don't be so mean about it. You're welcome,
Speaker 1: Like I felt much, I feel like I'm being more
Speaker 1: compassionate towards it and also being a new mom um
Speaker 1: getting through the fear of it and that it can
Speaker 1: still be a thing. I mean, as of right now,
Speaker 1: Alvic hasn't shown any signs of anything, but I have
Speaker 1: to say I won't let him have shrimp or sushi
Speaker 1: or any that kind of thing. But also going through
Speaker 1: it with Julie, I've been my eyes have been very
Speaker 1: very open to like, holy shit, this is and that
Speaker 1: and that should just be like a mantra of um parenting, right,
Speaker 1: Like I mean, I think that's with almost every aspect
Speaker 1: in life. Until you've wall through those shoes, you don't
Speaker 1: really understand and um. But you know, so much of
Speaker 1: parenting nowadays is so debatable. You can find a blog
Speaker 1: to support anything and another blog to support the exact opposite.
Speaker 1: And is there truly one right answer? Probably not, And
Speaker 1: so just have empathy and also even in treatments that
Speaker 1: they're trying to do to help people outgrow, you know,
Speaker 1: the oral immunotherapy, which it's that as gonna say, she
Speaker 1: can you can speak to it more technically than I can,
Speaker 1: but it's I mean, maybe explain it first. But it's
Speaker 1: something that we looked into and we talked to Dr
Speaker 1: Lee about it and decided it wasn't right for us yet.
Speaker 1: But other people feel differently and feel strongly about it.
Speaker 1: Say so right now, the same care for food allergy
Speaker 1: is to avoid the food care around your upper pen
Speaker 1: in case you have an excellentestion or reaction. UM. The
Speaker 1: new concept for food allergy, it's not actually not so new,
Speaker 1: there's just more data sort of coming down. The pipeline
Speaker 1: is treating food allergy with small amounts of the food.
Speaker 1: So starting with a small amount and gradually increase and
Speaker 1: so it's called oral immunotherapy o I T. And so
Speaker 1: there will be to have to get proved products for
Speaker 1: peanut in particular peanut patch and a peanut oral product.
Speaker 1: But since it's foods, you can sort of start that
Speaker 1: process before we have enough to approved product. And so
Speaker 1: it's pretty common actually all throughout the United States, and
Speaker 1: that concept, um, you know when you look at the
Speaker 1: data though, UM, we're not necessarily carrying a lot of
Speaker 1: children by doing this, and it is a very tedious
Speaker 1: process and the sense of sounds exhaust and doing it
Speaker 1: every day, you know, so it's like, for example, you
Speaker 1: would be doing tin peanuts every day with a two
Speaker 1: hour rest period um and the risk of antiflaxus is
Speaker 1: still there. And some of those kids on the d
Speaker 1: and fiftieth time that they've done their tin peanuts, they
Speaker 1: having a flaxus that day. And sometimes it's because they
Speaker 1: ran around or they didn't have anything else on their
Speaker 1: stumf virus. The other thing is that that rest period
Speaker 1: is that when you're more active when you're sick, like
Speaker 1: different things in your body. How am I supposed to
Speaker 1: explain to Ali that for two hours there's no running
Speaker 1: around or jumping, And you know, she's an active child
Speaker 1: and I want her to be that way. And so
Speaker 1: when we just looked at kind of the risks rewards
Speaker 1: for us at the moment, it's not for us, and
Speaker 1: we're going to continue to reevaluate it, and you know,
Speaker 1: we may feel differently about the patch when it's available
Speaker 1: because that's a little lower risk for us. Yeah, so
Speaker 1: the risk of aniflax is going to be much less um,
Speaker 1: just with the past, though the yield is probably much
Speaker 1: less as well. But it's that we're not necessarily curing
Speaker 1: children by doing this, Um, we are increasing their threshold.
Speaker 1: So for example, at the beginning of the study, you
Speaker 1: eat one peanut and you have a reaction. At the
Speaker 1: end of the study you eat tin peanuts and then
Speaker 1: have a reaction. So I do think we can increase
Speaker 1: the threshold. I just I don't know for a lot
Speaker 1: of kids, I don't know how meaningful that is. Most
Speaker 1: of my kids that I see, they come back to me,
Speaker 1: you know, a year later and I say, you know,
Speaker 1: or you're avoiding your food. Yes, have you had any
Speaker 1: excellent ingestions or reactions? No, have used your eppypin No.
Speaker 1: And they're not doing anything on a daily basis with
Speaker 1: a two hour rest period to accomplish that. They're just
Speaker 1: not having any issues. So I think it's possible. I
Speaker 1: think just of the cross contamination pieces of like definitely.
Speaker 1: Where So the argument is now with this sort of
Speaker 1: treatment or eveno therapy, is to protect from cross contact
Speaker 1: if you accidentally eat the food. No one's going to
Speaker 1: purposely eat the food, then, UM, you have some sort
Speaker 1: of insurance policy protection that that small amount is not
Speaker 1: going to cause a severe reaction, maybe something milder or nothing.
Speaker 1: This is like I'm quiet because I'm like wow, Like
Speaker 1: this is it's like motherhood. You just like jump in
Speaker 1: and you just last think I hangure it out as
Speaker 1: you go. I had no choice. It was like you're
Speaker 1: just like okay, so and here I go, and here's
Speaker 1: what we're going to do. Or are there any other
Speaker 1: things of how we can teach kids how to be
Speaker 1: advocates for themselves? I mean, what if you're a kid
Speaker 1: that's not like Ali, Like I just feel like, and
Speaker 1: she's so well spoken at such a young age, and
Speaker 1: and that's not every kid with allergies, so like she's
Speaker 1: helping easy to know that already she tell groundwork. Yeah.
Speaker 1: So UM, A lot of times with schools, I'll go
Speaker 1: and give a presentation to sort of speak to what
Speaker 1: type of culture can you set up to just protect
Speaker 1: all children? Um? And a lot of times it's you know,
Speaker 1: keeping food separate from the play areas. Um, no one's
Speaker 1: sharing food, no one's bringing any food in, You're not
Speaker 1: accepting food from anyone. So UM, I think a lot
Speaker 1: of those aspects. UM. Sometimes the hardest people to train
Speaker 1: our family members and when you go to a family event,
Speaker 1: they just want to feed children. Um. And maybe it's
Speaker 1: that in the sense of, um, we're not sharing our
Speaker 1: food so openly, um, until we know that we're just
Speaker 1: okay with all those ingredients. And the problem is like
Speaker 1: hidden ingredients to people don't realize what's in things. Andevitably,
Speaker 1: you know, a patient comes to me and they've had
Speaker 1: a reaction to hummus. It's always sesame and hummus and nevilly.
Speaker 1: The parents are like, oh, there's sesame in heaven. No
Speaker 1: idea I was, and of course, you know, I mean
Speaker 1: I never thought about these things until um, I did
Speaker 1: food allergy. And also it's like, oh, people understand that
Speaker 1: peanut allergies are severe, but they don't have the same
Speaker 1: understanding that other foods can be just as severe. So
Speaker 1: when I say Ali can't have eggs, and that means
Speaker 1: you can't have eggs, but she can't have eggs cooked
Speaker 1: into anything baked, it like there can't be eggs anywhere.
Speaker 1: So it's like, oh, but this cracker has eggs, but
Speaker 1: that's okay because like it's can't be involved in the
Speaker 1: making of this food. Exactly and also in terms of
Speaker 1: what you can do. I think for kids, there are
Speaker 1: kids books about sharing your food or being aware of
Speaker 1: your friends with food allergies that will read with Ali
Speaker 1: and starting to read with Izzy that it's I think
Speaker 1: they're good for kids also that don't have food allergies,
Speaker 1: because it's not just about advocating for yourself, but it's
Speaker 1: about being empathetic and understanding with your friends. I need
Speaker 1: to get a list when you have time. I know
Speaker 1: you're both. DN Tiger has one. I think Elmo has
Speaker 1: one as well. There's a book like I think it's
Speaker 1: called EPI the Elephant. Probably the most useful link from
Speaker 1: just a general educational perspective as Fair's website F A R. E.
Speaker 1: And I think there it's like food allergy dot org
Speaker 1: or something UM but it's a nonprofit started initially, you know,
Speaker 1: by families of kids who have food allergy, and they
Speaker 1: just do a really good job at sort of putting
Speaker 1: all the material out there and providing material, whether it's
Speaker 1: for you know, schools or restaurants. But have you, Julie,
Speaker 1: what are tips that you would give UM new moms
Speaker 1: who don't know if their kid is allergy or what
Speaker 1: is a tip you would give to moms who are
Speaker 1: dealing with kids who are having a lot of allergies.
Speaker 1: I think if you don't know, I think the early
Speaker 1: introduction and trying to do that, and for me, keeping
Speaker 1: logs and notes was careful. It was important so that
Speaker 1: you could kind of see what what you're reacting to. UM.
Speaker 1: Trusting your gut I think is really important because lots
Speaker 1: of kids have rashes or bumps or redness, and for me,
Speaker 1: any of those things can be incredibly serious. So I
Speaker 1: don't get to ignore those. So if you see something
Speaker 1: or something doesn't seem right, speak up, and you know,
Speaker 1: the worst thing that happens is you have reacted. And
Speaker 1: that's kind of for the you know, people that don't
Speaker 1: have allergies, UM, for people that do, be the advocate.
Speaker 1: Do everything you have to, and also don't be so
Speaker 1: hard on yourself because it's it's so hard. And I
Speaker 1: just remember feeling so overwhelmed when both of the girls
Speaker 1: were first diagnosed idea. I was just like, what how
Speaker 1: am I going to do this? It's just it seems
Speaker 1: so you know, monumental. You don't feel like you can
Speaker 1: never really let your guard down. But you, you kind
Speaker 1: of get more comfortable with what your game plan is.
Speaker 1: And then when it happened with Isabella, given that it
Speaker 1: was a completely different type of allergy, I was like, Okay,
Speaker 1: like I thought I had this under control. Now I
Speaker 1: have to step back. So it just don't be too
Speaker 1: hard on yourself. And there are other people out there
Speaker 1: that are dealing with the same things, and it's really
Speaker 1: nice to kind of have them as support. Um I mean,
Speaker 1: I was talking to someone who was first diagnosed and
Speaker 1: was so overwhelmed and what if my kid, you know,
Speaker 1: can't have pizza at a party. And I said, look,
Speaker 1: I said, Ali now can have pizza at a party.
Speaker 1: I was like, but the first time she did, even
Speaker 1: though it was pizza that I brought from a pizza
Speaker 1: place that I knew she could have, I cried at
Speaker 1: the party because I was like, she looks like every
Speaker 1: other kid eating pizza, Like I was so excited, you know.
Speaker 1: So it's emotional. It's hard. Gosh, I'm scary. It's your baby.
Speaker 1: It's so scary. Absolutely, I love that. Thank you and
Speaker 1: um Dr Lee, what are your advice tips for moms
Speaker 1: who are facing kids with a lot of allergies? Yes,
Speaker 1: I think generally speaking, just facing them UM new moms
Speaker 1: or to to reiterate boisterized your kids from day one
Speaker 1: and UM, you know, I I like to advocate UM
Speaker 1: to my patients and that to to find that working relationship.
Speaker 1: And so, you know, if they see the first physician
Speaker 1: and they don't feel like someone listened to them, or
Speaker 1: they didn't feel like they were getting the answers UM
Speaker 1: that they were expecting, maybe it is worthwhile to sour
Speaker 1: see another physician. UM. Interestingly enough, and surround touched on
Speaker 1: this when we first walked in the room, was everyone
Speaker 1: wants it to be foods, and actually the majority of
Speaker 1: the times is it's not foods, and so UM. You know,
Speaker 1: if you get to an allergist and they seem very
Speaker 1: well educated and confident in what they're saying and it's
Speaker 1: not food, then maybe it's not. UM, it's mostly what
Speaker 1: what's the other options? Sometimes it's just it's just it's
Speaker 1: just not anything specific. UM. Generally speaking, skin testing and
Speaker 1: blood testing for foods is only good at predicting immediately
Speaker 1: threatening reactions. And so if you're coming in with very
Speaker 1: good questions in the sense of is this food causing
Speaker 1: my baby to be gassy or fussy or spitty or
Speaker 1: eggs and me, I don't necessarily have a great test
Speaker 1: to predict that, but if you don't eat the food,
Speaker 1: then we're putting that kid at risk of developing an
Speaker 1: immediately threatened reaction. So I generally try to keep the
Speaker 1: food in the diet if we can, just in an
Speaker 1: aspect to sort of create alerance. While we can do that,
Speaker 1: because maybe later down the road when the skin is better,
Speaker 1: because it's just most kids are going to get better
Speaker 1: from eggsama, then now they've developed innimate like rent reaction
Speaker 1: to that food. UM. So it is a balance, um
Speaker 1: and and a lot of times it can take a
Speaker 1: little bit of time to sort of get to that point. Um.
Speaker 1: You know. But there's good medicine out there and good
Speaker 1: people out there, but there's also not trust your gut.
Speaker 1: Um you guys, thank you so much for coming on
Speaker 1: Katie's Crib, for sharing your personal stories, your professional stories.
Speaker 1: I'm loving your relationship. I wish you the best in
Speaker 1: this beautiful marriage. And thank you guys so much for
Speaker 1: coming on Katie's Crib. Thanks guys so much for listening,
Speaker 1: and if you liked the episode, please subscribe. Rate share
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