One year anniversary for food allergies

One year ago around this time, we were just learning about our baby’s food allergies. In retrospect, I’d say that it was a life-altering discovery and definitely a bit overwhelming at the start. Without experience with food allergies ourselves – as parents – and with little exposure to people living with multiple allergies, we had a lot of learning to do to understand (a) how to cook without the allergens and (b) how to read labels. Sure, we already loved to cook from scratch but the rules of the ball game had changed. A number of our go-to condiments were now a no-go.

As challenging as it has been to create safe family meals that don’t get repetitive and that include diverse ingredients and flavours, I think it’s led us to eat ‘cleaner’. We cook even more from scratch than before (remember we said bye to a lot of our condiments?), substituting things like ketchup (which is still on our list of foods to try with our toddler) with a mix of tomato paste, brown sugar and apple cider vinegar. We’ve tried different types of recipes than we may have been inclined to try before. I’d guess that our salt consumption is lower since we add a very minimal amount when we’re cooking.

I’ve also added new terms into my lexicon:

  • safe foods
  • Top 8 free (and I actually know off-by-heart what the Top 8 are)
  • ingredient cross-contamination (and not just in keeping raw meats separate from cooked meats!)
  • allergen free
  • hives

…and I’ve learned new concepts:

  • oats, barley and rye are typically cross contaminated with wheat
  • vegan recipes are great because they’re egg- and dairy-free but you have to watch out because they love nut substitutes
  • people with allergies have different levels of sensitivities and reactivities
  • things that don’t sound tasty indeed have a very useful purpose (think egg replacer and xanthan gum)
  • make friends with fads because they can make food shopping much easier (think gluten free, vegan – these are legitimate diets but the mass commercialization of them really helps me zoom in on foods that may be safe)
  • the importance of facilities in following Good Manufacturing Practices (GMPs) to minimize cross-contamination on processing lines
  • even ingredients like spices that seem so ‘raw’ or bare bones can be contaminated with allergens (the cumin recalls are a recent example
  • the cumin recalls mentioned above actually highlighted the complexities related to the global food chain and ingredient traceability as well as factory practices.

I now make use of the 1-800 numbers for manufacturers on the backs of packages, which I used to always wonder why they needed to be listed. Now I know. It’s for people like me who need to question the safety of the packaged food. And if there is no contact information or allergen information on your website, I won’t bother buying your product any more. Which reminds me, websites that DO list a company’s allergy policy get an A++ in my books and I will be brand loyal to them.

I’ve also learned how to use an auto injector, which is a good thing to know for anyone; I even think it should be taught as part of first aid courses, in addition to AED use.

So you can see, I have gotten so much out of our life situation. It doesn’t take away the anxiety that I feel trying new foods with our child or the stress that I feel when our child has an allergic reaction (because in the moment, you can’t predict how much that localized itchiness will escalate in 5, 10, 30 minutes). I can be okay with seeming like the paranoid parent who won’t let their child eat food prepared by others (did you use a clean cutting board? did you wash your hands? could any cross contamination have happened? how safe are all of your ingredients that you used?) if it prevents my child from having an allergic reaction. But I have learned so much, so far from this experience.

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Allergen labelling part of proposed food labelling changes in Canada

Health Canada is requesting feedback from Canadians on proposed labelling changes until August 27, 2015. Amongst the numerous proposed changes, they want to change the formatting of ingredient lists so that each ingredient is separated by a bullet point, black font is used against a white or neutral background and “Make the ingredient list and information on allergens easier to find and read.” These are basically changes to establish a more common look and feel to ingredient lists.

You can read about the label changes that impact allergen listings but the big differences on the allergen front are:

  • Food colours will be represented by their common name in the ingredient list. This would eliminate the use of a generic term such as “colour”.
  • “Contains” statements that list allergens used in the product must appear right after the main ingredient list. Allergens in the product will continue to be required on the label in a “Contains” statement.
  • “May Contain” statements that indicate potential cross contamination with allergens must also appear right after the main ingredient list and “Contains” statements, in the same size font as the rest of the information.

One ingredient in Health Canada’s illustration/example of the new label format is “Spices”, which continues to be vague and a possible source of contention for those who have food allergies. This is not addressed in the proposed changes.

If these changes to the Regulations are accepted, Health Canada is proposing a 5 year transition period before the new requirements come into force. Products sold by those who make them (think craft shows, farmers’ markets) would continue to be exempt from the requirements. Grocery retailers who use “retail or scale labels” would also be exempt.

The proposed changes would make sure that ingredients are all listed together in a legible manner on the label of packaged foods. Anything to make reading and interpreting labels easier is certainly welcomed by me but I’m thinking it would be helpful to require listing the specific spices in addition to colours?

Anyways, go make your voice heard!

Food allergies in emergencies

I’ve been thinking about this quite often lately. What do people with multiple food allergies do in an emergency? Obviously, there are many magnitudes of “emergency” (the natural disasters, being stranded somewhere, otherwise unexpected events) but no matter how small or great, they present a particular challenge for those with allergies. Dealing with multiple allergens, particularly ubiquitous ingredients such as dairy, egg and wheat, it’s not like you can just pop into a store or a gas station and expect to find any safe food. And then imagine if it’s a mass emergency that impacts lots of people…the shelves at stores would likely already be slim pickings….

Now more than ever, we have tried to have a decent amount of dry goods in our pantry for those just-in-case moments. Canned fish, rice cakes, Tetrapak hemp milk, sunbutter, some safe snacks that we’ve found. My personality already sets me up to do worst-case scenario analyses and honestly, the natural disaster-type scenario makes me extra anxious from the food perspective.

Setting aside those “emergency” scenarios that we typically think of, I started to think of those life changes that can impact food availability. Things like loss of income, ill turn in health, other situations of poverty. I read about the Food Equality Initiative just by chance through a social networking site. This is an organization based in Kansas that runs a gluten-free and allergy-friendly food pantry. Wow, what an amazing concept. I contacted the Ottawa Food Bank to ask how they work with clients who have allergies. They informed me that their community partners – the organizations who actually hand out the food items – work with clients to determine what foods they can or cannot eat. They also told me that some partners may keep allergy-friendly foods stored separately for clients who self-identify as requiring them. I think about what a challenge it can be walking through the grocery store to find safe foods so I wonder what the experience is actually like, trying to get safe foods from a more limited selection (like that available from the food bank).

Allergen-free toddler (family) meal planning

Ever since finding out that our baby has food allergies, as a breastfeeding mom, I have been working to cut out his allergens from my diet as well as cooking allergen-free family meals. It’s quite the educational experience for me as I delve into the world of cooking without dairy, eggs, nuts, soy, and wheat.

Okay, first things first. Our baby is now a bona fide toddler. I can’t believe it but he is looking more and more like a little person, walking around and expressing his desires ever more clearly. We spend a lot of our at-home time in the kitchen: prepping, cooking, baking, cleaning, hanging out. One of the cool things that our toddler loves to do is stand on his wooden learning tower, which brings him up to counter height, and watch us chop, cook, or clean. He’s also been working on his skill of placing items into other objects, so we help him apply that skill all around the house. In the kitchen, this means that he can pick up chopped items and place them in a pot for cooking or into a bowl for mixing (roasted veggies). He loves helping out!

He’s also picking up on many more details about the world around him and this means that I am trying to only cook food that everyone in the family can enjoy. He notices what is on everyone’s plate and I think he learns a lot about eating food by observing us parents eat, so I’d like to have the same foods on each plate. This can be a challenge because (a) we used to eat a largely Asian diet with soy sauce, dashi, miso, and many other Asian seasonings and (b) we like to eat a variety of dishes. Our running list of foods to avoid is dairy, eggs, nuts, avocado, soy and wheat. We also have yet to try shellfish and a lot of seasonings. Luckily, our list of available proteins includes all animal and fish meats, as well as sunflower seeds…but some days I feel like we eat the same things all the time. We consulted with a dietician very recently just to learn whether or not our food offerings for our toddler were meeting his health and nutritional needs. Much to our pleasure, we were doing a pretty good job. Not surprisingly, with a diet free of dairy, the weak area of his diet was calcium.

His meals look something like this:

Breakfast

  • Oatmeal with prune or gluten-free banana waffles/pancakes
  • Selection of fruits
  • Hemp milk

Lunch/Dinner

  • A protein (beef, chicken, turkey, pork, fish) – sautéed, baked, steamed; OR
  • Beef or vegetarian chili with a variety of beans; OR
  • Vegetarian or turkey/chicken/beef stock with vegetables; OR
  • Tomato sauce with or without meatballs.
  • Rice, brown rice pasta, or quinoa
  • Sautéed, steamed, roasted or raw vegetables
  • Hemp milk

Snacks

  • Baked good using flour alternatives or rice cakes with sunbutter
  • Fruit or vegetables
  • Breastmilk

Of course, there are additional variants on these meal options but this is a general idea of what we offer our toddler at the moment. By extension, this is what we eat as well. We cook everything from scratch now and I swear, we spend so much of our time either planning for, preparing or cooking food. Each week we meal plan to ensure that we get a good variety of food on our plates and to save us from having to hem and haw over what to eat during the week when both of us parents are working. We no longer have the option of just getting take out food from a restaurant as our toddler can’t eat that food.

We’ve recently begun introducing herbs (homegrown and dried). Unfortunately, we only dried thyme and oregano this year, so the remainder of herb introductions will have to be store-bought. I’ve contacted a number of major companies who package dried herbs and so far, they all have a possibility for cross-contamination in their manufacturing facilities with all of our allergens but do claim to follow good manufacturing practices. Some days it feels like the level of scrutiny that I put into our meals is overwhelming and borderline paranoia, but without questioning every preparation method and every single ingredient, I can’t feel safe giving our toddler the food. We’re firm believers in food being an enjoyable experience, as both of us parents love food, and we’re trying hard to instil that in our toddler despite the food allergies.

Soyless tofu?

Short anecdote for today: We had a follow-up appointment with our paediatric allergist and mentioned that it seemed our child may be a wee bit sensitive to tofu. The skin prick test hadn’t indicated a reaction to soy but he had gotten a bit itchy around his face on a few occasions when we’d offered him tofu.

The allergist asked us if the tofu had soy.

I looked quizzically at my partner. My eyes asked him, Did he just ask us if tofu had soy? When my partner cracked a smile, it confirmed that I hadn’t heard wrong. I told the allergist that yes, the tofu had soy.

The allergist told us that he hadn’t reacted to soy but that maybe we can try it without the soy.

Tofu. Without soy. Tofu, without soy? I remained dumbfounded for the rest of the day and chuckle whenever I think of that conversation.

Allergen-free chocolate

Ever since finding out that our baby has food allergies, as a breastfeeding mom, I have been working to cut out his allergens from my diet. It’s quite the educational experience for me as I delve into the world of cooking without dairy, eggs, and nuts.

Ah, chocolate. That brown square that melts like velvet in my mouth. Oh but so many of the chocolates lining the shelves at stores contain milk and if not milk, they may contain or be cross contaminated with a variety of nuts. At my local health food store, I asked for a chocolate bar that does not contain milk. The lady pointed out a few good choices. I further clarified that I needed a chocolate bar that has never made contact with nuts. I was given one bar out of their entire display of chocolate bars!

When I think ahead to the Halloweens, Christmases, Easters, and Valentines of my kids’ life, I’m saddened to think that he won’t be able to readily partake in the chocolatey goodness that so many others easily enjoy. That Lindt advent calendar just isn’t in our future *tear*. It’s not just the holidays that will be difficult but facing the sheer abundance of milk/nut chocolate bars that line shelves at the grocery store, gas station, restaurants, vending machines, practically everywhere (I swear I notice it more now that I can’t eat it).

However, there is hope and that hope exists in allergen-free chocolates. Unfortunately, they are challenging to locate and the selection of flavours isn’t the greatest, particularly in my city (ie. not in the United States). Still, they are hidden gems! So far, my finds are:

  • Giddy Yoyo (free of dairy/nuts/soy). An Orangeville, Ontario company!
  • Hummingbird Chocolate (free of dairy/gluten) has no nuts in their bars. An Ottawa, Ontario company! (updated July 2015: I’ve noticed that Hummingbird now has “may contain traces of nuts” on all of their bars…boooo)
  • Enjoy Life! chocolate bars, chips and chunks (free of the common allergens). An American company that produces many products that are all free of the common allergens.

It’s super exciting when I find an allergen-free chocolate and I’m hoping to discover many more in the months to come!

Ubiquity of milk ingredients

Ever since finding out that our baby has food allergies, as a breastfeeding mom, I have been working to cut out his allergens from my diet. It’s quite the educational experience for me as I delve into the world of cooking without dairy, eggs, and nuts.

I read labels when I shop. What are the ingredients? Where is it from? What is the nutritional information? However, I’m realizing that I hadn’t been reading labels on every single food product that I was purchasing.

My go-to chip is the Kettle brand chip and during one of my recent grocery shopping trips, I absent mindedly picked up a bag of sweet onion-flavoured chips…and yes, I had a chip craving one day and went to grab a handful of these chips, only to read the label at that point (did I mention I had an immediate craving!) and find milk ingredients! Reluctantly, I put the bag back in the pantry, unopened.

The more I scrutinize food products, the more I realize just how ubiquitous milk ingredients are. There are the obvious dairy products: the cheeses, yogurts, and ice creams. Then, there are the somewhat obvious milk-y products: many popular chocolates, sherbets, cheesy crackers, etc. But the chips!?

Luckily, products now have a clear statement when they contain any of the top food allergens (soy, milk, wheat, fish, shellfish, peanuts, tree nuts, egg, sulphites, mustard) – see Health Canada’s page outlining 2012 changes to allergen labelling requirements – and many have precautionary statements laying out possibility of inadvertent contamination with common allergens. Had I read the label on the chip bag, I would’ve easily seen “milk ingredients” among the list of ingredients but I didn’t realize that seasonings are another possible source of milk.

Milk. It’s in so much of the packaged foods that we consume and to an extent that I am only now realizing.

Being thrown into the world of food allergies

I love food, so when it came to introducing solid foods to our baby, I was quite excited to be able to share something that I loved with a person who I loved. We exclusively breastfed for six months and decided to let baby lead the weaning process as he started to explore foods other than breast milk. We would provide a selection of appropriate food items for him to choose from, and he would use his hands and all other senses to “eat” the food that he chose to “eat”. We didn’t start with rice cereal, as is so typical in our society. Instead, we gave him steamed broccoli florets, a bell pepper, an apple slice, and a strip of steak. The key with this approach is for the caregiver to provide a well-balanced assortment of foods and the eater to control if and how much they “eat”.

It was going fine until our baby experienced some fairly significant reactions to food. The look in his eyes as he scratched at his neck and face is something that I will not soon forget. After that first adverse reaction, we saw our family doctor and he referred us to a paediatric allergist. In the meantime, we avoided the foods that triggered that reaction but continued to offer other foods.

Meanwhile, while we waited to be seen by the allergist, another particularly strong reaction led us to the emergency room, where some Benadryl and the passage of time eventually calmed the reaction; I felt so thankful and grateful that the reaction didn’t continue to worsen. This ER visit led us to equip ourselves with an epinephrine auto-injector. Just having to fill the prescription for it illuminated the gravity of the situation. Heaven forbid we ever have to use it, but better to have it in our possession than be sorry.

Skin prick tests are not the most conclusive in determining whether or not a baby has an allergy but at our first allergy appointment, we had it done for numerous common allergens. The test indicated that he was positive for peanuts, nuts, dairy, and egg. Based on our history, we were also directed to avoid wheat until another test could be completed in a few months.

With neither parent having any known food allergies, we were thrown into a new world. That’s a bit of hyperbole…it’s more like we started to see our world with new glasses. Questions floating through my head included:

  • what can he eat?
  • how will we eat out?
  • how do we best equip ourselves in the situation?

A blessing and a curse, because I’m breastfeeding, I was also instructed to avoid all allergens to which my baby may react to. The curse: Our allergist mentioned that trace amounts of dairy and egg would be allowable for me (no nuts whatsoever) but if my ingesting these products was affecting my kid, I decided that I should try to eliminate them from my diet too. The blessing: Taking dairy, egg, and nuts out of my diet would give me the best perspective in what could end up being the life of my baby. I would be forcing myself to question what I’m eating, how that food was processed, and (I’d get a head start on determining) how to prepare foods without those allergens.