the thirties grind

The Reluctant Chef Part 2: Trying to make sense of allergies and allergy research

Your response to guest author, Stephane Shick’s, last post about raising a severely allergic child was amazing.  As promised, here is part two of Stephanie’s story.

The “Hygiene Hypothesis” (UCLA Food & Drug Allergy Centre)

I felt inspired to contribute my thoughts regarding allergy research after watching a story on the CBC news a few weeks ago. Bear in mind, I am not a medical professional but I have definitely learned “on the job” about childhood allergies. For those of you who are not aware of the CBC story, the latest research is suggesting that the dramatic rise in childhood food allergies is possibly related to the use of some toothpastes, mouthwash and antibacterial products. This has been referred to as the “hygiene hypothesis”.  Somewhat related, is an article from the July 10^th Vancouver Sun, which reports that having dogs and cats can help make kids less prone to developing allergies (specifically nasal allergies and eczema). The exposure to dirt and microbes from the pet may be protective against allergies.

As a parent of a child with allergies, I have learned to take all these studies with a grain of salt. There are so many factors that contribute to allergies that it is nearly impossible to pin point one reason. The study regarding antibacterial products, or at least the information reported, failed to mention the many other variables that might explain the connection between kids with allergies having increased levels of these products in their system. For example, kids with allergies also tend to have asthma so they may be sick more often. This may lead to an increase in the use of antibacterial products, especially during cold and flu season. The allergies likely existed before the use of these products. Also, kids with allergies tend to have eczema, which makes their skin porous and increases their absorption of the products when used. Just to clarify, my daughter was not raised in a sterile bubble while being slathered in antibacterial products. She was raised with a very microbe-filled, hairy dog for the first two years of her life, yet she still developed allergies (to pets as well as food). There is more to the puzzle of allergies than ensuring we expose our kids to dirt and pets.

I sometimes feel that the media tries to make sense of this trend of increasing childhood allergies by simplifying and personalizing the problem. The side effect is that the general public starts making inaccurate generalizations (i.e. “the parents must have been clean freaks, that is why their child is so allergic…”). This may serve to reduce people’s anxieties about their own kids potentially developing allergies but it can definitely lessen compassion and understanding. Is the unspoken implication that people with allergies (or their parents) are to blame for their medical situation? Does this subsequently make people less tolerant and accommodating? This seemed to be the case last year in Edgewater Florida when angry parents picketed in front of a school to demand that a child with a severe peanut allergy be removed. Some parents were so upset by the accommodations put in place that there were even threats made to spread peanut butter on the allergic child’s backpack. Thankfully, my daughter’s experiences at school have been very positive and inclusive.

Trying to make sense of the allergy research can be pretty crazy making because the “latest research” keeps changing. For example, when my eldest was a baby (5 years ago), the recommendation was to delay introduction of allergic foods. Fast-forward 2 years to my second child and now the research is suggesting that the late introduction of foods may have contributed to the increase in allergies. Quite the paradigm shift!  My eldest daughter’s allergist even told me that I “waited too long” to introduce peanuts and that is why she had an allergic reaction. She had tested negative to peanuts initially but by the time I got up the courage to give it to her (since by then she was allergic to dairy, egg, fish and mustard), she reacted. This definitely added to the already healthy dose of maternal guilt I carried. I now believe that the timing of food introduction did not cause my daughter’s allergies. She was primed from infancy and struggled with eczema and her digestion from the beginning.

The issue of maternal diet is also in question. Some allergists recommend avoiding allergenic foods during pregnancy and lactation to reduce the chances of allergies developing. This is troublesome because the research also says that the propensity for allergies can be inherited, but not necessarily to a specific food. So what food do you avoid? You could end up avoiding all the top ten allergens and still end up with a child allergic to milk….. or bananas! Other allergy research says that the early exposure in pregnancy and lactation is protective. Each theory is in opposition. So what is an expectant mother to do when there is a family history of allergies? Well, I ended up eating all foods during my second pregnancy and while breastfeeding  (just as I did with my first) and ended up with a second child with no known allergies. Can this be any more confusing?

If you live in Vancouver and you suspect that your child has food allergies, it can take anywhere from 6 months to ONE YEAR to see an allergist. That is a long time to be living in uncertainty about what to feed your child. The allergy testing itself is not always accurate (false positives and negatives can occur) and when the appointment is over, parents are left with a list of foods to avoid, an Epipen prescription to fill and limited follow up. Very little practical or emotional support is available to families of kids with allergies and this can be a very isolating experience. Currently, parents rely mainly on online allergy groups to share information and support.

Behind all the research studies and theories are real kids and families who are trying to make the best choices possible in the face of conflicting information. Add to that the limited medical, practical and emotional support and it is no wonder that stress and anxiety levels within an “allergic family” can run high. Whenever a study is presented to the public, I find myself trying to find connections between the research and my daughter’s situation. When I begin to feel overwhelmed, I remind myself that even the most prominent allergists and immunologists are uncertain about causation. The relationship between all the possible variables is so complex. Over the years I have developed my own theory about allergies. I believe that environmental changes, pollution, genetically modified and processed food, pesticide use, chemicals and the influence of all these factors on our genes all play a role in the development of allergies. Ultimately, the rising incidence of kids (and even adults) with food allergies should be all of society’s concern. These kids are the sensitive beings that are telling us that something is seriously amiss in our environment. The question is, can we turn this around, or will more and more of our kids be paying the price for generations to come?