Public schools don’t provide lunch here in Switzerland, as I’ve mentioned before. Kids either go home for lunch or to a grandparents house, for example, or they participate in an offsite parascolaire program. These programs in our Swiss city pick up kids from school at 11:40 AM, feed them and then bring them back to school by 1:45 PM.
Since I’m still working as a mère au foyer (i.e., stay-at-home mom), my son comes home for lunch. With a fixed amount of time to get him fed and returned to school, I find myself needing to do some meal prep in advance. This way, our time together isn’t too rushed (i.e., I keep my cool and don’t yell as much!), and he’s not late getting back to class.
This week, I wanted to share a very Swiss recipe from the canton of Schwyz that I’ve adapted to be dairy-free: Benediktinereintopf Kloster Einsiedeln (Benedictine Stew from Einsiedeln Abbey). It’s a hearty Swiss-style meal that can be made relatively quickly, with a little chopping done beforehand. So far, I’ve served it with mashed potatoes (which most of us prefer) and elbow macaroni (which my son with food allergies prefers). Surprisingly, it’s a dairy-free cheese that makes this dish work!
Our family visited the Einsiedeln Abbey this summer, where the Benedictine Stew apparently originated, but the torrents of rain prevented us from having a leisurely visit. We still enjoyed our time there, but I would love to return someday during the holiday season for the town’s famed Christmas market, as the Abbey makes a dramatic backdrop to the festive stalls of craft makers and food vendors.
The current Monastery and Abbey Church in Einsiedeln were constructed in the 18th century, but religious pilgrims have been visiting this site for over a thousand years. The courtyard include stables for the historic Einsiedeln breed of horses. The boys would have loved seeing them, but it was raining so hard that day, none of us wanted to venture out across the courtyard!
Back home after our trip, I came across the Benedictine Stew recipe in my Betty Bossi cookbook. Other than it being from the Einsiedeln Abbey, I haven’t learned much else about this Swiss dish. Although, I saw the Jewish Museum Berlin has a recipe online for a cheese soup served at the Abbey on “minor fasting days,” with leeks as a suggested addition. If you know anything else about the Benedictine Stew, please let me know!
The Betty Bossi recipe calls for a soft cheese with herbs, like Boursin. Instead, I substituted a dairy-free alternative: CreamyRisella, a soft Italian cheese made from brown rice. For the herbs, I just added some fresh tarragon. If you can use real cheese in this recipe, you should! However, if you’re like us and need to avoid milk-based products because of an allergy, CreamyRisella is a very good alternative.
Recipe adapted from Betty Bossi’s “The Swiss Cookbook” (Zurich, 2010).
400 grams ground beef
1-2 tablespoons dairy-free margarine
400 grams leeks, cuts into thin strips lengthwise (or into rounds—it’s easier and tastes the same!)
3 small onions, finely chopped
500 ml vegetable broth
200 grams CreamyRisella (or another very soft dairy-free cheese)
1 tablespoons finely chopped fresh tarragon
1. Brown the ground beef in a large pan. Remove the beef and set aside. Drain the fat from the pan.
2. Add 1-2 tablespoons of dairy-free margarine to the same pan, and sweat the leeks and onions slowly for about 5-10 minutes over medium heat.
3. Pour the vegetable broth over the leeks and return the ground beef to the pan. Bring to a boil, and then reduce the heat. Cover and simmer for about 15 minutes.
4. Stir in the CreamyRisella (or other cheese substitute) and tarragon, over medium heat, until both are fully incorporated and the dish is heated throughout. Serve immediately over your choice of an accompaniment: allergy-friendly boiled or mashed potatoes or elbow macaroni.
The Swiss holiday, Jeûne Fédéral, is this weekend, so I’ll be making a Tarte aux Pruneaux to celebrate. Bon week-end, everyone!
New research suggests that changes to the bacteria inside our bodies may be linked to the growth in allergic diseases. Horizon, a BBC Two science program, covered this topic during a recent episode entitled, “Allergies: Modern Life and Me.” By profiling the experiences of two UK families living with various allergies and asthma, this program tests the hypothesis that bacteria living inside the gut, or a lack thereof, are affecting the development of allergies.
Researchers think environmental factors have played a role in the growth of allergic diseases in the last few decades, and daily practices of modern life may be the culprit. High bacterial diversity in the gut has been associated with lower levels of allergic disease, according to several recent studies. For example, researchers have found connections between lower levels of allergies and things like having plants in your house, living on a farm or spending time outside, as these can increase bacterial diversity. Furthermore, the Johns Hopkins Children’s Center reported last month that an estimated one in 10 inner-city children in the United States has an egg, milk or peanut allergy (and researchers contend the actual number could be higher)—a finding that seems to lend support to the bacterial diversity theory.
A Swiss Connection
As I watched the Horizon program on allergies, I was pleased to see Switzerland mentioned, as there’s a prominent researcher here who’s leading some work examining the relationship between bacterial diversity and allergic diseases. Dr. Ben Marsland, an Associate Professor at the University of Lausanne, was interviewed about his work with “germ-free mice.”
While these mice are normal in their appearance, they are free of bacteria, fungi or viruses. Dr. Marsland and his colleagues found that when these mice were exposed to dust mites, they were more prone to an allergic reaction. (Similar results were found recently by a team of researchers led by Dr. Cathryn Nagler at the University of Chicago that exposed germ-free mice to peanut.)
I sent Dr. Marsland an email following the program, to thank him for his research and inquire about current and future work. He passed along three recent publications from his team’s research this year. The citations appear below, if you’re interested in a more detailed description of his findings:
- Gut microbiota metabolism of dietary fiber influences allergic airway disease and hematopoiesis, Nature Medicine; 20, 159–166 (2014).
- Increase in dietary fiber dampens allergic responses in the lung, Nature Medicine; 20, 120–121 (2014).
- Lung microbiota promotes tolerance to allergens in neonates via PD-L1, Nature Medicine; 20, 642–647 (2014).
Dr. Marsland added that his current work includes fundraising for a birth cohort study in Norway involving some basic interventions, such as introducing certain foods at an earlier age. In the future, he hopes his basic research can be translated into effective clinical practices to treat allergic diseases.
Living a Modern Life
During the program, I couldn’t help but think about our own family. How would we fare in a similar experiment like the one conducted with the two families for Horizon? How often do we spend time outside? How many plants do we have in our house? I didn’t have a c-section when either of my sons were born (a vaginal birth results in higher exposure to bacteria). Neither had antibiotics during their first year of life.
I’ve certainly wondered at times if there’s something I could have done to cause my son’s allergies, and this episode of Horizon definitely raised those concerns again. While it may not be possible to determine one specific thing as the root cause, it made me question our current practices. What are some practical ways we can increase bacterial diversity in our lives? I’m already planning to take the boys hiking more often on one of my favorite routes—through the forest and alongside an organic farm with goats, pigs, donkeys and chickens!
For further reading on this topic, check out “Horizon on Allergies,” an excellent post from Michelle’s Blog, written by UK food allergy and intolerance blogger, Michelle Berriedale-Johnson.
Did you watch this episode of Horizon? What did you think? If you have any thoughts or questions to share, please leave a comment below.
What are Reine-Claudes? Maybe you know them as Greengages? Now after two years of living in French-speaking Switzerland, I finally discovered these little green plums with a sweet fresh flavor. Typically grown in southern France, we see Reine-Claudes at our farmers’ market and all the local grocery stores. Their size can vary, but most often they’re smaller than purple plums (pruneaux) and slightly larger than the yellow-hued Mirabelles.
Named after a 16th century French queen, these special Reine-Claudes have a distinct flavor and are really best eaten raw. Even so, I’m not a huge fan of plums—although I’m slowly acquiring a taste for them. Generally, I prefer them baked in a cake or tart.
Over the last few weeks of summer vacation (my son’s school year started on Monday already!?), I’ve been perfecting my recipe for a cake with Reine-Claudes. When I served my second test-cake to my father-in-law last week, he suggested calling it a coffee cake, given it’s overall appearance and texture. I agreed with him, and since I’m usually downing a large cup of coffee (or several) when eating cake, it seemed like a good name for my new recipe. I had lots of coffee cake growing up in Minnesota, and this one reminds me of one my mother used to make with a cinnamon-streusel topping—except it’s made without dairy and contains French plums befitting a queen!
Reine-Claude Coffee Cake
A 9-inch round cake tin or springform pan
Parchment paper and/or dairy-free margarine for greasing the pan
1 cup all-purpose flour
3 tablespoons ground almonds (optional)
1 teaspoon baking powder
1/8 teaspoon salt
3/4 cup sugar
1/2 cup dairy-free margarine, softened
1 teaspoon vanilla sugar (or vanilla extract)
2 large eggs
Zest of 1 lemon
About 8 Reine-Claudes (Greengages), pitted and halved
2 teaspoons fresh lemon juice
2 tablespoons sugar
1 teaspoon ground cinnamon
1-2 tablespoons sliced almonds (optional)
1. Whisk together the dry ingredients in a small bowl. Set aside.
2. In a large bowl, beat together the sugar, vanilla sugar and margarine. Add one egg at a time, and combine until the mixture is smooth. Then stir in the lemon zest.
3. Add the dry ingredients to the wet ingredients in two batches, stirring together gently until combined, but do not overbeat. Put the cake batter into the prepared pan, spread evenly.
4. Place the Reine-Claudes face down and evenly dispersed on top of the cake batter. Then, sprinkle the lemon juice over the plums and the cake batter.
5. Combine the sugar and cinnamon and sprinkle it over the top of the cake. Finally, sprinkle on the sliced almonds.
6. Bake for 40-50 minutes at 180ºC/350ºF until a toothpick inserted in the center of the cake comes out clean. Best served warm, but also very good the next day!
We’ve had a cool and rainy Swiss summer, so I’m hoping for a warm autumn season. Hope you’re all doing well and enjoying the final weeks of summer.
Dairy/egg-free meal at Grindelwald’s Hotel Belvedere
During a rare meal out at a restaurant last month, my son raised up his arms and cheered loudly at the table—with a fork in one hand and a knife in the other. He really liked his fish, and was pretty excited about having a meal in a restaurant. Although, I can’t help but wonder if he was just glad to not be eating my cooking! Either way, it was a nice moment on our vacation that I won’t soon forget.
Have you ever been served a delicious allergy-friendly meal, carefully prepared by a restaurant in Switzerland? This most recent meal was at the Hotel Belvedere‘s restaurant in Grindelwald. With a lot of advanced preparation and emails back and forth, my son enjoyed a safe meal made without dairy and eggs. We were all very happy to be there—even though I can never fully relax when my son eats a meal I didn’t prepare myself.
Based on our experiences, and those of others living and traveling with food allergies in Switzerland, I’m constantly adding to my list of allergy-friendly restaurants and accommodations. For example, I just received an email last week with a new restaurant recommendation for Zurich: Widder Restaurant.
If you have places to recommend, please leave a comment below or send me an email. We can learn so much from each other. This information is helpful to our family and for so many others living with food allergies and intolerances. I really appreciate your help!
I’ll be offline for the next two weeks until school starts, as we’re taking a short vacation with family visiting from the United States. As usual, I hope to discover some new Swiss foods while we’re traveling. Thanks to you all for your continued support!
Every year on August 1, Switzerland celebrates Swiss National Day. Here in Suisse romande, we know this holiday as Fête nationale or 1er août. Given the Swiss affinity for bread, it’s not surprising that there’s a special bun prepared for the holiday. Known as August-weggen (German), Pain du 1er août (French) or Panino del 1° agosto (Italian), the small and large versions are cut and baked to look like there’s a Swiss cross on top. They’re typically decorated with a small paper version of the red and white Swiss flag.
This year marks our first time celebrating Fête Nationale in Switzerland. Our first year here, we arrived one day after the celebration on Saturday, August 2, 2012. Now I understand why everything was so quiet the morning we drove from the airport in Zurich to our new home! The Swiss were sleeping in after a day of local celebrations and feasting—traditionally an outdoor brunch at a local farm—and watching fireworks late into the evening.
Instead of heading to a farm for a local brunch on Friday—which would undoubtedly have tables heaped with delicious Swiss cheeses and other milk and egg-filled dishes—we’re choosing to have our own picnic and bonfire at a local park. We’ll be roasting cervalas, often referred to as the Swiss national sausage, as well as marshmallows, to give our celebration an American twist. I’ll also be serving my own version of Petits Pains du 1er août, but mine will be made without dairy.
Rütli Meadow: The Birthplace of Switzerland
To give you some background, Swiss National Day commemorates the founding of Switzerland in 1291. The story goes that the leaders of three cantons—Schwyz, Unterwalden and Uri—came together at the Rütli Meadow to form a strategic alliance. The pact made by these three original cantons ultimately led to the formation of Switzerland and the 26 cantons we know today (there’s a great video from Swissinfo.ch with some beautiful images of Rütli and more detailed info about its history).
We visited the Rütli Meadow earlier this month when we stayed a few nights in Brunnen (as an aside, we had a pleasant stay at the Hotel Schmid & Alfa, which has a few apartments with kitchens, so we could make our own meals). From Brunnen, we took a 10-minute ferry ride across Lake Lucerne to Rütli. During our visit to this historic site with incredible views, only a few other families crossed our path. We had a peaceful time exploring the pristine meadow, seeing happy Swiss cows and having a snack at the picnic area (that’s shown in the video above). If you’re in the vicinity, it’s certainly worth a stop.
Swiss National Day started in 1891, but it became a federal holiday over a century later in 1994. Also, the Swiss didn’t start making Pain du 1er août until 1959, when it was invented by the Swiss national association for bakers and confectioners. The small version of the buns are very similar to Petits Pains au Lait, except they have a patriotic shape cut into the top.
Petits Pains for Swiss National Day
Recipe adapted from one of my favorite Suisse romande bloggers, Delimoon
(dairy/nut-free, can be made without egg)
Makes 8 rolls
500 grams all-purpose flour
2 teaspoons sugar
1 teaspoon salt
300 ml soy or rice milk, very warm
7 grams (2 1/4 teaspoons) active dry yeast
60 grams dairy-free margarine, softened
1 egg, beaten (or 1-2 tablespoons dairy-free margarine, melted and cooled)
1. Whisk together the first three ingredients in a large bowl. Add the softened margarine. Set aside.
2. Add yeast to the warmed soy or rice milk, along with a pinch of sugar. Gently stir and let sit for a few minutes until the yeast has dissolved and the mixture begins to foam slightly.
3. Pour the yeast mixture into the large bowl with the flour mixture and margarine. Stir until a dough forms. Knead the dough for 10 minutes, stopping when it becomes smooth and elastic.
4. Let the dough rise for about 1 to 1-1/2 hours. Punch down the dough and cut into 8 equal pieces. Shape the pieces into round buns and set on a baking sheet lined with parchment paper. Cover the buns with plastic wrap and let them rise for another 30 minutes.
5. With a pastry brush, gently brush on the egg wash (or melted margarine). Then, using kitchen shears or a very sharp knife, make cuts into the dough that resemble the cross on the Swiss flag.
6. Bake the buns for 20-30 minutes at 200°C/400°F. Remove and tap the bottoms. If they sound hollow, then they’re done. Place on a wire rack to cool.
Happy Swiss National Day! We’re looking forward to a 3-day weekend. Thanks so much for visiting my blog. Bon week-end, all!
I have a really hard time hiding my emotions. Yesterday morning, in particular, was challenging for me. After finishing off two small pieces of cake made with powdered milk, my 3-year old suddenly refused to eat another bite during his food challenge. We had to stop the test. After only two doses, even though he didn’t have a reaction, the results were inconclusive because he wouldn’t eat all five doses. While I tried to remain upbeat and cheerful, my frustration was clearly visible.
This was his fourth food challenge, so we all knew the routine pretty well. Of all the scenarios I considered, my son refusing to eat wasn’t one of them. All of us kept talking about how wonderful the food challenge would be, since my son would get to eat cake during the test. Compared to his 3-year check-up a few weeks earlier—which required a painful finger-prick for a blood sample and a vaccination injected in his thigh—the baked milk food challenge would be so much easier.
Signs of Trouble
Once at the hospital though, the signs of trouble appeared early on. First, I was disappointed to learn the cake contained chestnut flour, instead of an all-purpose flour made from wheat. My son doesn’t have a wheat allergy or gluten intolerance, but this was apparently the standard cake the hospital used for a baked milk challenge. While I didn’t mind the taste of the cake, my finicky son wasn’t loving it.
While his first small piece of cake went down relatively easily, the second almost made him vomit. As he started lurching, the doctor quickly grabbed a bowl for him. Thankfully it stayed down, but I started wondering how he could possible manage the final and largest dose, if such a small piece caused this type of response.
For the third dose, the nurse suggested crumbling the cake and mixing it with applesauce. We did this during his food challenge with baked egg, and he gladly ate it up. Today was different though. When the spoon was presented, he refused to open his mouth. He really didn’t want to eat it, but at the same time, he had a little sparkle in his eyes, like we were playing a game—and he was winning. Did I mention our son is 3 years old?
We waited an hour after the second dose with all of us attempting to feed him the cake and applesauce mixture. Airplane spoons were flying into his mouth. I tried dancing and singing with him, while sneaking in a spoonful. His older brother even tried to help out. Nothing worked, and so the doctor said we should stop. You can’t force someone to eat, and our attempts just seemed to strengthen his determination.
How often does this happen?
According to my son’s pediatric allergist, this certainly wasn’t the first time a child refused to eat during a food challenge. It happens—especially with kids around our son’s age. I poked around for some data on the prevalence of situations like ours, but haven’t come across any yet. I’m curious about this, so if you have any info—either stories from your own experiences or quantitative data from a peer-reviewed journal article, for example, please let me know.
In 6 months, my son will repeat the food challenge for baked milk—except this time I may be bringing a homemade cake. The pediatric allergist will be sending a recipe, so I’ll practice it a few times with all-purpose flour, along with a little cocoa powder or some Enjoy Life chocolate chips. I’ll do whatever it takes to make sure we don’t have the same result!
In the meantime, while we’re waiting to redo the test, we’ll be scheduling another food challenge for raw/undercooked egg as soon as possible. We’ve already been serving our son lots of foods containing baked eggs, so I’m really hoping for a negative test result in the coming months.
Have you ever repeated a food challenge because your child refused to eat? If you have any advice to share with us and others about food challenges with children, please leave a comment below or send me an email. Thanks in advance for your help!
My oldest son—who doesn’t have food allergies, had previously stopped eating the vegan pancakes I made for his brother. He claimed to no longer like ANY pancakes. Thankfully, he’s changed his mind in the last few weeks. With a new ingredient, I’ve developed a recipe that both my sons really like: Lemon “Ricotta” Pancakes sans dairy, eggs and nuts.
MozzaRisella Vegan Cheese
While I don’t usually share recipes that call for specific brands of food products, I make an exception when I find something really great, especially if it could be helpful to others living with food allergies. My latest discovery here in Switzerland is MozzaRisella—a vegan cheese made from germinated brown rice. I’ve seen it in our small Swiss city at several bio (organic) shops, and I know you can also find it in the UK.
We started buying MozzaRisella to make dairy-free pizza for our son. Compared to the frozen pizza with fake cheese we tried last summer in the US, the homemade pizza with MozzaRisella is so much better. This product even tastes good uncooked and straight from the package. My boys and I were sampling pieces last night when I was making pizza again, and my 3-year old with food allergies kept asking for more.
In addition to pizza, we also tried using MozzaRisella for nachos. I would have never considered this before, but we recently had nachos with mozzarella at our local Swiss-Mexican restaurant. We hadn’t made nachos for years, but during the World Cup, we ate dairy-free nachos with black beans and corn and topped with cilantro and thinly sliced radishes. Not as good as ones made with real cheese, but still an excellent alternative.
The Italian company that makes MozzaRisella also makes CreamyRisella, but I didn’t start buying this other product right away. Then, The Kitchn posted their easy recipe for Fluffy Ricotta Pancakes, and I wondered about using the CreamyRisella as a substitute for the ricotta. It worked from the start, and with a few other modifications, I now have a pancake that even my oldest son will eat. On Sunday, I served them for brunch with fresh raspberries and a side of bacon.
Lemon “Ricotta” Pancakes
Serves 3-4 people
3 tablespoons freshly squeezed lemon juice mixed with 1 tablespoon flax meal
1 package of CreamyRisella (200 grams)
2 tablespoons canola oil
2 tablespoons sugar
1 teaspoon cider vinegar
1/2 teaspoon vanilla sugar (or vanilla extract)
zest of 2 lemons
1 cup flour
1 teaspoon baking powder
1/2 teaspoon baking soda
1/8 teaspoon salt
1 1/4 cup soy or rice milk (I’ve been using Alnatura’s Soja Drink-Vanille from Migros)
1. In a large bowl, stir together the lemon juice and the flax meal and set aside for a few minutes.
2. Then, add the next six ingredients to the flax meal mixture and whisk together until smooth: CreamyRisella, oil, sugar, cider vinegar, vanilla sugar and lemon zest.
3. Whisk together the dry ingredients in a separate bowl. Next, gently whisk the dry ingredients into the wet ingredients in about 2 batches, alternating with the soy or rice milk. Do not overbeat.
4. Using a measuring cup, pour pancake batter on a medium-high heated skillet. Flip the pancake once air bubbles throughout the pancake begin to burst. Cook about 1-3 minutes on each side, until light golden brown, and serve warm.
What’s your favorite vegan cheese? Have you tried MozzaRisella? I’m curious to hear about other vegan cheeses in Switzerland and beyond. Please leave a comment below or send me an email. Thanks!
When I was a kid, I would drink a large glass of cold milk with every meal. Unfortunately, my son can’t do the same because of his milk allergy. Instead, we give him soy milk fortified with calcium. Thankfully, he loves the stuff. At the same time though, I’m always looking for new brands that have a perfect combination of nutrition, taste and an affordable price.
So, when Migros sent me a complimentary box of Alnatura’s organic products for my family to try—including several different kinds of milk substitutes—it seemed like a good time to to reevaluate which milk substitute is best for my son. Migros recently started offering Alnatura products via its home-delivery site, LeShop.ch, and in selected stores. Here’s what I’ve compiled so far to compare the milk substitutes from two major Swiss supermarkets—Migros and Coop—based on a review of their websites today: July 11, 2014.
Dairy-Free Milk Substitutes: Coop and Migros
|None listed||isola Bio Mandorla Boisson aux amandes Bio, 1 liter
(reg. 4.80 CHF, on sale for 3.90 CHF)
|Oat Milk||Coop Naturaplan Bio Boisson à l’avoine, 1 liter
(Not available online; price not listed)
|Alnatura Drink avoine (hafer) et calcium or natur, 1 liter
|Quinoa Milk||Naturaplan Bio Max Havelaar Boisson de quinoa & riz
1 liter (3.50 CHF)
|Rice Milk-Calcium||None listed||Alnatura Drink riz calcium, 1 liter (2.30 CHF)
Isola Bio, Boisson au riz Nature – avec calcium, 1 liter
(reg. 3.50 CHF, on sale for 2.80 CHF)
|Rice Milk-Nature||Naturaplan Bio Boisson au riz nature, 1 liter (3.30 CHF)||aha Boisson au riz, 5 dl
Isola Bio, Lait végétal à base de riz nature, 1 liter
(reg. 3.40 CHF, on sale for 2.70 CHF)
|Rice Milk with Almond||Coop Naturaplan Bio Boisson au riz amandes, 1 liter (3.40 CHF)||Bio Boisson au riz-Amandes, 1 liter
Isola Bio Boisson à base de riz-Amande, 1 liter
(reg. 3.80 CHF, on sale for 2.90 CHF)
|Spelt Milk||None listed||Alnatura Drink à l’épeautre (dinkel) natur and calcium,
1 liter (2.90 CHF)
|Soy Milk-Calcium||Sojasun Soya drink avec calcium, 1 liter (3.45 CHF)||Alnatura Drink soja et calcium, 1 liter (1.60 CHF)|
|Soy Milk-Nature||Naturaplan Bio Drink au soja nature, 1 liter (1.90 CHF)
Sojasun Soya drink nature, 1 liter (2.20 CHF)
|Alnatura Drink au soja nature, 1 liter (1.60 CHF)
Soja Line aha – Drink Boisson Bio nature-100% végétal, 1 liter (1.90 CHF)
Soyana Soy Drink, Boisson à base de fèves de soya bio Original,
|Soy Milk-Vanille||None listed||Alnatura Drink soja vanille, 1 liter (1.90 CHF)|
Please note: I focused on the more typical milk substitutes intended as beverages (e.g., those beverages marked with “Drink”). Also, I have not included lactose-free milk substitutes that include other forms of dairy or chocolate-flavored milk substitutes. Finally, the actual selection of these products can vary at each individual store.
Full disclosure: I received a complimentary box of Alnatura products from Migros, as shown in the photo above. However, I did not receive any compensation from Coop or Migros, and any opinions expressed in this or any of my other posts are solely my own.
We have a grocery order arriving at our home this evening, so we’ll be doing some taste tests this weekend. What are your favorite milk substitutes in Switzerland? Bon week-end, everyone!
No, there isn’t a shortage for the moment. However, the supply of adrenaline auto-injectors (AAIs) in Switzerland has been limited recently, due to defects found last fall in one of the two available brands here. According to an official from Swissmedic—the Swiss federal agency responsible for authorizing and supervising therapeutic products—the situation may be more accurately described as “an undersupply,” and it’s improving.
The issue of a potential shortage first came to my attention in January 2014, when I picked up a new prescription for EpiPens because our son’s were expiring. I brought them home from the pharmacy to discover they would expire in May 2014—only a 5-month shelf-life. We had to request a new prescription from our son’s allergist again this spring. I wanted to know more about why this occurred, especially since a typical shelf-life for EpiPens is about 13-14-months—a fact I learned this week via email from a representative of MEDA, the company that distributes this brand in Europe. Also, I’ve been reading about similar situations in the United States via the food allergy blog, Oh Mah Deehness!, and in the United Kingdom via Anaphylaxis Campaign.
Please note: In the United States, from my experience, AAIs are more commonly referred to as epinephrine auto-injectors.
What are AAIs?
We always carry two AAIs with us because our son has severe food allergies. If he had a life-threatening allergic reaction, known as anaphylaxis, we would need to inject him with a dose (or more) of adrenaline. Some symptoms of anaphylaxis can include skin reactions and difficulty breathing. While we’ve thankfully never had to use them, we need to make sure we’re carrying AAIs that haven’t expired.
What brands of AAIs are available in Switzerland?
In Switzerland, people who need AAIs have two options: EpiPen or Jext (see the table note below). Anapen has also been licensed in Switzerland, but hasn’t been available since a product recall in 2012, and it’s not known when it will be available again, based on an email response I received from aha! Swiss Allergy Centre. Here’s a quick comparison of the two available AAIs in Switzerland:
|Types of AAI||EpiPen Jr and EpiPen||Jext 150 and Jext 300|
|Shelf-life||18 months||24 months|
|Refill reminder system||Yes (My EpiPen and My EpiPen App)||Yes (Expiry Alert Service)|
|Distributor||MEDA Pharma GmbH||ALK-Abelló AG|
*While the Jext 150 and Jext 300 haven’t been available during the first half of 2014 in Switzerland, a Swissmedic official emailed me on July 10 to report that new lots of the product are expected in July 2014.
What caused a batch recall of Jext AAIs?
In November 2013, there was a batch recall of Jext 150 and Jext 300 in Switzerland. It was discovered that in rare cases, a defect would prevent the adrenaline from being administered properly for certain batches of these products.
How did the recall affect the supply of AAIs in Switzerland?
The batch recall meant the retail sector (i.e., pharmacies) had to return their supply of Jext that could potentially have the defect. At the same time, patients with Jext were informed to keep them, since the probability of a malfunction was very low, and based on a November 2013 notice from Swissmedic, a replacement of AAIs could not be guaranteed due to a limited supply—a situation that was occurring throughout Europe.
To help alleviate the increased demand for AAI in Switzerland, Swissmedic approved the distribution of an “emergency batch” of EpiPens “with a relatively short remaining shelf-life,” according to an agency official there. It provided temporary relief and helped prevent a shortage of this medication. Patients with extremely severe and recurrent allergic reactions that had the potentially defective Jext were allowed to receive another AAI during the recall as a precaution.
What’s the situation now?
EpiPens with a more typical shelf-life are now being made available to patients in Switzerland, according to an agency official from Swissmedic. This matches our family’s experience, as the two AAIs we picked up in May 2014 had an expiration date of June 2015. Furthermore, new lots of Jext should be coming on the market yet this month, as indicated by an Swissmedic official. All of this is good news for people living with food allergies, who depend on this medication if they ever experience a severe allergic reaction.
What kind of AAI have you or your family members been prescribed? How, if at all, have you been affected by the Jext recall? Please share a comment below, when you have the chance. Thanks in advance for your help.
Updated: July 10, 2014
The signs of summer are apparent here in Switzerland. Outdoor music festival season started locally with Festi’neuch. Swiss summer trail racing is also underway, and I’ll be attempting my first one next weekend. Most importantly, my son’s summer vacation from school starts in one week. And in terms of food, I’ve noticed restaurants around town are advertising their summertime salads or salades estivales.
My research indicates there’s no set rule for making a Swiss salade estivale, other than it should contain some sort of fresh summertime vegetables. Since I’m always trying to get my boys to eat more vegetables, we’ll be making lots of salads again during our summer vacation. The first Swiss salad recipe I’ve been making this summer is appropriately named Salade estivale, which I came across a while back in one of my Suisse romande cookbooks.
With seven vegetables to choose from in this salad, my boys tend to pick out the ones they like and leave the rest, but I still try to see it as progress. I was reminded this week by registered dietician Julia Marriott of Alimentary Bites that when it comes to serving vegetables to picky eaters, “perseverance and patience” are the only way. As with many salad recipes, the directions below serve as a guide, so feel free to swap in your favorite vegetables or mess with the quantities a bit, depending on the preferences in your household.
Adapted from Les recettes de Grand-Mère, Tome 4. Published in 2010 by the Association Alzheimer Suisse, Yverdon-les-Bains.
1 cup kohlrabi, peeled and diced
1 cup carrots, peeled and diced
1 cup potatoes or sweet potatoes, peeled and diced
1 cup corn kernels, fresh or frozen
1 cup green beans, chopped
1 cup red pepper, diced
1 cup peas, frozen
4 tablespoons colza/canola/rapeseed oil
3 tablespoons white wine vinegar
2 tablespoons parsley, finely chopped
2 tablespoons chives, finely chopped
1 tablespoon tarragon, finely chopped
1 tablespoon soy yogurt
salt and pepper, to taste
1. Make the dressing. Put all the ingredients in a sealed jar and shake vigorously. Add salt and pepper to taste. Set aside.
2. Cook the vegetables. Bring a pot of water to a rolling boil and cook kohlrabi, carrots and potatoes together until fork tender, about 5-10 minutes. While these vegetables are cooking, use a steamer basket to steam the corn, green beans, red pepper and peas, just until tender. Do not overcook.
3. Put all the warmed vegetables in a large bowl and toss gently with the desired amount of dressing. Sprinkle with some fresh herbs and serve immediately, while still warm.
I’m always grateful for the good advice and support of other food allergy parents. Many thanks to you all, and bon week-end!