As a parent of a child with food allergies, I am always seeking out the latest news and research in an effort to improve my son’s overall health and quality of life. For this reason, I attended Europe’s leading conference on food allergies: the Food Allergy and Anaphylaxis Meeting (FAAM) in Dublin, hosted by the European Academy of Allergy and Clinical Immunology (EAACI). With about 600 participants from roughly 50 countries, the multidisciplinary seminars at FAAM 2014 covered various topics related to managing food allergies, as well as prevention and finding a cure.
EAACI represents doctors, researchers and other medical professionals. It has over 7,800 individual members and also works with National Societies and patient organizations, such as the aha! Swiss Allergy Center in Bern. Most recently, I wrote about EAACI’s efforts to raise awareness of food allergies via a written declaration on allergic disease presented before the European Parliament.
FAAM 2014: A Few Highlights
The FAAM 2014 seminars spanned over three days, and nearly 200 abstracts were presented as part of the conference. In the coming weeks and months, you’ll notice that these seminars will be informing many of my future blog posts, as well as the management of our son’s allergies (e.g., requesting a consultation with a nutritionist). In the meantime, I just wanted to share a few of the key findings presented at the conference that I found especially interesting.
- Mr. Jerry Buttimer TD (Ireland), a member of the Irish Parliament, said that if President Barack Obama can sign into law a bill encouraging schools in the United States to have access to epinephrine (a.k.a. adrenaline) auto-injectors, then surely a similar law could be passed across Europe. Mr. Buttimer was referring to the School Access to Emergency Epinephrine Act (H.R. 2094), which enables states to pass legislation requiring schools to carry “stock” epinephrine auto-injectors for emergency use.
- Dr. Audrey Dunn Galvin (Ireland), a registered physiologist and lecturer at the University College Cork, presented her research on the socioeconomic cost of food allergies. She discussed the high levels of stress and anxiety that parents can experience due to the constant monitoring of their child’s food allergies. In particular, she discussed how parents must balance the need to protect their child’s environment, while ensuring their positive development. In addition, she mentioned several recent studies socioeconomic costs, including a study of adults with food allergies in Sweden.
Oral Food Challenges
- Dr. Carina Venter (United Kingdom) talked about food challenges as the best way to identify a true food allergy, and questioned the reliability of self-reported data to determine the prevalence of food allergies. Overall, she stressed the need for more and better data on food allergy prevalence, particularly to evaluate changes over time. As part of her presentation, Dr. Venter discussed her research on trends in the prevalence of peanut allergies in the UK.
- Dr. Galvin’s research on the socioeconomic impact of food allergies found that routine oral food challenges help to improve health-related quality of life for families living with food allergies. From our own experience, I certainly find this to be true, as food challenges have either allowed us to introduce new foods into our son’s diet or have provided us with greater knowledge and awareness of his allergies, even though he didn’t “pass” the test.
- Dr. Margitta Worm (Germany) discussed her research examining an anaphylaxis registry for German-speaking countries, including Switzerland. Her study found that adrenaline was rarely used. More specifically, for the emergency treatment of anaphylaxis among 197 children and adolescents between 2006 and 2009, adrenaline was used in only 22 percent of the registered cases.
- Dr. Kirsten Beyer (Germany) described oral immunotherapy (OIT) as a promising treatment for allergies, but highlighted that it is not yet ready for clinical practice. She said that many different protocols exist for OIT, which makes it difficult to compare results and assess its effectiveness. Generally, researchers agree on three primary phases for this treatment: 1) a starting dose, 2) dose escalation and 3) a maintenance dose. During her presentation, she cited a recent study on the side effects of OIT for peanut allergy.
You can also review the tweets from other FAAM 2014 participants by searching for the event hashtag via Twitter: #FAAM2014.
EAACI Food Allergy and Anaphylaxis Guidelines
Throughout FAAM 2014, presenters referred to the EAACI Food Allergy and Anaphylaxis Guidelines, which were published earlier this year. The purpose of these guidelines is to translate knowledge of food allergies into clinical practice, and in particular, for such areas as diagnosis and management, prevention, quality of life and anaphylaxis. EAACI included a hard copy of these guidelines as part of the printed materials I received during the conference, and I will be sharing what I learn as I review them. While the full document is only available for EAACI members to download, sections of the guidelines are also via the EAACI website.
I will continue to provides updates on the research presented at FAAM 2014, and next week, I also plan on sharing a recipe from our excursion to Northern Ireland. Bon week-end, everyone! Thanks for your continued support.
The Swiss bake their bread in all different sizes and shapes, and in Suisse-Romande, there’s a loaf resembling a cluster of grapes—Grappe de Miches. Last weekend, when our small Swiss city celebrated the grape harvest with its annual fête des vendanges (wine festival). I noticed two boulangeries with these festive loaves prominently displayed in their windows.
Grappe de Miche
Inspired by the “Pain blanc en couronne” from Supertoinette.
(dairy, egg, nut and soy-free)
500 grams all-purpose flour
1 teaspoon salt
7 grams of dry active yeast
300 ml of water, very warm
2 tablespoons sunflower oil (plus about 1 tsp. more)
1. Whisk together the flour and salt in a large bowl.
2. In a separate container, add the yeast to the warmed water and set aside for a few minutes to let it dissolve. Stir until it’s completely absorbed in the water.
3. Pour the yeast mixture and the sunflower oil into the large bowl with the flour mixture. Stir together until a dough forms. Knead the dough for about 10 minutes, until it become smooth and elastic.
4. Add about 1 teaspoon of oil to a large bowl, and turn the kneaded dough in the oil mixture. Cover the bowl with a towel or plastic wrap, and let it rise for about an hour, until it’s doubled in size.
5. Next, divide the dough into about 13 pieces. Form 10 round buns of equal proportions as the “grapes.” Arrange them on a baking sheet lined with parchment paper, as shown below, leaving a little room between the buns. Next prepare the decorations (I used a maple leaf cookie cutter and made a small grapevine) and place them on top. Finally, using the remaining dough to make a stem. Cover the loaf with plastic wrap and let it rise again for about 30 minutes.
6. Sprinkle the loaf generously with flour and bake at approximately 30 minutes at 200ºC/400ºF.
7. When the top of the loaf is nicely browned and the bottom sounds hollow when tapped, then it’s done. We like eating this when it’s still warm, but the buns can be kept for a day or two, if they’re tightly wrapped in plastic.
My 3-year old and I had a picnic yesterday with sandwiches made from our Grappe de Miche, while my 7-year old hiked along the lake with his school. I hope you have a wonderful first weekend of October. Bon week-end, all!
As I’ve done in the past, I like to share allergy-friendly product recommendations when I find something exceptional. Here in Switzerland, I often buy the following products, all of which are free of dairy and eggs. We really like these products because they’re allergy-friendly (at least in our home), and because they taste great. Maybe they’re some of your favorites too?
Please note: Ingredient lists and allergen information can change, so please make sure to read food labels carefully. We recently noticed a new allergen warning added to one of our favorite products, Roland Sticks. It occurred because of a change in the company’s manufacturing practices, so we’ve unfortunately had to stop buying it.
I. A Savory Spread: Crème à Tartiner
Allergen info: Free of the top-10 allergens.
Where to buy: This product can be found in select Migros stores in German-speaking Switzerland or online via LeShop.ch. The full ingredient list and nutritional information for this product are available at Alnatura’s website (in German and French).
My review: This versatile German product has “creme” in its name, but doesn’t contain milk. I probably wouldn’t have given it a second look at the store because of the name alone, but when Migros sent me a complimentary box of allergy-friendly Alnatura products, including the Streichcreme-Toskana, we had to give a try. Since then, we’ve been hooked. Somehow this smooth spread made of sunflower oil and seeds, red pepper, tomatoes, herbs and more tastes deliciously creamy. It’s great on a sandwich with turkey or chicken. I also toss it with hot pasta and steamed veggies to make a quick lunch for the boys. Along with the Toskana, Alnatura’s Streichcreme comes in other flavors, which I have yet to try: Aubergine (Eggplant), Curry Mango Papaya and Beet.
II. Biscuits sans Dairy and Eggs (contains: tree nuts)
Original Dar-Vida 5-Korn Biscuits
Where to buy: Available at Coop and Migros. Hug AG makes Dar-Vida products, and information is available in English via their website.
My review: We always have a box of Original Dar-Vida crackers in our house, and now we’ve discovered this company makes an allergy-friendly biscuit as well. This Swiss product reminds me of the Belvita biscuits my mother brings us from the United States. While these biscuits are a safe treat for my son, some of the other flavors with pear or chocolate either contain or may contain traces of milk, so please read labels carefully.
III. Allergy-Friendly Ice Cream
Glace à l’arôme de cacao or vanille, Glace avec gaufrette
Where to buy: Migros. You can search for these products via Migros’ Migipedia website (in German, French and Italian).
My review: These Italian-made products from Migros saved me a lot of time this summer. In April and May, I began collecting allergy-friendly ice cream recipes, free of dairy and eggs. Then, I somehow came across these aha! products online when I was placing order via LeShop.ch. First, we tried the vanilla ice cream with much success. After that, my sons tried the Cornets, or ice cream cone treats, which they both loved. Finally, we sampled the chocolate ice cream, and it’s just as good as the other products. Instead of having to experiment with my ice cream maker all summer, I served these products to my son instead. Plus, it was so wonderful being able to give him his first-ever ice cream cone!
Full disclosure: As I mentioned, I received a complimentary box of Alnatura products from Migros, including the Streichcream-Toskana. However, I did not receive any compensation from Migros, Coop or other manufacturers to write about these products. Any opinions expressed in this or any of my other posts are solely my own. If you produce an allergy-friendly product and would like to send me a sample, please feel free to contact me. However, please keep in mind that I will only share information about a product if I think it’s exceptional and could be helpful to others.
What are your favorite allergy-friendly products that are available in Switzerland? Please leave a comment below and let us know. These products can make such a difference in expanding the options available to people with food allergies and intolerances. Many thanks!
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!