An amazing thing happened last week. My nearly 3-year old son ate almonds for the first time during his food challenge at the hospital. He started with a small dose of ground almonds mixed in applesauce. In all, he had five increasing doses—a total of 28 grams of ground almonds (more than a 1/4 cup). Thankfully, he had absolutely no reaction.
With this test behind us, our allergist said we could start feeding my son almonds at home and should continue to do so regularly in order to build his tolerance. I was thrilled to start making one of my favorite almond recipes again—Scandinavian Almond Cake.
To give you some background, we started avoiding almonds for my son, along with peanuts, other tree nuts and sesame, after he had a positive blood test for peanuts back in the United States in the spring of 2012. Then, he had a positive skin prick test in December 2012 specifically for almonds, so we continued to avoid them, while also getting the go-ahead from our allergist to start introducing other tree nuts at home, like hazelnuts and pistachios. Even though he had never experienced an allergic reaction to almonds, we made sure he didn’t eat any food that contained them as intended or unintended ingredients.
Why did we wait to schedule an oral food challenge for almonds? In comparison to milk and eggs, almonds were easier to avoid and a lesser priority in terms of daily nutrition. For these reasons, and in consultation with our allergist, we focused his first two food challenges on baked eggs and cold cow’s milk. They were conducted at a local hospital and under the supervision of our son’s pediatric allergist and other medical staff. With these behind us, it was finally time to try out almonds, and thankfully, he had a great result.
Was my son ever really allergic to almonds? I can’t help but ask myself this question. We will never know for sure. Even though he had a positive skin prick test, these results are not always accurate. According to Food Allergy Research and Education (FARE), apparently 50-60 percent of these skin tests have “false-positive” results. In other words, you can eat the food without a reaction, even though you have a positive test. From what I’ve heard and read, food challenges serve as the best indicator of whether a person is truly allergic to a particular food.
While it bothers me to think we could have unnecessarily avoided almonds because he was never really allergic, I understand how we got to this point, and I’m just so grateful for the result. People typically hold onto their tree nut allergies for life. While he hasn’t tried every single tree nut out there yet, we can say confidently now that he doesn’t have any (known) tree nut allergies. He’s already been so lucky.
Furthermore, there’s a good chance my son could outgrow his egg and milk allergies in the coming years. With this most recent food challenge for almonds completed, it brings us another step closer to my goal. I’ll continue to be cautiously optimistic. In the meantime, I’ll just keep making and eating cake!
Recipe: Scandinavian Almond Cake
My dear mother introduced me to Scandinavian Almond Cake years ago. It’s a sweet cake that doesn’t need any icing. Just a dusting of powdered sugar and some almonds, served alongside a strong cup of coffee. Here in Switzerland, it reminds me of the almond-topped Financier cakes I see in the bakery windows around our neighborhood. I had a bottle of almond extract left in my cupboard from the United States that hadn’t yet expired, so I made this cake last weekend to celebrate the happy news about my son’s food challenge. We ate it up!
(Dairy-free with baked egg, but can be made without eggs.)
1 1/4 cup sugar
1 egg (or one tablespoon flax meal mixed with 3 tablespoons water)
1 1/2 teaspoons almond extract
2/3 cup rice milk
1 1/4 cup all-purpose flour
1/2 teaspoon baking powder
1/2 cup dairy-free margarine, melted and cooled
1. Grease an almond cake pan or another loaf pan. If using a non-stick pan, also dust the greased pan lightly with flour.
2. Whisk together the first four ingredients: sugar, egg (or egg substitute) and rice milk. Then, whisk in the flour and baking powder—just enough to make a smooth batter.
3. Add the melted and cooled margarine. Stir, just until blended—do not overbeat.
4. Pour into the prepared pan and bake at 180ºC/350ºF for about 45-50 minutes, until a toothpick inserted into the center of the cake comes out clean.
5. Cool cake for about 10 minutes, loosen it gently from the pan and invert onto a cooling rack.
Optional: Before serving, dust with powdered sugar and sliced almonds.
Tomorrow marks the last day of Food Allergy Awareness Week (May 11-17). According to FARE, 1 in 13 children has a food allergy in the United States—about 2 students in every classroom. If you’re wondering how to get involved, there’s still time to participate! Bon week-end, everyone.