Ethan's skin was clearing up this week but flared up just in time for our first appt with the allergist. I expected the appt to be a consult but we ended up having skin allergy tests and blood work done. They could only perform about 10 skin tests because his back was covered in eczema. Thankfully he didn't mind the skin test at all. The wait after the skin pricks was long because he was tired and I watched little hives form on his back and shoulders from the allergens. I didn't know which ones were causing a reaction so of course my mind was racing.
He did not show a reaction to milk, soy, wheat, oat, or rice. I was relieved since I've been eating a lot of oat and rice. I still cannot consume milk or soy because while he may not be allergic to them, he has an intolerance to milk and soy protein. His MSPI symptoms are likely caused by an immaturity of the GI system. The allergist listed it as "food protein enterocolitis as opposed to an IgE mediated food allergy". She said that MSPI should resolve itself by the time he is 18-24 months old. She suggested that I do not introduce dairy or soy into my diet if I plan to continue to breastfeed. This contradicts what I've heard about soy protein intolerance possibly resolving between 6-9 months of age. I didn't plan to introduce dairy until he was closer to a year old but had hoped to introduce soy sooner. She also suggested giving him a hypoallergenic toddler formula until he is 18-24 months old since he will not be able to consume whole milk. Some MSPI children are given soy milk or rice milk at a year old. This doctor stated that rice and soy milk do not have enough fat needed for brain development so the formula is recommended.
Ethan's skin tests showed a mild reaction to dogs, which we do not have but he has been in contact with on an occasional basis. The doctor stated that children and staff at his daycare who have dogs likely have dog dander on them so Ethan is being exposed that way as well.
Sadly, Ethan showed a reaction to cats. We are waiting to see what the RAST to cat dander shows before making a decision. While we cannot imagine having to find new homes for our cats, as they are members of our family, we cannot have Ethan suffer or be on long term medication. We're going to work on some other options first before it comes to giving up our cats as a last resort. Our vacuum has a HEPA air filter. We need to vacuum more often. It was suggested that Ethan be in a different room during and for a short while after vacuuming. We also need to invest in a HEPA air filter for our home. We need to keep the cats away from his toys, play mat, etc and out of his room, which is going to be the most difficult. They love to sit on the ottoman in his room. Kylie also loves to join us while we're on the floor with Ethan. Ethan enjoys watching her and most recently has started grabbing for her as she walks by. It's very cute but can no longer happen. We cannot pick up the cats unless we plan to change our shirt afterward. We also need to wash our hands between petting the cats and touching Ethan's face/hands. We already put blankets down while playing on the floor. We'll have to wash those often.
Although he showed a reaction to the skin test for cats I wonder if it really is our cats causing his symptoms. He has been around them his entire life and didn't have any reaction until he was about 4 months old. My SIL has allergy testing performed yearly (I think it's yearly). She usually shows a reaction to dogs but not cats. This year she showed a reaction to cats and not dogs but she is able to live with a cat. I'm wondering why her tests are inconsistent. I keep thinking - what if we find new homes for our cats and Ethan symptoms remain the same?
Ethan also showed a reaction to cockroaches. I wasn't too concerned since we certainly do not have cockroaches in our home. The allergist warned me about reactions when we are in public places.
The scariest reaction was to eggs. I KNEW that he had a reaction when I ate eggs but the confirmation of this allergy makes me angry with our previous pediatricians office. They repeatedly told me that Ethan was too young to have an allergy to eggs. I will be writing them a letter. I feel that my concerns about his MSPI and possible egg allergy were brushed off too many times.
The allergist is checking RAST to egg white and yolk (as well as milk, soy, wheat, and peanut). We will have to carry an EpiPen and have one at his daycare. This will be more of a concern when he starts eating solid food but is already a concern since he is reaching for everything. Just yesterday we had a bowl of cereal spilled because he was interested in it. The concern is not only for eggs such as an egg salad sandwich but also mayonnaise, baked goods, etc. The allergist said that 66-90% of children typically outgrow an egg allergy by school age. She also said that 6-8% of kids have food allergies/intolerances and about 50% outgrow them.
New meds and skin regimen:
-give him a 1/2 tsp of Hydroxyzine at bedtime.
-nightly luke warm soaks, air or pat dry
-immediately after bath apply 2.5% hydrocortisone ointment followed by Vanicream on top
-spray skin with water during the day to replenish before applying hyrocortisone and Vanicream
-apply Bactroban to open areas of skin twice a day
Lots of information and it was an overwhelming day.