Parents of children with food allergies constantly live in fear. What if your child ate something he was allergic to? What if you were not around?
Ingestion of just a tiny amount of allergen can cause effects ranging from a mild rash, to a life threatening reaction known as anaphylaxis. A reaction usually occurs within seconds or minutes of exposure to the allergen, and in severe cases , it can lead to death if left untreated.
Says mum Syafini Sjuib, about her son Caydin Sujith, "When I came to know of Cayden's peanut allergy, I made sure I read the ingredients on food packaging before buying them. When dining out, I would scan through the menu and sometimes even confirm with the waiter whether the food was peanut free. When my son was younger, I would always carry food from home when we went out."
Detecting peanut allergy
So how did she first realise her son was allergic to something?
"When my son was 1.5 yrs old, I spotted a swelling on his lips after giving him a bit of my peanut butter sandwich. I took him to his paediatrician and he suspected peanut allergy. I was given a referral letter to National University Hospital (NUH) for allergy testing.
At NUH, a skin prick test was done to determine the allergy. They concluded that Cayden had peanut and tree nut allergy. It meant that I would have to refrain from giving my son any food that had peanuts or tree nuts in it."
Living with an allergy
Both Syafini and her husband Sujith Sekharan are not allergic to anything. When they came to know of their son's condition, they had to make changes to their food and lifestyle.
"For my own cooking, I never use peanut oil and peanuts, so it was not that difficult. I also never cook anything with peanuts as ingredients. However, we stopped having peanut butter."
She however had to be constantly vigilant about any food that she bought or ate outside. Medication was important too. She informs, "I always made sure I had allergy tablets in my bag whenever I went out with my son. When travelling overseas, an EpiPen was a must. So I had to make some preparations before travelling. When booking air tickets, I would request for a nut-free meal for my son."
New hope for children with food allergies
"I had read an article about children having peanut allergy being cured using immunotherapy, in the UK. I got to know about the Food Oral Immunotherapy (FOI) programme in Singapore in 2015. So I called NUH and requested for the program for my son," says Syafini.
The Food Oral Immunotherapy (FOI) programme for peanuts was introduced in NUH in August 2015. During the treatment, patients are introduced to a minuscule amount of food allergen, which then increases gradually. The programme is the first of its kind in Singapore, and is helmed by Dr. Soh Jian Yi, Consultant from the NUH Division of Paediatric Allergy, Immunology and Rheumatology.
Treating peanut allergy in Singapore
FOI works by raising the threshold of reaction, which is the minimum amount of allergen the child must consume to cause an adverse reaction. Before enrolling in the programme, the presence of allergy in the child must be confirmed. This requires a consultation in the clinic with the child and family.
Says Syafini, "My son was tested for peanuts through a skin prick test and blood test. He underwent a food challenge with other tree nuts he was not allergic to, like macadamia, pine nuts and pecan nuts. After clearing all the tree nuts successfully, we started on peanuts, for which the allergy test showed highly positive."
The first dose is performed under monitoring and supervision, with observation for 2 hours. Syafini adds, "For the peanut immunotherapy, we started on 50mg of peanut protein powder for the first two weeks, this was increased every two weeks. First dose is done at the day therapy ward at NUH. It took a total of 4 hours, inclusive of monitoring after the ingestion of peanut powder."
"Upon completion of 4 hours of therapy at the ward, I would bring home the supplies of peanut protein and continue the dose at home daily for next 2 weeks. For this to be successful, we have to follow the procedures given. So I followed them strictly. After two weeks, I would return to NUH for increasing the dose of peanut protein. This went on for about 8 months, until we reached a maximum dose of 12 peanuts a day. The treatment cost me approx $5,200 for the entire duration."
Today 8-year-old Cayden is able to take 12 peanuts a day!
Life has changed now
Syafini is a relieved mum now, "It is a big relief that I don’t have to worry so much about my son eating peanuts by mistake. He can now have chocolates with some peanuts in it.
Even though he can have peanuts, I fear that if he ate too much, he could still get a reaction, so I still carry the allergy tablets with me. I continue to give him peanuts on a daily basis. I guess this will build up his immunity."
Advice from a mum
Meanwhile, Syafini has these helpful tips for other parents whose kids have allergies, "My advice to parents with children who are allergic to peanuts, is to first go for an allergy test. If the allergy is confirmed, I highly recommend the FOI programme, because it does not involve medication. But it has to be done in a controlled environment, which means never to try it yourself at home.
Take necessary precautions and try to read up more about the allergy. It is not the end of the world. Life still goes on, but with some adjustments. Be positive. When with family members, explain to them about your child's allergy and request them to not offer food containing the allergens.
For school going children, to have peace of mind, please let your child bring his own food. Also, inform your child's school teacher about his allergy .
Most importantly, explain to your child about his condition, in a simple way that he can understand. For my son, I taught him at a very young age that he couldn't eat peanuts because he would get itchy, swelling and sometimes, even vomit. Now that he’s older, he understands what food allergy is.
I also advised him not to eat snacks he got from friends in school, before bringing it home and checking with me first."
Details of the Food Oral Immunotherapy Programme (FOI)
- About 20 children between 6 and 16 years of age have taken part in the FOI programme so far.
- Children younger than 6 are not advised to enroll in the programme, as many children outgrow their allergies by age 5.
- Duration of the programme can range from a few months to a year.
- Cost of the programme would range from S$5,000 - S$9,000
- At the end of the programme, the child has to take the allergen in the form and dose they choose, at least twice a week to maintain its effect.
- The NUH team are starting the tree nut and egg FOI programme in the first half of 2017. Syafini is excited, "I am looking forward to the tree nut program. I have requested for cashew and pistachio and am very happy that NUH is going to do this soon."
- For more details about the FOI programme, email allergy_kids@nuhs.edu.sg
- Here are some useful links about the programme:
https://www.nuh.com.sg/ktp-nucmi/health/disease-and-conditions/allergies/food-allergy.html
Also READ: How to prevent allergy and asthma attacks in children
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