'We try not to let fear dictate our lives' - Navigating the world of food allergies
One young couple shares how their baby daughter's allergy diagnosis has impacted their life, writes Kathy Donaghy
Like any first-time dad, Shane McDermott (36) had no idea the way fatherhood would turn his world upside-down. Shane and his wife Donna had left their lives in Dublin, where they both grew up, to start a new life in Letterkenny, Co Donegal.
The property crash had hit them hard and Shane says they were literally drowning financially in Dublin. The birth of their daughter, Sally, almost two years ago changed their lives in more ways than they could ever have foreseen.
At the age of seven months, Sally, who will turn two next month, was diagnosed with a cow's milk protein allergy (CMPA) and an egg allergy.
Sally had suffered a reaction to formula milk when the McDermotts tried to wean her off breast milk. Within minutes of taking some formula milk, Sally broke out in hives and her face began swelling. Her parents took her to the doctor, who sent Sally to the emergency department. Blood tests confirmed the allergies and Sally was prescribed adrenaline auto-injectors.
Shane says they had never in their lives even heard of anyone having a milk allergy and they were totally unprepared for how to cope with it. He says at first they were scared over how they would manage because eggs and milk are the ingredients of so many of the foods we eat.
The McDermotts had already planned that Shane would stay home with Sally and be the main carer while Donna went back to work with the Citizens Information Centre in Letterkenny.
READ MORE: Ireland's most common food allergies
As well as throwing himself into fatherhood, Shane dived deep into the world of allergies and connected with the parents of children who had been diagnosed with food allergies all over the country and further afield.
He also started experimenting in the kitchen to find dairy- and egg-free alternatives to what was on offer in the supermarket shelves.
He began sharing his recipes on his Instagram account and blogging about his experiences as a father. And he says he wanted to share his experiences with other parents to demystify the whole area of allergies because often when an allergy is diagnosed parents can be afraid.
Creating a menu of healthy dairy- and egg-free meals for Sally is now something he enjoys and he believes the family is healthier as a result. Porridge and peanut butter breakfasts with smoothie bowls, coconut cream smoothies and fruit are all part of the weekly meal plan.
Even pizza is not off the menu and Sally enjoys hers with dairy-free cheese. Scrambled tofu wraps and a penchant for spicy foods, Shane explains that Sally probably has a more experienced palate than most two-year-olds.
However, he says what he really wanted to do by connecting with other parents and blogging about his experience was to raise awareness of how common food allergies are and advocate for change.
"In 2015, our taoiseach [Enda Kenny] and the then minister for health, Leo Varadkar, introduced a bill into law allowing trained members of the public to administer life-saving rescue medicines, including adrenaline, if necessary. Public facilities such as schools, colleges and sports venues are now permitted to hold epi-pen medication, yet many remain oblivious to this legislation," says Shane.
He says servers in restaurants also need to be better educated about what's on the menu.
"Before Sally's diagnosis, I might have ordered a plate of battered mushrooms and garlic dip without hesitation or concern. Nowadays, we are those 'special' diners who almost interrogate the staff before ordering. This is necessary though, as a lot of people confuse allergies with intolerances.
"We might ask what the batter on the mushroom contains and the response might be, 'It's OK, the batter is not made with eggs and it is lactose-free.'
"I would then try to explain, in the nicest way possible, that lactose is not the problem and it is not sugar we are battling with but the milk protein that is our major concern. Not to mention the egg hiding in the mayonnaise garlic dip. Essentially, this would not be something we would order these days," he says.
"Fear is a big issue in the parent- of-children-with-allergies community. But we try not to let this stop us doing anything.
"There needs to be more information out there about allergies - and publicity helps. Information is key to empowering people and parents," says Shane.
The McDermotts hope that, in time, Sally will "grow out" of her milk and egg allergy. They are engaged with doctors at Children's Health Ireland at Crumlin and are intent on making sure that Sally will not miss out on anything in life despite the challenges that having allergies has presented.
According to Dr Aideen Byrne, Consultant Paediatric Allergist at Children's Health Ireland at Crumlin and at Tallaght University Hospital, there are two types of food allergy: immediate and delayed food allergy.
Immediate food allergy causes children to develop redness and hives (nettle rash) itch, swollen lips and eye lids, and, in more severe cases, difficulty breathing, dizziness and weakness. These more severe reactions are known as anaphylaxis. Dr Byrne explains that hen eggs, cow's milk, peanuts and tree nuts are, in that order, the most common foods that trigger immediate food allergic reactions.
Delayed food allergy commonly causes vomiting and diarrhoea in infants. Cow's milk is the most common trigger. Symptoms begin two hours or longer after the milk is ingested.
Dr Byrne outlines that the number of infants and children living with an immediate food allergy has increased across the western world and Australia during the last decade.
A complete explanation for this increase requires further research. However, she says it's recognised that our immune systems are responding to a changed, more sterile environment and this is thought to be leading to many children developing allergies.
Dr Byrne explains that infants with eczema are more likely to develop immediate food allergy than other infants. "It is commonly assumed that eczema is triggered by something a child is eating, when in fact, the opposite is true. Eczema can cause immediate food allergy; food allergy does not cause eczema".
She explains that, in simple terms, allergy is the opposite of tolerance.
"Tolerance to a food can only be achieved through the eating of the food.
"Delaying introduction of foods such as eggs, dairy, fish and nut - in safe forms - until after one year of age is no longer advised as it prevents infants from developing early tolerance to these allergic foods.
"Research has shown that giving peanut to babies with eczema as soon as they begin to eat and keeping it in their diet two to three times a week can prevent peanut allergy," she says.
However, she points out that some infants with moderate to severe eczema may need to be evaluated by their doctor before the introduction of peanuts.
Dr Byrne also says that most children outgrow their cow's milk and egg allergies and do not need to carry adrenaline auto-injectors.
"In fact, many infants can tolerate baked dairy and egg in foods such as buns and pancakes even when they are still allergic to whole egg and milk.
"By encouraging them to eat those foods, we increase their tolerance to dairy and eggs, helping them to outgrow the allergy".
She explains that doctors use specific tools to guide parents: the Irish Food Allergy Network's 'egg ladder' and the iMAP milk ladder, specific tools designed for the purpose of inducing tolerance by health-care professionals.
However, she warns that there is currently no safe way for parents to introduce even small amounts of nuts into the diets of children who are already nut-allergic.
Dr Byrne and Professor Jonathan Hourihane, Professor of Paediatrics and Child Health at University College Cork, along with allergists across Europe, US and Australia are researching different ways of desensitising children to peanuts.
None of these treatments are yet available and trials are ongoing.
Dr Byrne says she recognises how frightening a diagnosis of food allergy can be for parents.
However, she advises that it's important that food allergy is seen in the context of the other risks in life that present to children.
In cases where adrenaline auto-injectors have been prescribed by a child's doctor, she says parents should rest assured that this is a very safe medication.
"Parents should feel confident to use it. If in doubt, give adrenaline, and always, always carry two adrenaline devices".
She points out that children with food allergies should not be left out of things. "We all have a responsibility to ensure that every aspect of our society is inclusive of the one-in-20 Irish children who are now food allergic. People need to understand that with a few basic precautions there is really nothing scary about having an allergic child in your class or club or party".
See the Irish Food Allergy Network (ifan.ie) for more information. You can keep up to date with Shane McDermott on Instagram at @dairyallergydad