Life WHEN FOOD IS THE enemy
REAL For the Govender family, just one mouthful of the wrong food can mean the difference between life and death for their extremely allergic toddler
Hannah Govender is an active, bright and bubbly three-year-old. What sets her apart from other children is a severe and life threatening allergy to certain foods. Even the tiniest morsel of the wrong food could result in her immune system going into a state of shock, her airways closing, cardiac arrest and even death.
Hannah was exclusively breastfed until she was five months old. When mom Janine first introduced solids (cereal with dairy) she noticed a rash immediately form around her baby’s mouth after just a few bites. A few days went by before Janine tried feeding Hannah cereal again, but had the same reaction. A third attempt resulted in projectile vomiting so she took her daughter to see a paediatrician. The paediatrician advised that Hannah was more than likely not allergic to dairy but suggested Janine feed her baby chocolate to positively rule it out.
“Despite what the paediatrician had said, my instincts told me it was an allergy so I avoided dairy in her diet for a while,” says Janine, who lives in Hillary, Durban. “After a few months I tried giving Hannah a piece of chocolate. She didn’t even need to eat it – it just touched her lips and she broke out in hives all over her face and started coughing. After a second serious allergy attack from skin contact with cashews, I demanded that she be allergy tested.”
MIXED EMOTIONS
Janine insisted that Hannah – who was then 13 months old – have a blood test, but when the results came back she says she was simply given a prescription for an Epipen and referred to a dietician without any explanation of her child’s condition or treatment thereof. It took a while before Janine found a paediatrician who took her child’s allergies seriously, explained the best treatment for her situation and did further skin prick testing. Hannah now sees paediatrician Dr Nelan Chetty of Chatsmed Hospital, who specialises in allergies and asthma. “When I first heard my child had a severe food allergy I was disappointed but in no way did I anticipate the challenges that lay ahead. I just thought it meant we had to avoid the offending food and that if we did, Hannah would be fine,” says Janine. “Later, as Hannah’s allergy list grew I became very depressed, angry and felt very alone. It was only after joining the babycenter.com food allergy board that I realised that there were other families out there with children who also suffered from food allergies. I got support and information from other moms who were going through the same thing. They also enlightened me on things to look out for regarding an allergic attack and how to deal with it.”
ALLERGY ATTACK
Hannah is severely allergic to all dairy products, eggs, all nuts and strawberries. She also has more minor allergic reactions (sneezing, eye swelling, skin redness, hives, itchiness) to soya, oats, fish, gluten and wheat, as well as sinusitis allergies. Hannah is also what is termed “contact reactive” to these foods, which means that even if she so much as touches them, she will break out in a rash. Since her diagnosis Hannah has had only one serious allergy attack but one attack, says Janine, is one too many. “It was at a family lunch and Hannah, who was two years old, was given a ‘presumed safe’ ice lolly to eat. The ingredients made no mention of dairy, nuts or strawberry,” says Janine. “About 10 minutes later we noticed our child’s behaviour change from active to quiet. She started scratching her head and sneezing. Her face started getting a rash and her eyes became very watery. We gave her an immunosuppressant (Aspelone) and headed for the closest emergency hospital. En route Hannah’s lips and eyes swelled, her body went limp and she lost consciousness for a few seconds. Slowly she came to, she threw up
and by the time we reached the hospital she was much better. In a later checkup, we were told that Aspelone was, in fact, the wrong medication for anaphylaxis so we were incredibly fortunate that Hannah vomited and the allergens got out of her system in life-saving time.”
LEARNING TO COPE
Like every parent, losing Hannah has always been Janine’s biggest fear. “The reality is that Hannah can die within minutes from eating something that seems safe for her [but contains an allergen],” says Janine. “Following various food allergy tests done over the last year and seeing her reactions to foods, we have had to exclude all dairy, eggs, nuts, strawberries, wheat and soya from her diet.
“Because of Hannah’s allergies, her diet consisted of only boiled chicken, carrots and rice for breakfast, lunch and supper for most of her first two years. It progressively improved after she turned two but it remains very limited and consists mainly of rice, fruit, vegetables, chicken, bacon and lamb. Milk is now Neocate Advanced on special order from Clicks. We no longer keep her allergens in the house and only eat them on rare occasions when we are away from her.”
ADVICE FOR PARENTS
Janine’s advice to other parents of children with severe allergies is to never take any ingredient label for granted. “Food allergies are severe, dangerous and unpredictable. My husband and I are very strict with hand washing and reading food labels. We can no longer eat out as a family and we have to think about food exposure when attending events and special occasions. We have had to restrict Hannah’s eight-month-old brother Jonathan’s diet so as not to crosscontaminate Hannah’s food. We carry an Epipen for her at all times and pray we don’t need to use it. We use lots of Epimax Junior moisturiser throughout the day to control Hannah’s eczema, which has decreased significantly since adjusting her diet. Deselex is used whenever she has eye swelling, rashes or severe sneezing. The daily but moderate sneezing is treated with saline nasal spray, while we feed her lots of fresh fruit, especially oranges, to curb constipation. To make life easier and less stressful, we have learnt not to question the sacrifices we have had to make. We accept that while not a ‘normal lifestyle’ in any sense of the term, it is our family’s lifestyle!”
AN EXPERT OPINION
Paediatrician Dr Nelan Chetty explains that more than 80 percent of allergic food reactions are caused by milk, egg, soya, wheat, peanuts, tree nuts, fin fish and shellfish. Up to eight percent of children and two percent of adults have food allergic reactions, with the majority of food allergic reactions occurring in the first year of life. “If you suspect your baby may have a food allergy, a food diary plays an important role, and helps to eliminate difficulties in memory recall,” says Dr Chetty. “Skin prick testing and blood RAST testing has a role to play in the confirmation of suspected sensitisation. Elimination diets and food challenges may be required to help diagnose food allergy but there are risks here, such as anaphylaxis during testing. In cases of proved food allergy, the food should be eliminated from the child’s diet. The incriminated food could cause a serious allergic reaction or anaphylaxis. It is important to read food labels to avoid accidentally ingesting the food.”
Dr Chetty adds that a Medicalert bracelet should be worn and self-injectable adrenalin should be prescribed, especially if the child has associated asthma, because of the higher risk for anaphylaxis in these situations.