A Day at the Doctor

Brief History: Benny has had eczema since he was about 3 weeks old. He was taken off breast milk and milk-based formula at 4 months and his skin made an instant and dramatic improvement. He still gets occasional flareups, but nothing like it used to be. At 6 months we had him allergy tested and he has an egg allergy. They also assume he has some food intolerances, but told us you can-not test for them, it's just trial and error with his diet.
Ethan never really had any problems. He occasionally gets an upset belly and a small patch of eczema on his left cheek. He wasn't tested at 6 months old.
After their 6 month appointment we were told to introduce low allergy solid foods. Our boys ate pears, potato, swede, choko, green beans, rice, rice cereal, chicken and veal. They tolerate all of these foods very well, and are doing well eating them.

9 Month Checkup: On Wednesday we took the boys back to the allergy clinic for a checkup. Last time we only got Benny looked at, this time we got both boys tested. We only did Ethan because Ben has allergies.... We were shocked to find Ethan also has an allergy to egg. Benny still showed positive for his egg allergy, and did not reveal any other allergies.

We now start the long process of introducing a wider variety of food into their diet. In consultation with a dietitian, we have a plan so this is done in a controlled manner so we will pick up issues as they arise.
Our first step is to wean Ethan onto formula. Ethan has been drinking expressed breast milk since he was born. He did have some formula in the first few months when he was sharing the supply with Benny, but since we've taken Ben off the breast milk (5 months ago) Ethan has been drinking 99%breast milk (occasional formula if we're out for a long time). Ethan is currently drinking 4 bottles a day. We have already swapped his morning bottle to formula. We will swap one more bottle each week until in a few weeks he's on 100% formula. If Ethan tolerates the formula, we can also start giving him other dairy foods such as yogurt and (egg free) custard. Benny will try dairy after he's a year old.

Once Ethan is weaned to formula we start to introduce more food. This is our plan, which must be done in this order. We can only try to introduce new foods when they have had 3 eczema free days in a row.

Step1: Wheat. We will give them a basic egg free wheat pasta. If that goes well we can try bread.

Step2: Salicylate challenge. We need to give them a diet high in Salicylates to see if they react to them. This includes apples, stone fruit, mango, strawberries, capsicum, carrot, pumpkin, sweet potato, cucumber and several other fruits and veges (we have a long list). If they react, we stop, if they tolerate it we are then safe to give them these foods. - the dietitian expects Ben to fail this challenge and have a reaction.

Step3: Amine Challenge. We give the boys a diet high in amines. The list of baby suitable amine products is shorter. We can give banana, paw paw, pork and cocoa powder. Similarly, if they react, we stop, if they tolerate it we are then safe to give them these foods. - the dietitian expects Ben to fail this challenge and have a reaction.

Step4: If the boys fail either or both challenges we have to go back to the beginning and very slowly introduce the foods in small doses (one teaspoon a day) and gradually increase the amounts in the hope that we will be able to eventually tolerate them.

We'll let you know how it goes....