early on, we found out that jan breaks out in rashes when coming into contact with cow’s milk and products made out of cow’s milk. but slowly, the last few weeks, he has been showing greater and greater tolerance, and he is now able to finish a cup of yoghurt or a slice of cheese without breaking into hives, nor suffering from diarrhea. because jan is slowly outgrowing his milk allergy, we have been getting complacent and less vigilant with what he puts in his mouth. he himself knows what he can and cannot eat. he asks if he’s not sure and readily accepts the fact if he can’t.

nuts, however, is still an unknown territory. all i know is that he is highly allergic to peanuts, and the panic and hysteria i was thrown into the very first time he showed allergy symptoms were enough for me never to try any nut ever again. and just two days ago, jan and i took the whole of 4 hours ridding his body of peanuts he unknowingly ate. it took 4 heaving fits, 4 mopping duties, 5 changes of clothes, three trips to the toilet, 30 drops of antihistamine, a layer of cortisol cream and hours of cooing and consoling to get the peanuts in that one bite of butterfinger out of his sytem.

but is he allergic to almonds, walnuts, pine nuts and other tree nuts? we simply don’t know. we’ve simply decided to scrap nuts off the menu altogether, rather than subject him to an “oral food challenge” i.e., deliberately introducing a suspect food to see if there would be allergic reactions.

we could have had him take the skin allergy test. but we worried that such a test would be traumatic, since it involved injecting small amounts of possible antigens (allergy-causing compounds) just beneath the skin. about 20-30 of them. my husband had it a couple of years ago in an attempt to pinpoint the cause of some rashes he has been having, but it did not give a definitive result. so we thought it wasn’t worth it to put jan to so much stress, possibly into a trauma with medical procedures and devices, if it would not provide us any answers anyway.

we’re hoping jan will outgrow his nut allergy just the same way he did with milk. the john hopkins children’s center say about 20% of nut allergics do.

“Allergic reactions to tree nuts as well as peanuts (which are not nuts but legumes) can be quite severe, and they are generally thought to be lifelong,” says senior author Robert Wood, M.D., director of the Division of Allergy and Immunology at the Children’s Center. “Our research shows that for some children, however, lifelong avoidance of these nuts, found in countless food products, may not be necessary.”

In the United States, an estimated one to two percent of the population is allergic to tree nuts (almonds, pecans, walnuts, cashews, Brazil nuts, hazelnuts, pine nuts, pistachios and macadamia nuts), peanuts or both. Wood and colleagues previously reported that as many as 20 percent of children outgrow peanut allergy and recommended that allergists periodically retest their patients. The current study explored whether the same held true for tree nuts.

Wood and colleagues evaluated 278 children, ages 3 to 21 years old, with a known allergy to tree nuts. Nine percent passed oral food challenges, the standard test to prove a child has outgrown a food allergy. Fifty-eight percent of children with TN-IgE levels of 5 kilounits per liter or less also passed the challenge.

“These findings give allergists a safe guideline in deciding whether to advise their patients to continue avoiding tree nuts, or whether it’s time to try an oral food challenge to see if they’ve outgrown the allergy,” says Wood. He cautioned that oral food challenges should be presented only under the close supervision of an allergist.

next time we’re with his pedia, i’ll have to ask whether jan’s TN-IgE levels can be determined (whatever that is).

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