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Steroids after Anaphylaxis

post #1 of 19
Thread Starter 
My 9 month old was rushed into the ER after having anaphylaxis to an unknown cause. He hadn't eaten any food that day (he is on an elemental diet) and was in my arms when he started going into anaphylaxis.

Anyway, he received his Epi Pen and we went to the ER and thank goodness he was just fine since we acted so quickly. They prescribed zyrtec, benadryl and prednisone for 3 days to prevent a rebound event.

Do I really need to give him the third dose of prednisone? I hate the idea of giving him steroids at such a young age. In fact I hate all of the medications he has wound up needing. Since he's had two days of prednisone, zyrtec and benadryl can we just stop at that?

I worry about his gut health. He is also having to take prevacid solutabs for extreme reflux and is on elemental formula since he is seemingly allergic to all food through my breast milk. He is waiting for his appointment at Seattle Childrens to be evaluated for Eosinophilic Gastrointestinal Disorder. I am giving him a milk free probiotic but we are hesitant to use much else on him at this point until we are better able to identify his allergens. He's done one round of prick and rast testing and has another round of prick testing for 20 foods on the 21st.

We did food trials last week and he is even allergic to applesauce.
post #2 of 19
I am so sorry to hear about your DS's ana event. My DD was 20 months when she had one. I remember all the meds, but was scared of the rebound effect. We did give her all prescribed meds. Her reaction was to peanut butter and we did not have an epi-pen (yet). So she had progress to being beet red along with asthma, vomiting, diarrhea. She had a rough few days after so looked like she needed the meds.
post #3 of 19
I would say if the doctor prescribed it for 3 days and you've already given it to him for 2 of them, give him the third dose like they said. It sounds really scary to me!

My dd2 can't have apples either. I'm sure you'll find some foods that he can tolerate.
post #4 of 19
I'd give the last dose of prednisone. But, unfortunately, it is common to have a rebound effect when the steroids wear off. Assuming, this was an isolated, rather than ongoing exposure, it is less likely to occur. The other meds will help to suppress the immune system.

I'd suggest water kefir to help recolonize the gut.

Unfortunately, even elemental formula has the most common highly allergenic corn, dairy and soy.

Personally, I'd avoid introducing ANY solids until closer to a year. But, consider trialing the Weston Price dairy-free homemade formula for improved nutrient-dense alternatives. http://www.mothering.com/discussions...a#post13725688

I'd explore environmental allergens also. Do you have a HEPA air filter in the bedroom, dust mite covers on the mattress and pillows, no animals or stuffed animals in the bedroom, windows closed to bedroom at all times to avoid pollens, grasses, tree allergen exposures?

Corn is severely anaphylactic for some children. Corn is in EVERYTHING. Dairy exposure is everywhere. Here is a list of hidden diary: http://www.kellymom.com/store/handou...dden-dairy.pdf

Hidden corn: http://www.cornallergens.com/list/co...ergen-list.php

Even touching it could create an anphylactic reaction for some folks. If you touch it and don't wash your hands first, ingredients touched the table, etc.

Here is more about starting the allergen identification journey. http://www.mothering.com/discussions...n#post13719101



Best wishes, Pat
post #5 of 19
Thread Starter 
Quote:
Originally Posted by kjbrown92 View Post
I would say if the doctor prescribed it for 3 days and you've already given it to him for 2 of them, give him the third dose like they said. It sounds really scary to me!

My dd2 can't have apples either. I'm sure you'll find some foods that he can tolerate.
I hope so. We had stopped giving all solids because of his reactions but had to do some food trials for the allergist because they wanted to document his reactions to go in his portfolio for the pediatric GI we will be seeing.

He has literally reacted to every food we had given him except for rice and a few days ago it seemed like he was starting to react to that. If he has EGID it is possible that he will develop allergies to all food, all though I'm hoping that will not be the case.
post #6 of 19
Thread Starter 
Pat,

Thank you for your post. I sincerely hope he will not have another reaction but considering we don't know what the trigger was yet there is definitely that possibility.

We know he is ana to eggs and dairy but as far as we know he was not exposed to either of those. There is the possibility that I somehow exposed him to enough dairy to trigger the ana because I ate toast with grass fed butter about 30-40 minutes prior to his reaction. It's possible that the amount left on my hands or from me kissing him, etc was enough to set off the reaction. If so, that is very worrisome. Granted we can control our home environment and rid the entire house of dairy but we certainly can not do that within our community and so I fear we will have many ER trips if he is that sensitive. Plus, butter is mostly fat so it is intimidating to think of a secondary contact to butter giving him anaphylaxis. This was the first time we had to use the Epi on him. His first bad reaction was to egg and it was from me touching him after handling raw cookie dough when he was 3 months old. I had rinsed my hands off, but not washed them with soap because he was crying. He developed hives everywhere my hands had touched him. His second reaction, an anaphylactic one was to trialing him on goats milk formula when we were trying to find out if it was my breast milk causing him pain at night. He had two sips and had a very serious reaction (full body hives, swelling, itching and a bit of trouble breathing) he didn't have an Epi pen at the time and I had given him Benadryl and thankfully the reaction slowly improved over the next six hours. Our allergist was VERY upset that we didn't call 911. We learned our mistake.

I have some water kefir grains that I received from a friend but they have been sitting in my fridge for about 2 months because things have been so crazy I've barely been able to function. Are they still good?

He has mostly been completely off solids for the last month or so. We had to trial a few foods to document his response for the allergist and the pediatric GI. Unfortunately we will have to trial a few more before his scope because the only way to get an accurate diagnosis of what his eosinophils are doing is by having him consume foods that he responds to (obviously we will not be using any that he is ana to). Rather than giving him solids I think we will just have me nurse him with me not eating the big triggers.

The other thing that make this difficult is that he is desperate to eat. It is very difficult and I feel tremendous guilt each day because of how much he wants to eat. He signs to eat and whines and cries and throws himself on the ground when he sees us eating and we don't share. It's very hard.

We are going to be doing some prick testing next week to check him for beef and chicken allergies as well as 18 other foods and then if he is okay with beef than I might consider making him some homemade formula. The problem is that they want to see if we can get him to a baseline without food proteins.

This whole thing just drives me batty because it is in direct opposite of the research and way we lived prior. I was consuming a Weston Price diet during my pregnancy and while nursing. It was actually one of the coconut milk smoothies (with raw egg) by Sally Fallon that initiated his allergy to eggs.

He is also completely unvaccinated and had received no antiobiotics, drugs or other things I would have considered "at fault" prior to this cascade. I too was healthy during the pregnancy. I hate allergies.

I also question the leaky gut as a causative factor for us. I've been working with a naturopath and all of my blood work has come back not indicating that I have leaky gut (though I am treating myself as if I did). I am also donating my breast milk to another mom and her son is thriving off of it. In fact, for the first time ever he does not have green stool (she didn't realize her son was allergic to dairy until he had my dairy free milk). I started eating raw dairy again this week to try to help my own gut until I nurse my son again and then I will need to be dairy and egg free again.

Anyway, sorry for my rant but I am just so frustrated. I did everything I possibly could during my pregnancy, etc to avoid food allergies in this baby because my daughter is allergic to peanuts, eggs, peas and chicpeas and I thought for sure it was because she was vaccinated. Now here is my son, unvaccinated and his allergies are much, much worse than hers.

Quote:
Originally Posted by WuWei View Post
I'd give the last dose of prednisone. But, unfortunately, it is common to have a rebound effect when the steroids wear off. Assuming, this was an isolated, rather than ongoing exposure, it is less likely to occur. The other meds will help to suppress the immune system.

I'd suggest water kefir to help recolonize the gut.

Unfortunately, even elemental formula has the most common highly allergenic corn, dairy and soy.

Personally, I'd avoid introducing ANY solids until closer to a year. But, consider trialing the Weston Price dairy-free homemade formula for improved nutrient-dense alternatives. http://www.mothering.com/discussions...a#post13725688

I'd explore environmental allergens also. Do you have a HEPA air filter in the bedroom, dust mite covers on the mattress and pillows, no animals or stuffed animals in the bedroom, windows closed to bedroom at all times to avoid pollens, grasses, tree allergen exposures?

Corn is severely anaphylactic for some children. Corn is in EVERYTHING. Dairy exposure is everywhere. Here is a list of hidden diary: http://www.kellymom.com/store/handou...dden-dairy.pdf

Hidden corn: http://www.cornallergens.com/list/co...ergen-list.php

Even touching it could create an anphylactic reaction for some folks. If you touch it and don't wash your hands first, ingredients touched the table, etc.

Here is more about starting the allergen identification journey. http://www.mothering.com/discussions...n#post13719101



Best wishes, Pat
post #7 of 19
Hi Jessica,

I have no answers, only cyber HUGS! We are in a similar boat with a baby who reacts to every single food we have trialed. He also is on an elemental formula. I am attempting relactation but it's not too successful at the moment. I've had a breast surgery which I completely believe is inhibiting my efforts.

I'm sorry your ds had such a bad reaction. I live in fear of that! My oldest dd also has allergies but hers are nothing like my ds's. I, too, chose not to vaccinate so as to maybe avoid allergies b/c I felt like maybe that played a role in my dd's allergies. But, same as you, this unvaxed babe is way worse it appears!

I'm frustrated too Our ped has mentioned getting a scope done but I just keep hoping something will change--somehow he will grow out of it but so far, no luck.

And mine too, at only 6.5 months, wants to eat so bad. He grabs for our food and stares at every bite we take. It breaks my heart & I just don't know what we are going to do as he gets older.

Anyway, I just wanted to say i understand where you are at and I'm so sorry you are having to go through this.
post #8 of 19
Thread Starter 
Quote:
Originally Posted by CO_mamato3 View Post
Hi Jessica,

I have no answers, only cyber HUGS! We are in a similar boat with a baby who reacts to every single food we have trialed. He also is on an elemental formula. I am attempting relactation but it's not too successful at the moment. I've had a breast surgery which I completely believe is inhibiting my efforts.

I'm sorry your ds had such a bad reaction. I live in fear of that! My oldest dd also has allergies but hers are nothing like my ds's. I, too, chose not to vaccinate so as to maybe avoid allergies b/c I felt like maybe that played a role in my dd's allergies. But, same as you, this unvaxed babe is way worse it appears!

I'm frustrated too Our ped has mentioned getting a scope done but I just keep hoping something will change--somehow he will grow out of it but so far, no luck.

And mine too, at only 6.5 months, wants to eat so bad. He grabs for our food and stares at every bite we take. It breaks my heart & I just don't know what we are going to do as he gets older.

Anyway, I just wanted to say i understand where you are at and I'm so sorry you are having to go through this.
Thank you! It helps to know that we are not alone. It's been painful for us as well because it has made us truly consider not having more children and I wanted 2 more. We were so careful about everything, switching to raw foods, avoiding GMO foods, no OTC meds, grass fed meat, organic everything, no phthalates or bpa, etc, etc, etc

I certainly makes me want to beat my head against a wall.

I'm sorry you're going through it with your son as well. My only suggestion if he does have an anaphylactic reaction is to not wait to give the Epi. I really, really didn't want to give it to him and even though they told me what to look for and at what point he needed the Epi I gave him zyrtec first and called his allergist at the same time hoping they'd tell me that when x happened, then I needed to give it. Instead she yelled give him the epi and call 911. We did and he recovered almost immediately after the Epi (it took about 2 minutes and then all of the hives went away). If I hadn't of called the allergist I would have waited a lot longer to give him the Epi. The nurses and doc at the ER were pretty impressed with what good shape he was in, apparently they see some awful, awful responses in little ones so young. She told me waiting even a minute or two in babies this young can be the difference between life or death and she said most parents wait far too long before giving the epi. I've also learned that as much as I fear the side effects of an epi and what the drugs might do to his body I fear losing him more.

Watching them want to eat and not feed them is awful. I really hope he does not have EGID. A life without food is such a huge burden for a little one to bare.
post #9 of 19
I don't know much about EGID. Our ped just mentioned EE to me a couple of days ago. The symptoms seem pretty vague so I don't know what to look for. Why do they suspect an EGID in your ds? You might have mentioned this in your first post, but are there any foods he can eat? So far, mine has reacted to every single thing. I guess, I just think his system is really immature & will mature with time. Maybe I am being naive My ds is on Prevacid also.

We are going to be receiving some donor mama's milk from a gal who eliminates dairy, soy, wheat, eggs & peanuts from her diet. I so badly want him to tolerate it but I'm scared he's not going to. Does your ds seem to tolerate the elemental formula ok?
post #10 of 19
Thread Starter 
Quote:
Originally Posted by CO_mamato3 View Post
I don't know much about EGID. Our ped just mentioned EE to me a couple of days ago. The symptoms seem pretty vague so I don't know what to look for. Why do they suspect an EGID in your ds? You might have mentioned this in your first post, but are there any foods he can eat? So far, mine has reacted to every single thing. I guess, I just think his system is really immature & will mature with time. Maybe I am being naive My ds is on Prevacid also.

We are going to be receiving some donor mama's milk from a gal who eliminates dairy, soy, wheat, eggs & peanuts from her diet. I so badly want him to tolerate it but I'm scared he's not going to. Does your ds seem to tolerate the elemental formula ok?
EE is the most common form of EGID (Eosinophilic Gastrointestinal Disorder). Basically the body produces eosinophils (a type of white blood cell) in response to food or other environmental allergens and they cause damage in the part of the body where they occur. EE is Eosinophilic Esophagitus (sp?) and means that the eosinophils are found in the esophagus. EG is in the gut/stomach, EC is in the colon and then there is one where they occur in the blood but I can't remember the acronym for that one.

We are suspecting EE with my son as well. When we were trialing food he seemed to do well with rice and we learned this because the only way we could get him to take the Elecare originally was by mixing it with rice milk. He now takes it without rice milk. Other than that, I've seen him react to everything else. We were hopeful for green beans but I think he was just starting to react to that the day before his ana reaction and I'm too afraid to try introducing foods again right now until we do his scratch testing.

If he has reflux and is allergic to solids I would definitely seek a diagnosis. And quickly. The one thing I've learned from other parents that have children affected by this is to not wait for years for a diagnosis. The longer it is left ignored/untreated the higher potential that they will never be able to tolerate any food.

If we get the diagnosis I will be doing a lot of research on "curing" this naturally but first I want to know what we are dealing with.

I hope the milk works for your son. I am donating my milk right now as well. I'm hoping to reintroduce him to breastmilk soon. I know he'll need to be back on it before his scope but first we need to figure out what foods he is anaphylactic to so that I can strictly avoid those.

He seems to be doing fine on the formula other than the fact that I hate that he takes it. I breastfed my daughter for 3 years so this was a big blow for me. It is nasty smelling stuff and insanely expensive. $45-55 a can and my son goes through a can every 2 days. Thankfully we are receiving help with the formula costs since my DH was laid off last month from his union. Feel free to email me at jessicareid823@gmail.com and I'd be happy to stay in touch.
post #11 of 19
Is scratch testing absolutely necessary? I don't know how I feel about this ... introducing allergenic proteins into a little one who is obviously so reactive. I think if you wouldn't give by mouth (nuts and seeds) you shouldn't scratch it right now b/c the scratch will just introduce something to his bloodstream and give him the chance to react.

Did he have blood test? Was that not conclusive? I know it's hard at this age, but I would start at blood testing b/c it's not invasive.

Sorry to be so negative! I feel for you mama I really do! Sending lots of good vibes you can get him back on breastmilk :

Pears would be a better choice than apples for first trial.
post #12 of 19
Thread Starter 
Quote:
Originally Posted by JaneS View Post
Is scratch testing absolutely necessary? I don't know how I feel about this ... introducing allergenic proteins into a little one who is obviously so reactive. I think if you wouldn't give by mouth (nuts and seeds) you shouldn't scratch it right now b/c the scratch will just introduce something to his bloodstream and give him the chance to react.

Did he have blood test? Was that not conclusive? I know it's hard at this age, but I would start at blood testing b/c it's not invasive.

Sorry to be so negative! I feel for you mama I really do! Sending lots of good vibes you can get him back on breastmilk :

Pears would be a better choice than apples for first trial.
We have all ready done a RAST test, blood testing. At this point doing the scratch testing is important because we have to help narrow down what he is reacting to and it is part of getting the EGID diagnosis. For me it is important because my goal is to be able to nurse him again. I have not been able to determine all of his allergens through elimination diets and emotionally it has been hard. My daughter is dealing with serious health issues as well. So doing the scratch testing is part of standard protocol with EGID and it is basically one of the only tools (besides patch testing) at helping me find a long term diet.

We have tried pears, he is allergic to those as well as banana, avacado, sweet potato, etc. We did the RAST and only his allergies to egg, dairy and wheat came up positive. We are doing the scratch to see if they come up positive on that. We also want to do it because I suspect he is allergic to meats as well and we need to know if I'll be able to eat those, etc.

Anyway, this whole thing is a nightmare that is for sure.
post #13 of 19
Quote:
Originally Posted by WuWei View Post
Unfortunately, even elemental formula has the most common highly allergenic corn, dairy and soy.
Pat, most, if not all, elemental formulas are dairy-free.

Happyhippo--my son is also very allergic to apples, as well as to many of the other foods you listed (maybe all? I'd have to go back and look). Two things caught my attention. My son's first anaphylactic reaction was to a kiss on his forehead from my older son, who had just eaten yogurt. It never went anywhere near his mouth. No matter what anyone tells you, it is possible to have an ana. reaction on contact.

Also, I noticed you mentioned allergies to bananas and avocados. Have you tested him for latex? Our son's ana reactions to bananas and avocados were the first sign that he was also severely allergic to latex.
post #14 of 19
Thread Starter 
Quote:
Originally Posted by Missy View Post
Pat, most, if not all, elemental formulas are dairy-free.

Happyhippo--my son is also very allergic to apples, as well as to many of the other foods you listed (maybe all? I'd have to go back and look). Two things caught my attention. My son's first anaphylactic reaction was to a kiss on his forehead from my older son, who had just eaten yogurt. It never went anywhere near his mouth. No matter what anyone tells you, it is possible to have an ana. reaction on contact.

Also, I noticed you mentioned allergies to bananas and avocados. Have you tested him for latex? Our son's ana reactions to bananas and avocados were the first sign that he was also severely allergic to latex.
The contact anaphylaxis is what I am afraid of. I can't remember if I put this in the above thread or not but before we left for the day I hate eaten toast with butter and I kiss him all the time on his head which I'm sure I did, if I didn't kiss him I at least touched him with my hands and I know I didn't wash them, or if I did I rinsed them only with water.

For the latex allergy do you think we would see that displayed by now since he has played with balloons several times? I believe he played with one today, if not today then yesterday. We just have a few that hang out around the house from Trader Joes. I will call tomorrow and ask if we can add that to our testing.

Does your son also have reflux? When I was nursing he had silent reflux and now that he is on the formula the reflux is more obvious, he actually spits up now but it may be because the formula is so thin. His stool is much better on this formula than it was on breastmilk.

Did you nurse your son or did he go on elemental formula. I am really hoping we can find a way to get him back on breastmilk and sleeping at the same time. LOL.
post #15 of 19
Which formula is your son on? Our son got mostly breastmilk, but, for a very brief period (about four weeks) was receiving nightly feedings via an ng-tube of Neocate 1+ (which is dairy- and soy-free, but contains corn and coconut, which ultimately caused a problem). He has both IgE- and non-IgE-mediated allergies and his allergists and gastro believe that, once a few of the milder IgE-mediated allergies are gone and we start trialing those foods, we'll end up with an EE dx. His extremely limited diet has helped us to avoid it thus far. So, when the time comes, there will be a lot of trial and error.

He did have silent reflux. Still does if he is exposed to certain allergens. We didn't find out until he was about 18 months old and changed gastros after he had a horrible gut reaction and wouldn't eat for weeks. Now we know what to listen for.

I would at least be careful with the latex. When ds2 reacted to the bananas and avocados, our allergist told us it was best to assume a latex allergy, so we did until it was time to test again, and the test did show the allergy. Those two allergies, along with kiwi, chestnuts, hazelnuts, mangos and a few others can suggest at least a vulnerability. He's pretty sensitive, though. We've had to leave TJ's a few times when they were blowing up the balloons.
post #16 of 19
Thread Starter 
Quote:
Originally Posted by Missy View Post
Which formula is your son on? Our son got mostly breastmilk, but, for a very brief period (about four weeks) was receiving nightly feedings via an ng-tube of Neocate 1+ (which is dairy- and soy-free, but contains corn and coconut, which ultimately caused a problem). He has both IgE- and non-IgE-mediated allergies and his allergists and gastro believe that, once a few of the milder IgE-mediated allergies are gone and we start trialing those foods, we'll end up with an EE dx. His extremely limited diet has helped us to avoid it thus far. So, when the time comes, there will be a lot of trial and error.

He did have silent reflux. Still does if he is exposed to certain allergens. We didn't find out until he was about 18 months old and changed gastros after he had a horrible gut reaction and wouldn't eat for weeks. Now we know what to listen for.

I would at least be careful with the latex. When ds2 reacted to the bananas and avocados, our allergist told us it was best to assume a latex allergy, so we did until it was time to test again, and the test did show the allergy. Those two allergies, along with kiwi, chestnuts, hazelnuts, mangos and a few others can suggest at least a vulnerability. He's pretty sensitive, though. We've had to leave TJ's a few times when they were blowing up the balloons.
Wow, thanks. That is good to know about the latex allergies.

I wouldn't be surprised with the EE diagnosis for you guys too. It appears that the word is really getting out and they are getting better about testing and diagnosing for it. When I hear of children having allergies to many different foods and having reflux, it is the first thing I think of. I'm sure there are many kiddo's on this board that have it but their moms are so good at avoiding the allergens that it takes many years to get diagnosed. The problem is the silent offenders, which make it much tougher and then we don't even know that they are damaging their bodies.

My son is on Elecare, unflavored. It's main ingredient is corn. It's been several days since his reaction and he's been having it every day and so far no more anaphylaxis so I think we are safe to say it was not caused by the formula. It had to have been a contact reaction, something he inhaled or something he found on the floor and snuck into his mouth without me knowing.
post #17 of 19
For anyone wanting to learn more about EE or EGID
http://www.apfed.org/

HappyHippo -- what foods are you considering trialing? Did your GI give you a list?

Hugs to you. I know it is frustrating and upsetting but you have found a wonderful place here with lots of support.
post #18 of 19
Thread Starter 
Quote:
Originally Posted by Catt75 View Post
For anyone wanting to learn more about EE or EGID
http://www.apfed.org/

HappyHippo -- what foods are you considering trialing? Did your GI give you a list?

Hugs to you. I know it is frustrating and upsetting but you have found a wonderful place here with lots of support.
We are no longer trialing foods at this point until we have more information but I just got a good list off of the EGID yahoo group for how to introduce foods after being on an elemental diet. There is an A, B, C, D group and you start with the a group and after your child tolerates a few foods from group A you can try group B, etc.

We haven't seen the GI yet, our first appointment isn't until June 19th but that is what he is going to be tested for. We are only guessing by symptoms that this could be his problem.
post #19 of 19
Quote:
Originally Posted by thehappyhippo View Post
We are no longer trialing foods at this point until we have more information but I just got a good list off of the EGID yahoo group for how to introduce foods after being on an elemental diet. There is an A, B, C, D group and you start with the a group and after your child tolerates a few foods from group A you can try group B, etc.
Hi Jessica,

I've been awaiting approval for that Yahoo group for days! Anyway, do you mind sharing a few of the A group foods from the list you got? I'm considering trialing my ds on something but not sure what to start with. TIA!

Wendy:
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