He took the lesson with him into his private medical practice at Allergy and Immunology Associates of Ann Arbor. To that end, he tasted all the medicines he now prescribes (No wonder kids don't like that one. It tastes lousy!) and has undergone every medical procedure with which he treats a child (I tell kids and their families how it feels so they know what to expect?).
Even at home, Leo, an amateur cook, experiments with new allergy recipes in the family kitchen, baking up egg-free and milk-free items and trying out the gluten-free diet. "What's it like to not eat this food every single day? Maybe it's a lot harder than you think but maybe not. I wanted to find out so I could talk about it with my families," he says. "So I tell people, look, it's doable."
Make It Personal
About two years ago, Leo noticed a stubborn rash on his 2-month-old daughter, Miriam. His wife had used a little mineral oil during a baby massage, causing irritation on the baby's skin that had blossomed into a persistent red, flaky patch. Examining Miriam with an allergist's eye, Leo had a sinking suspicion. He called in two friends, both doctors, to check it out.
"As a pediatrician and an allergist, I had a feeling--but as a father, I just didn't want to wish one of these rashes on my kid," Leo says. "We all looked at my daughter's rash and we all said, yeah, that's the rash." He ran a panel of blood and skin tests on the baby. Results pointed to a food allergy: Miriam was allergic to peanuts.
"It was devastating news," Leo says. "Every day I tell families that their children have food allergies or eczema or some combination thereof, that their child can't eat this or their child may die if they come across that, etc. I had the same sort of discussion in my head about my own child."
According to the Food Allergy Initiative, the majority of food-allergic children under five (almost 85 percent of these kids, says Leo) has allergies to only a handful of substances-- peanuts, milk, wheat, egg, tree nuts, shellfish, fish and soy. An allergy to peanuts is one of the most common, and often the most serious, because it can lead to anaphylaxis, a potentially fatal IgE antibody-triggered reaction.
Symptoms of a peanut reaction, which can occur immediately or over a period of up to two hours, can range from hives, rashes, runny nose to gastrointestinal distress (vomiting, diarrhea, nausea), swelling of the mouth, tongue, airways (causing wheezing and obstructed breathing) and shock as blood pressure drops. Some people are so sensitive that just the smell of peanuts in the air or second-hand contact (e.g., kissing someone who has
just eaten peanut butter) can prompt a response.
"Reaction can be mild, like a rash, to life threatening--or nothing at all," says Leo. "In many cases, a child will not outgrow it." Leo says the odds are better for milk and egg allergies. "Assuming it's diagnosed in infancy, under a year of age, a child has about an 80 percent chance of outgrowing a milk or egg allergy by the time he's 4 or 5 years old. That's why you'll hear parents say that their baby was sick, throwing up, crying every time he ate milk but got better at five," he says. "Peanut and tree nut allergy are almost the reverse of that. Depending on whose data you look at, just 10 to 20 percent of kids diagnosed early in life will outgrow it by age four or five."
By analyzing blood work, considering a child's history and ultimately performing an oral challenge, doctors can potentially "tease out" the children who might be the lucky ones.
"Peanut allergy is specific to each child. But the science has gotten so much better in the past few years that there are some indications we can track kids. If we identify them early and do the right thing, we may be able
to do something to help them outgrow it," Leo says. He urges parents to check with their child's pediatrician and then work closely with "a reputable doctor who specializes in childhood food allergy."
On the Rise
The incidence of peanut allergy has spiked over the past decade, with the number of U.S. children diagnosed under age five doubling between 1997 and 2002. The allergy affects 0.6 percent of the population, according to the
National Institutes of Health.
"It's not just peanut but all food allergies in general, as well as diseases like celiac disease and diabetes, are becoming more prevalent," says Leo. |
