Food Challenge Take 3

The allergist office: home of the best (so loud your parents won't let you have them at home) toys in town.

We just had our THIRD food challenge! And it went well! Bringing our record against food challenge anaphylaxis to a solid 2-1. The first two food challenges my kid had when she was around one year old. Now that she’s an official two year old, I knew this food challenge was going to be a little different.

She has a lot more opinions about food now.

The magic time when I could feed her vegetables and she would eat them without question has passed. She’s still not a picky eater (the title of pickiest of all eaters will forever be bestowed upon her older brother), but she definitely lets us know when she doesn’t like something. So, we followed the instructions of bringing her to the office a little hungry – this way she had a better chance of actually eating the cashew butter.

She can actually tell us how she feels since upset stomach can be an early sign of a reaction.

Last time, when she started to act differently- more fussy, refusing to eat more baked muffin- we just guessed that maybe she was having a reaction. But we had to wait for her to show other signs (hives) to know for sure what was going on. Now she can actually talk to us! (Unfortunately, when she doesn’t like the taste of something at home, she says “don’t feel good.” That’s a pretty unfortunate wording for somebody with food allergies…)

Some things don’t change with trips to the allergist, though.

We were still there for 4 hours.

You got to pack a lunch and a snack (for you AND whoever is getting tested), books, toys, a clown, and if you can find a babysitter that would be great. About 3 hours in my kid tried to walk out of the room saying, “All done. Go home.”

They still let her watch TV.

It seemed crazy to put on TV on the computer when she was a baby, but now she was super excited about picking a show to watch!

They still gave her toys that light up and make noise.

This time it was a toy smart watch (she was not impressed. Not nearly as much fun as the real thing) and duck that rolled around quacking and singing. Her allergist said some kids love the duck so much their parents immediately buy one on Amazon. You know what I don’t want in my house? A duck that sings 2 songs over and over again at the press of a button. No matter how much my kid loves it.

She got a new stuffed animal AND stickers to go home with

They always have the best prizes at the allergist office. I guess the risk of anaphylaxis leads to a better selection. High risk, high reward.

 

Strutting out with a new bear and covered in stickers, finally leaving.

But, by far, the biggest thing I learned about food challenges was to read the nutrition label and not just the ingredient list. The cashew butter I picked out was the cheapest kind I could find at the store that wasn’t processed right next to peanuts. However, the first thing my kid’s allergist did was check the nutrition label for how much protein was in each serving. She needed to decide how much cashew butter my kid needed to eat to get a full exposure. The allergist was shocked at how little protein was in each tablespoon. It turns out they thinned the whole batch out with vegetable oil, so it was runny AND contained very limited actual cashew protein. This prompted her allergist to talk about how some parents bring in homemade nut butters and how good they are. OK. I hear you. Let's add making my own nut butters to my to do list next week.

Homemade or not, next food challenge I’m going to make sure I get something with a bunch of potentially deadly protein. Nothing says food challenge like signing a form saying you are okay that your kid might get sick!

Bulking Up a Baby with Allergies

 

We had our visit with the dietician last week. I was hoping for some magical way to bulk up my skinny little toddler, but it turns out we were already doing most of what she suggested. Adding vegan butter to her rice and vegetables. Making sure each snack had a high calorie component (sun butter, vegan cream cheese, avocado, etc.) There’s no magic bullet to raise her BMI (though if there was it would definitely be dairy, too bad that would kill her in the process :-/).

After the visit, the dietician sent us some handouts that had general education on nutrition, ideas for picky eaters, and tips for increasing protein and calories. The dietician mentioned to ignore any of the tips that included foods my kid was allergic to. Clearly a good idea. But take a look at this list of high calorie foods-

High Calorie Food	Calories per Tablespoon	Allergens?
Vegetable oil	120
Butter	100	milk
Peanut butter	85	peanuts
Whole egg	74	egg
Heavy whipping cream	52	milk
Cream cheese	52	milk
Sugar	46
Nuts	45	nuts
Light whipping cream	44	milk
Granola cereal	35	nuts
Sour cream	30	milk
Light cream	29	milk
Half and half	19	milk

Yowzer! From this list, the only allergen free suggestions are vegetable oil and sugar. That’s crazy! My kid can’t be the only kid who needs more calories and is allergic to milk, eggs, and peanuts.

The easiest things to replace for dairy are store bought dairy free alternatives but those have a couple of problems. One, they usually have less calories than their cow counterparts. You know how nobody has ever said, “I’m too skinny, I think I’m going to cut out animal fats to try put on some pounds.” It turns out vegans are really missing out on easy sources of calories. Second, the dairy alternatives can sometimes have soy or tree nuts instead.

So, here’s my list of high calorie foods that have none of the top 9 allergens in them (well, maybe, depends on the brand).

Allergy Friendly Foods	Calories per Tablespoon
Vegetable oil	120
Coconut butter	100
Sun butter	100
Vegan butter	80
Chocolate chips	70
Coconut cream	50
Sugar	46
Vegan sour cream	45
Vegan cream cheese	30-50
Full fat coconut milk	30
Avocado	14

I added chocolate chips because if pure sugar can be on the original list, chocolate chips seem like a perfectly acceptable addition. The whole sugar angle was one thing I hadn’t been doing much. I had over looked adding honey or maple syrup to add calories, because I had only considered fat/protein content. Well, if this can make me feel good about adding chocolate chips to pancakes and yogurt (it’s for her health!) than I'm not going to argue.

Online Grocery Shopping with Food Allergies

I've been going to the grocery store in person throughout the pandemic and had missed out on the joy of online shopping with food allergies until we were forced into quarantine for 1 million (I mean TEN) days this past week. My local grocery store has a pretty nice online shopping set up- you go to their website, you can search or browse for what you need, and they even have a list of frequently bought items (linked to my shopper’s card). It wasn’t nearly as painful as I thought it would be. I did, however, really anguish over whether or not to click “substitutions allowed.” Pre food allergies, I never would have considered not allowing substitutions. They don’t have Cheerios? Fine, give me the store brand. Give me literally any flavor. It’s okay, it might not be my favorite, but it’s not like I’ll die or anything.

But now, if they are out of Nabisco Teddy Grahams? No, we can’t have the organic kind, they may have eggs. No, we can’t have the store brand, they may have milk. Dear lord, do not get something with peanut butter instead. It is VERY much like my daughter could die. BUT clicking the no substitutions allowed seems crazy. What kind of entitled, insane person doesn't allow any substitutions when grocery shopping? In the middle of a pandemic?

Anybody with food allergies, I suppose. But I refuse! I refuse to be the crazy person who doesn't allow substitutions. I'll just... I don't know... starve my kid?

Other than the existential crisis of trying to decide to substitute or not to substitute, the worst part about online shopping was not being able to check each item's ingredient list. Some packages had full ingredient lists on them (though they came with a disclaimer that the actual package could be different...)

Oh, a full list of ingredients! What a dream!

Other brands didn't have ingredient lists, but they did list the top allergens. That's at least something.

So not super helpful for a garlic allergy, but we do know this nuggets don't have any milk or eggs!

Unfortunately, a majority of processed food didn't have any ingredient or allergen information. Just useless nutritional facts.

Come on! Give me some useful information! I don't care about your fortified vitamins and minerals!

Overall, using the search function, I easily found all of the items I needed. Except for a nondairy half and half substitute. Just clicking through the "dairy" section, all of the “half and half” or “heavy cream” replacements are sweetened and flavored, I assume for people’s coffee; and if they are unsweetened, then they are at least made out of coconut and have a very distinct flavor.  I wanted this vegan “creamer” to make a delicious chicken and rice soup, and I didn’t want a coconut, chicken, and rice soup. I didn’t want to be confused whether I was eating dinner or dessert. I wanted a chicken and rice soup who’s predominate flavor was chicken. The last time I made this soup, I used a mushroom based, unsweetened, neutral flavored creamer and it turned out pretty well; but I could not remember the brand name. So I browsed through all of the dairy section online. I googled nondairy cream companies. Finally, my wife remembered “Laird.” I typed it in and YES! They did have it! I added it to the cart and checked out.

I got all of the groceries unpacked, the substitutions they did make were all in the meat section, so no food allergy worries there. I checked the ingredients as we unpacked and I was feeling pretty good about the whole situation.

I was feeling pretty good until I was making my my soup and got out my Laird creamer. I reread the ingredients and I saw “vanilla.”

This is the most subtly "vanilla" labeled thing I've ever seen. Where's the giant picture of a vanilla bean? Where's that white vanilla flower? I thought this was PLAIN!

I tasted a spoonful. Nope. That stuff is a step away from vanilla pudding. Do NOT put into my delicious soup. I used oat milk. Soup was still good. 

Anybody got any ideas of what to use a mushroom vanilla creamer for?

Meat with Vegan Problems: Pork Chops

The easiest way to find dairy and egg free recipes is to search for vegan alternatives. Vegan cupcakes. Vegan banana bread. Vegan “mac and cheese”. The internet is full of vegan recipes that do not use milk or butter or eggs. But what do you do when you want a meat dish but without the milk and eggs? How do you search for “vegan breaded pork chop but with real pork is fine, I just mean no eggs or milk”? That hasn’t really taken the internet by storm. So, I’m going to embrace meat, but cut the allergens out, this week, with...

Meat with Vegan Problems: 

Parmesan Crusted Pork Chops

This has been my favorite way to eat pork chops since I learned to cook in college. I mean look at this food network recipe- it’s got 1093 reviews, almost all of them 5 stars. The pork is juicy, the coating stays on, and while I’m not convinced I could actually taste the parmesan once it was breaded and fried, I definitely miss it now that it’s gone.

No parmesan would be one thing, but the main ingredient we can't use is the egg. Eggs are great at a lot of things, but one thing I definitely miss is their ability to coat foods. From the kid’s allergist, the suggested replacement for 1 egg for coating food is 1 tb oil and 2 tb water. This is what I’ve used in the past- but a lot of times the coating will peel off. It just doesn’t adhere well. Online some suggestions for what to use instead include: butter (nope), cream (still nope), gelatin (I don’t have that at home and it seems like a lot of work?), egg replacers (often processed with eggs), and tomato paste (that seems like it would change the taste a lot). So I opened my fridge and peaked around. Immediately the vegan mayo caught my eye. Real mayo is just egg yolks and oil; fake mayo is mostly oil but it’s pretty sticky which seems like it would be a great way to bind the breading to the pork.

So I made my breading mixture- nooch, panko, flour, salt, pepper, some oregano, some onion powder and I set up an experiment. A tried a few with an oil/water mixture and a few with a mayo/water mixture. 

For those keeping score at home it's: 

Oil and Water- 1 good, 1 ok, 1 things could have gone better vs.

Mayo and Water- 2 good and 1 ok

Initially it looked like the mayo/water mixture was the clear winner, but after everything was fried up, the oil/water made a comeback with arguably the best looking one (but also the definitively worst one... it's a hard battle to score for sure). The breading ended up a little patchy on both. The pork inside the oil/water ones was a little dryer than the mayo/water; but not a great deal different. My wife and I liked them both, my kids refused to try them. 

So who was the winner? My wife and I. Extra pork for us.