Sunday, February 26, 2012

Baked Milk Dosing, Domino's Pizza and Fenugreek

I have some nice news to report for once: my son ate his first Domino's Pizza last night.

As I've mentioned before, my son passed a baked milk challenge last summer. Even though he ate a milk CUSTARD during the challenge, we've had a lot of trouble getting our heads around what's required to dose him with baked milk each day. To complicate things, he seems to be able to tolerate baked milk in most foods, but baked cheese definitely still causes a reaction.

After we learned that some things will still cause a reaction (although all have been relatively minor), we lost our enthusiasm. Since we need to be prepared for reactions at any time, we have to only dose after school and far enough away from bedtime that we can account for biphasic reactions. That means his milk has to be done as soon as he gets home from school, while my husband is still at work. The hospital is 45 minutes during rush hour.

After we were scolded by the doctor for not keeping up with this, we've been trying to figure out how to ramp up our tolerance for anxiety along with his tolerance for milk. The daily dose has become Pepperidge Farm cinnamon bread. It has so little milk in it that he's had no trouble at all.

A few weeks ago, I discovered that Domino's actually offers both a pizza crust (thin) and sauce (plain) that are milk free! A year ago, we would have never considered this because of all the cross-contamination issues. However...with baked milk cleared, we gave it a shot. I'm happy to report he had no problems, although my son did comment "your homemade pizza is SO much better." Score one for mommy! But...having a delivery pizza option is one more important step toward independence at college.

Is it always risk free? Well, no...because if someone contaminates it with raw cheese and the dose is enough, he could still have a reaction. The hope is, though, that the baked milk dosage will some day also raise his tolerance to raw milk, so the small cross-reactions don't occur any more. Time will tell.

One other important note I wanted to make (and will just tack on to this column since it's a catch-all) is about fenugreek. Over the last several years, I've noticed a trend in food allergy deaths that occur in Britain: adults who clearly knew they had a peanut allergy and were generally very careful about it. The thing these deaths had in common? Carry-out curry.

Cross-reactivity between fenugreek, a spice used quite often in Indian dishes, and peanut is something that has only recently been studied and not well communicated. I'm afraid people are dying because they are unfamiliar with the high level of cross-reactivity between this herb and peanut. Make sure you know the ingredients in your curry spices!