Operation Achoo!: Treating Kids with Allergies

People are giving you advice of what diapers, detergent, to use, body lotions, and then forget about it when they start eating food. Um, once we get into nuts and eggs and shellfish, and you hear stories about kids throats closing, and it's basically just complete alarmist, insane fear all the time,

or at least that's how I felt. Also, my husband is literally allergic to everything, like when you do those little prick things, the fifty things on your back, forty eight of his rise up, but none of his are the death ones, but they're all all like, he's basically allergic to every single fruit and vegetable and whatever. So I was convinced when I had my son, like he

was going to be the most allergic kid on the planet. Um, so here to bless us with their expertise and ease my anxiety and hopefully some of you all out there listening is Dr Tricia Lee and my dear friend and fellow mom and lawyer, Julie Feldman, Um Doctor Triciallie is an adult and pediatric allergist and immunologist. She's board certified with the American Board of Pediatrics and the American Board

of Allergy and Immunology. Her research has included clinical trials and asthma and food allergy, and she has published articles and presented at national meetings about immune deficiency, food allergy, and infectious disease. Julie is a super fancy entertainment lawyer who has two little girls who do both face serious allergies and um she's been in this world as a

mom for a few years now. Um So, Julie, let's start with you talk to me about your two daughters, their ages differences, and what they're allergic to and what were their initial symptoms which I can repeat those questions back if there were too many of months. Okay, So I have two girls. Alexandra, who we call Ali, is my older one, and she's three now. And my baby Isabella we called Izzy, is sixteen months and they're cute.

Not that that matters, but let me tell you, getting the picture of the two of them anytime is a gift. So what are they both allergic to? Doctor Tresuali is Julie's doctor allergist who has saved her life, who has saved my life on so many occasions, and my emotional stability on so many occasions. So they are both allergic to eggs and peanuts, and Isabella is also allergic to oats. Oh my god, I can't. But they're also which makes it more complicated allergic differently so my older one Ali.

Her allergies are kind of what you think of your throat closing anaphylaxis, typical allergies UM that most people are afraid of. Isabella has a what I understand to be like pretty uncommon or you know, more rare digestive but very serious allergy where when she eats her trigger foods, she'll start throwing up to the point where her body kind of may not be able to balance itself, so she needs UM. She would need so many boose thumps right now. Even with this I mean, this is crazy.

So if she throws up that much, it's like rush to the hospital. Situation exactly called doctor Lee, go to the emergency room. I was in an ambulance, right, I was want to say two weeks ago, I was in an ambulance. I don't think I even told you this wasn't what My eyeballs just became saucers. I was an ambulance on the way to the er because Izzy had a bad reaction. And this is when we confirm that

she is also has this allergy. The acronym for it is f pies um, but she has an allergy to peanuts as well, and so her her allergy is also it happens it's a delayed reaction. So Ali's happen immediately after you eat the food Izzy as are about two hours after starting to name than what it is, because you in movies it's like the kid eats the peanut and it's like we're in the emergency room. We're dying.

But like for her to have a delayed reaction, that must be hard to do an elimination sort of diet and figure out what the triggers, especially since there's no testing for this type of allergy, so you can do skin tests and blood tests for the anaphylactic type allergy. So when you think you might have something, you go to doctor Lee. She tests them all, she figures it all out, and then she tells you what to avoid.

For f pies, there's no test. You basically have to eat foods trial it for depending on the food like a you know, several days to a few weeks to see if you start having an issue from it. And the other thing for that is that some of the more common foods for f pies allergies are not ones that you would think about. So chicken and rice and banana and not a hat out are all an oats are all really high risk foods, so they don't fall

into the dairy, eggs, peanuts category. You normally think of, um, what was um the first symptom you saw with UM, I'm trying like which way do we want to go first? I'm like, you're older or you're younger, which, by the way, when you had Izzy, I was like, this kid isn't gonna have any allergies because she was put through such a ringer with your first and I was like you, like, you're done you're like, you're done. You did it, like

you survived. And now we have number two who has a lot of allergies and they're different, right, So so Alie, it's funny because we went to we sat at a coffee shop across the street from an emergency room to give Alie peanut butter for the first time. Because I'm just type a anxious person. That makes you a great lawyer, well, thank you, and it also makes me, you know, a difficult wife and you know a mom like so sitting across this room leaving peanuts for the first time exactly, sorry,

dragged my husband with me. Didn't give her a whole lot, but she was fine, like it was everyone just that I was up. That's Julie. And she overreacted and then a few you know, she had that a few more times and things seemed to be okay. We introduced eggs. She seemed to be okay with eggs. She then had a few hives or like like of a rash that we're like, h what is this And again it wasn't the first time she had had eggs, so we didn't know. We gave her egg whites, thinking that egg whites were

less you know, allergic allergy complete opposite. Most people who have egg allergies are more allergic to the egg white than to the egg yolk, So hell knows that. We just learned that here on Katie's grip folks exactly. So there you go. I messed that up, and that's when Ali's face started blowing up, her eyes were getting swollen, her lips were getting swollen. So we rushed over the doctor, got that agil. She kind of settled down from there, But after that was when I went over to doctor Lee.

We also had been avoiding dairy just because she had had some digestive issues and really bad reflux, and so we didn't know if she had a digestive allergy to dairy or if there could also be something more of an anaplaxis dairy allergy. Ali did outgrow her dairy allergy right before she turned three. Now, Dr Tricia Lee, do you normally meet moms and their kids when we're at this sort of crisis mode? Um? Does it vary when

do they come to you? So normally it's after the first reaction, and for some of those families that takes them in to the emergency room, and the emergency room physician will say okay, now you need to see an allergist, or if it not even taken them to the emergency room, just to the general pediatrician's office, then they will be referred to the allergist. UM. Very rarely am I seeing

um sort of a new diagnosis before the first reaction. UM. Nowadays, with sort of new recommendations and pushed to get children in tested early introduction, a lot of these high risk kids meaning moderate to severe egma will be sent before they've even eaten anything I see, right, So there's also the kids that are having crazy skin stuff happening before they've even eaten solid foods. And sometimes I'll see four eight week olds and then we're not really doing food

testing at that time. UM, it's really probably not acuratetil close to four months old, UM, but sort of following along there. So sometimes we're capturing it before they actually eat it. UM. But most of the time my suggestion is to to eat the food and then sort of go from there. The problem with skin testings it's not perfect. You can get a lot of faults positives. For example, if you go to local mall tore that people have a positive test of peanut, they eat it and they're

fine with it. So testing is just not accurate, and so you can end up with a lot of false positives. UM sort of unknowingly unfortunately. I feel like when we were kids, they would wait awhile to test it. Now there's all these new stuff saying like give them small doses before even the age of one, exactly, and that was actually UM. Probably part of the problem in the United States when food allergy increased in the United States was when the ap had recommended delay an introduction of

these foods for that reason. Part of the reason is UM more from a choking hazard perspective in the sense of like nut, you're not going to feed a four month old nut. But nowadays, with nut butters and nut powders, it's much easier to accomplish. UM. A lot of times I'm hoping to even capture that family before the first introduction. UM. So now there's some data to support sort of moisturization.

So from day one of life to moisturize head to toe. UM. Every day I'm imagining a one week old being slathered in peanut butter. That's not what you mean. I'm glad you clarify, So what do they do somewhere like a cream or vasselin just what you would moisturize your skin with. And the concept is the or the hope even is that if we can prevent sort of eggs ma starting and progressing, then maybe we could prevent this progression into

UM food allergy. UM even to the extent of UM a little bit of data to support that if you touch an allergy with your hands, like if you were eating a peanut butter and jelly sandwich, to then not directly touch your kids skin. UM. There is a hypothesis out there that UM, these kids are seeing allergens through their skin first as opposed to through their gut, and then they're forming an abnormal reaction so in the reverse

sance as well not putting foods on the skin. So UM in England, UM, some of their food allergy increase after they started using things like coconut oil and the egsma. So until the kids eating the food. I don't really prefer food products on the skin, got it, But from there with food introduction, I think early what first like I vasoline. Vassoline is like one product and no one's allergic to it. Y, Seravey, Vanning cream or good brands um. Even Aquifer though has vanolin in it. I'm so glad

on this podcast because I'm switching it up. I feel like vascaline is like what we used kids like a head to toe grease the kid up every single diaper change. Um. But then you know, close to four or five months, and this is going to pin a lot on the child developmentally speaking in the sense of can they hold their head up and are they thrusting their tongue out? But just starting eating, we just don't know until you

eat it, like you just got to eat um. And so starting sort of early with fruits, vegetables, and then pretty quickly going through sort of those top eight allergens um all so, milk, egg, wet fish, shellfish, peanut, tree, nuts, sesame, soy um and generally speaking in in order of like weed and then milk and then egg um and then obviously peanut very soon. And they also now have it in pouches. So there are brands where you give your baby like these, like many pouches that have these different

allergens in the pouches. So even though they can't eat a nut or an egg or like soy like things like that they can be exactly. So that's what we started doing for Isabella because we were trying to introduce everything early. I mean, when you say, what point do you to Dr Lee start seeing patients for Isabella, I was like, I'm pregnant, now tell me what to do. It's like she's born, now tell me what to um. But so we gave her all of these pouches as

early as we could. You know, when she was having a symptoms of Isabella with being allergy is different, right, So when we gave when we gave her one of the pouches that had egg in it, she was fine. We put her down for a nap. We well, first we had tested everything on the skin testing with Dr Lee, so we felt okay trying it at home. Then two hours after she threw up and it was she's a baby baby, so you're kind of like this a spit up? Is it? Like? So you're kind of like, as a

second kid, is it a coal qualifying? So I called Actor Lee and she's like, okay, well, I don't want to say that. We're not going to try egg again. We'll see, like let's just like let's be aware of it. So and she didn't even tell me what f pies was or anything like that. She hit it from me and so then there's like nobody this is. Yeah. So the next time we gave her egg, we gave her the same page and we tried to do it at

a time when she wasn't sick. She's like, they're like that we kind of knew her baseline of where she was. And she threw up again about two hours later. So I called Dr Lee again. I'm like, what do I do? And that's when she said, Okay, Isabella has f pies and here's what we do. And PIES stand for food protein induced innercalitis, which is why I say F pies. Is that like what it's called F pies? No, that's no. I feel like that's there's an I C D tinko

for the diagnosis of f pies. It's like a I feel like it's a rare group of people who know what it means. But among the people that have this allergy, that's what it's called or how we refer to it. UM. So a lot of times you think, oh, my kid is sick and I have a virus. You also don't think when you're giving your baby bananas or wheat cereal or these foods, and they're throwing up two hours later,

and you're giving it to them at multiple times. That they're throwing up multiple times, you don't realize that it's related or an allergy. Almost think it's acid reflux or something. Right like at first, like the vomiting is so bad, you do go into the emergency room, especially as like a first time parent, um, and sort of time and time again, Um, the emergency room is not connecting it as well because it's so delayed in the sense of its two hours later, and a lot of times it's

not within the first even a few ingestions. I've seen it within the first ten ingestions, for example, So like the first five times, like okay, you sort of marked that food off your list, You've done it. You don't even think about it. You're now then combining it with other things. You know, the kids thrown up a few times. You go into the emergence room. Just seems like a

virus every single time. So I felt really lucky that we had is about throw up twice and Dr le knew exactly what it because you already had it all in place. I had my system in places, so I was like, Okay, now I'm calling our nutritionist because we started working with a nutritionist for Ali because she being

allergic to eggs at the time. Dairy. You want to make sure it's getting the food exactly and the nutrients she's supposed to be and she's tiny and so she wasn't gaining weight, so we needed to really be on top of it and make sure that she was going to thrive despite her food restrictions. So and it was funny because the day before I had a conversation with the nutritionist and she was like, Isabella is not Ali. You have to like take steps and start feeding her

more proactively and not be so afraid of things. And then I called her back. You were like you were wrong, and and then I called her back the next day. I'm like, so Isabella has f pies and she's like, oh boy, She's like, now we need a whole new game plan. So at least felt fortunate that I had that support system in place, because it's when you find out about it at first, and you don't know anything more than just kind of the stuff that you're afraid of.

It's very overwhelming. Oh, I want to ask you, um, so do you recommend Dr Lee, do you recommend when people start introducing foods like the sort of thing where it's like you do the same thing every day. I also know women who like wrote like they did the same food every single day for lunch and then they moved that food tonight and then they introduced a new

food in the lunch time. Is that ye know that it has to be so I was like, this is making me nuts, especially for like fruits, vegetables, and meats, because generally they're not going to be an issue. Um for some of those highly allergenic foods, you know, I say, start with a small amount gradually increase. Doesn't necessarily have to be in consecutive days. Not really doesn't have to be at the same time. No, so maybe day one,

day three, day five, day seven. The goal is just to get to a full serving, which generally I would say with peanut, it's like to teaspoons of peanut butter peanut powder, and you've done it multiple times. So normally, and I'm taking a history from a patient, that threshold for me is five times. The problem, particularly in a four six month old, is they're not getting that much.

They're not getting anywhere close to two teast, So you've really got to push the amount because a lot of times that allergy is not going to be obvious until we've had enough to make it obvious, which is probably why for Ali, we didn't realize that at first because she had had so little, like a little tiny of eggs and peanuts, so it wasn't until later on that

we saw her reactions. My next question for Julie is do you ever get like judge moms about because I know, as a mom of someone who's dealing with some pretty scary allergies, I've seen you as a mom in action and you have to be the advocate for your child, meaning you're asking all the other mom's questions, who are around, what's in it? Did Ali grab it? Like all that kind of stuff? Because it's on you? Um and so have you had issues with that kind of thing we have?

I have to say I've been really lucky with close friends and our community who understand that you know, this is serious and important, and especially our close friends who know everything that kind of we go through regularly, they're more apportive about it. It gets harder as there's school and birthday parties and things like that where and I try very hard to not feel like I have to control what everyone else is doing, but do what I

have to to protect the girls. So you know, now they can eat pizza as long as I make sure it's from a place that doesn't have egg in the dough, because sometimes they do. When we get a birthday party invitation, I'll respond yes, so excited, and then I also say, are you planning to do pizza or other food? Ali has allergy, so just let me know so I can plan accordingly. Like I don't, I don't expect everyone else

to make an accommodation for us. I mean, if you tell me that you're gonna have a peanut butter birthday cake, then we're not going to go because then I can't do it. And if it's brunch and you're having eggs and like that's your scrambled eggs is your meal, then

I'm not going to go. But if you're having something that has you know, eggs in it or things where you know, I kind of have to balance the balance it and also educate Ali as she gets older, because she's gonna be responsible for herself and so not that I would ever leave her to her own devices at this point. But she's she's pretty good. I mean, she just turned three, and she knows what she's allergic to.

She knows what Isabella is allergic to. She knows there's a song that she sings that has her rules of what to do and liked her this song Did you write this? Daniel Tiger? Daniel Tiger and three? Or what's the song? Can you sing it for us? Is a good? Oh my god? No? Is it like I can't eat um? What are her ones again? Eggs and dairy and she can do darry now. I grew out a dairy and I can have that now. But she has these, she

has the tools and Daniel Tigers. It's basically the song in Daniel Tiger has three rules in it, Um, don't eat the food that you're allergic to, ask before you eat something new, and if you don't feel well till a grown up. And so Ali knows those rules and so she will be somewhere, you know. She was talking to her other best friend who turned three the other and her friend was like, Ali, I'm going to have a frozen cake at my birthday, like so excited, and

Ali goes, that sounds great. Does it have eggs and peanuts? Because I can't have eggs and peanuts And her friend was like, I don't know. Like her friend was like, but so I have in my freezer a bunch of cupcakes and cookies that are safe for Ali that I will defrast And I always tell Alle, I say, oh, today So and So's birthday, there's gonna be cupcakes. She'll

say did they have eggs and peanuts? And I say they do, so we can't eat them, And then say I'm going to bring one for right And she's excited by that. So she's she's really good about it so far. And I love Daniel Tiger. Oh my god. Yeah, we are big fans of Daniel Tiger. Now, UM, I was going to ask you are there chances of these kids growing out of these allergies? Like what do you see as far as especially for Izzy from an f PIS perspective, A, there's never been any documented DUTs UM and then be

most kids. I'll l so right now, the nation recommendation is UM eighteen to twenty four months after the last reaction, you should try it. UM. The recommendation right now is to do that within a hospital setting, though hopefully that tide will will try. You have to go do this so for three foods. When we get to that timetable,

we'll see if those are still the recommendations. The other thing for her you said, we probably will just because she has small veins and they've had trouble getting i vs, so they want to have the i V in already if she needs medicine. Wow wow wow wow wow wow. Now is there any link to like my husband parents, like why is why does a kid have allergies? And why does a kid not have allergies? Why does this as the question of the decade are people asking me about?

Like why? Um? So you know, we have realized some of these answers through research in the sense of early introduction. And that's probably the greatest study. It's called the Leap study, done a few years ago in England. And the reason why it was done is because we realize as Israeli kids eating bomba, the peanut puff um, and so they seem to have less peanut allergy than the rest of

the world. Um. And so that study looked at sort of early introduction between four and eleven month olds for high risk kids, meaning monitor to see eggs and or egg allergy. UM. So certainly early introduction I think sort speaks to that. UM. There's a lot of study of medicine nowadays sort of looking at the microbiome in the sense of the good or back bacteria or whatever the bacteria is, whether it's on your skin or in your

gud and how are we affecting that. That concept of like if you have UM exposure to farm animals are living on a farm and having less allergy has certainly been validated. So I think one thing moms she says always like I don't know where she pulls this out, but she'll just be like, it's always good for a house to have a dog because then your kid won't be allergic to dogs. Like she says stuff like this, And I'm like, where are you getting these facts? UM,

But I guess that that is true. Well, it's also speaking to UM sort of going back to that microbiome in the sense of the more sort of viruses, bacteria, germs you're exposed to, the greater variability that you're going to have, And that's what we're realizing, is the variability is sort of what is protective? Um, But it's one of a million questions. It's one of a million probably reasons. They're probably a some genetic component going from the first

child to the second child. Is the seven percent chance of having food allergy? It's not, But that's not because we were saying they're allergic to the same food, but their reaction and the treatment and what I have to look for completely different. Like it's actually think she's my only family who there are two kids with food allergies. That's not necessarily rare, but like two kids with different types of reactions. Um. So I was stilling around the look and that is how special her genes are. So

are you guys, like on speech? How often do you see Dr Julie? Um? I feel like pretty regular because we do a bunch of food tests. We do because in trying to see if she can, if you know, Alie at this point can outgrow them. We've had tests every year for her and then to outgrow her dairy allergy. We had to start with dairy baked into food, so it's like baked milk in muffins, and then it was milk in like um crackers or and like then it was cooked cheese, and it was pizza, then it was

a glass. And so depending on kind of where we feel she is, we have to do multiple food challenges in Dr Lee's office, which is like a four to five hour challenge every time. And so we've done that for eggs, We've done that for peanuts, We've done that for skin test saying I feel like we've done that for a lot. So were you allergic to anything? Nope? Nothing, So this is like new to you. It's my Nope, neither of us hill eat anything. I'm weird and picky

about food, but not allergic. Um, but it's really just this generation so I wouldn't need nearly say. It's hard to think gets worse than ever. Oh yeah, it definitely is roast peanut butter, for example, and it was introduced into Australia. You know, there was an increase in their food allergy. We've always had roasted peanut butter, and we're probably doing you know, other things to our foods as well to sort of change it's allergenicity of it in the how we make the food. Oh my god, this

is so and I talked to it. Actually I'm like, okay, So is there anything that I did while I was pregnant with Ali that I shouldn't do, but then I should do differently with Easy? I'm like, we're doing it again, and I ate less. I ate a lot of peanuts and eggs when I was pregnant with Alley. I ate much less if it when I was pregnant with Easy because I obviously couldn't have it in the house. So,

you know, neither neither works. Can you take me through when you meet a baby or something and you're testing them for allergies, is it the same as with an adult, Like, is it those pricks? Yeah? So the way I described it to older chilling some mouse how to fork, this is what he would used to eat with. It's dipped into liquid and then pricked on top of the back. It's not a needle, there's no blood. We wait fifteen minutes. I expect a readit chey bump. So very similar adults. Obviously,

we're doing you know, many more with kids. Specifically with food, you try to be very targeted because you're not wanting to get those false positives and avoid foods for no good reason. Um, so it should be you know, specific in the sense of what have you had a reaction to, what is associated with that food. So, for example, if you come into me and you've had a peanut reaction up to pen allergic, kids are going to be allergic to tree nuts. So I'm going to skin test those

tree nuts before you know, we try them. It's so crazy that it's worse now than ever. I mean, I feel like that's even a thing. There's preschools that are no nut schools, so our school is not a nut free school, but Ali's room is a nut freedom room, and so this is like a real thing, you guys. And I feel bad because, like my husband is really allergic to a lot of things. But I'm always like, Okay, it's fine, like get over it because his aren't. His

aren't like ones and their life rereatening. And they're like, he gets a scratchy throat for a walnut and he gets a scratchy throat and like sneezy if the apple is really ripe, like all of those things, um and sneezing a lot. And he's like, but you don't understand how uncomfortable this is. Like this is terrible, like it is, but it's so much lower risk to progress. Get over it. It's like, so I'm so, I'm so mean about it,

Like can't, So don't be so mean about it. You're welcome, Like I felt much, I feel like I'm being more compassionate towards it and also being a new mom um getting through the fear of it and that it can still be a thing. I mean, as of right now, Alvic hasn't shown any signs of anything, but I have to say I won't let him have shrimp or sushi

or any that kind of thing. But also going through it with Julie, I've been my eyes have been very very open to like, holy shit, this is and that and that should just be like a mantra of um parenting, right, Like I mean, I think that's with almost every aspect in life. Until you've wall through those shoes, you don't really understand and um. But you know, so much of parenting nowadays is so debatable. You can find a blog to support anything and another blog to support the exact opposite.

And is there truly one right answer? Probably not, And so just have empathy and also even in treatments that they're trying to do to help people outgrow, you know, the oral immunotherapy, which it's that as gonna say, she can you can speak to it more technically than I can, but it's I mean, maybe explain it first. But it's something that we looked into and we talked to Dr Lee about it and decided it wasn't right for us yet. But other people feel differently and feel strongly about it.

Say so right now, the same care for food allergy is to avoid the food care around your upper pen in case you have an excellentestion or reaction. UM. The new concept for food allergy, it's not actually not so new, there's just more data sort of coming down. The pipeline is treating food allergy with small amounts of the food.

So starting with a small amount and gradually increase and so it's called oral immunotherapy o I T. And so there will be to have to get proved products for peanut in particular peanut patch and a peanut oral product. But since it's foods, you can sort of start that

process before we have enough to approved product. And so it's pretty common actually all throughout the United States, and that concept, um, you know when you look at the data though, UM, we're not necessarily carrying a lot of children by doing this, and it is a very tedious process and the sense of sounds exhaust and doing it every day, you know, so it's like, for example, you would be doing tin peanuts every day with a two hour rest period um and the risk of antiflaxus is

still there. And some of those kids on the d and fiftieth time that they've done their tin peanuts, they having a flaxus that day. And sometimes it's because they ran around or they didn't have anything else on their stumf virus. The other thing is that that rest period is that when you're more active when you're sick, like different things in your body. How am I supposed to explain to Ali that for two hours there's no running around or jumping, And you know, she's an active child

and I want her to be that way. And so when we just looked at kind of the risks rewards for us at the moment, it's not for us, and we're going to continue to reevaluate it, and you know, we may feel differently about the patch when it's available because that's a little lower risk for us. Yeah, so the risk of aniflax is going to be much less um, just with the past, though the yield is probably much

less as well. But it's that we're not necessarily curing children by doing this, Um, we are increasing their threshold. So for example, at the beginning of the study, you eat one peanut and you have a reaction. At the end of the study you eat tin peanuts and then have a reaction. So I do think we can increase the threshold. I just I don't know for a lot of kids, I don't know how meaningful that is. Most of my kids that I see, they come back to me, you know, a year later and I say, you know,

or you're avoiding your food. Yes, have you had any excellent ingestions or reactions? No, have used your eppypin No. And they're not doing anything on a daily basis with a two hour rest period to accomplish that. They're just not having any issues. So I think it's possible. I think just of the cross contamination pieces of like definitely. Where So the argument is now with this sort of treatment or eveno therapy, is to protect from cross contact

if you accidentally eat the food. No one's going to purposely eat the food, then, UM, you have some sort of insurance policy protection that that small amount is not going to cause a severe reaction, maybe something milder or nothing. This is like I'm quiet because I'm like wow, Like this is it's like motherhood. You just like jump in and you just last think I hangure it out as you go. I had no choice. It was like you're just like okay, so and here I go, and here's

what we're going to do. Or are there any other things of how we can teach kids how to be advocates for themselves? I mean, what if you're a kid that's not like Ali, Like I just feel like, and she's so well spoken at such a young age, and and that's not every kid with allergies, so like she's helping easy to know that already she tell groundwork. Yeah. So UM, A lot of times with schools, I'll go and give a presentation to sort of speak to what type of culture can you set up to just protect

all children? Um? And a lot of times it's you know, keeping food separate from the play areas. Um, no one's sharing food, no one's bringing any food in, You're not accepting food from anyone. So UM, I think a lot of those aspects. UM. Sometimes the hardest people to train our family members and when you go to a family event, they just want to feed children. Um. And maybe it's that in the sense of, um, we're not sharing our food so openly, um, until we know that we're just

okay with all those ingredients. And the problem is like hidden ingredients to people don't realize what's in things. Andevitably, you know, a patient comes to me and they've had a reaction to hummus. It's always sesame and hummus and nevilly. The parents are like, oh, there's sesame in heaven. No idea I was, and of course, you know, I mean I never thought about these things until um, I did

food allergy. And also it's like, oh, people understand that peanut allergies are severe, but they don't have the same understanding that other foods can be just as severe. So when I say Ali can't have eggs, and that means you can't have eggs, but she can't have eggs cooked into anything baked, it like there can't be eggs anywhere. So it's like, oh, but this cracker has eggs, but that's okay because like it's can't be involved in the making of this food. Exactly and also in terms of

what you can do. I think for kids, there are kids books about sharing your food or being aware of your friends with food allergies that will read with Ali and starting to read with Izzy that it's I think they're good for kids also that don't have food allergies, because it's not just about advocating for yourself, but it's about being empathetic and understanding with your friends. I need to get a list when you have time. I know you're both. DN Tiger has one. I think Elmo has

one as well. There's a book like I think it's called EPI the Elephant. Probably the most useful link from just a general educational perspective as Fair's website F A R. E. And I think there it's like food allergy dot org or something UM but it's a nonprofit started initially, you know, by families of kids who have food allergy, and they just do a really good job at sort of putting all the material out there and providing material, whether it's

for you know, schools or restaurants. But have you, Julie, what are tips that you would give UM new moms who don't know if their kid is allergy or what is a tip you would give to moms who are dealing with kids who are having a lot of allergies. I think if you don't know, I think the early introduction and trying to do that, and for me, keeping logs and notes was careful. It was important so that

you could kind of see what what you're reacting to. UM. Trusting your gut I think is really important because lots of kids have rashes or bumps or redness, and for me, any of those things can be incredibly serious. So I don't get to ignore those. So if you see something or something doesn't seem right, speak up, and you know, the worst thing that happens is you have reacted. And that's kind of for the you know, people that don't have allergies, UM, for people that do, be the advocate.

Do everything you have to, and also don't be so hard on yourself because it's it's so hard. And I just remember feeling so overwhelmed when both of the girls were first diagnosed idea. I was just like, what how am I going to do this? It's just it seems so you know, monumental. You don't feel like you can never really let your guard down. But you, you kind of get more comfortable with what your game plan is.

And then when it happened with Isabella, given that it was a completely different type of allergy, I was like, Okay, like I thought I had this under control. Now I have to step back. So it just don't be too hard on yourself. And there are other people out there that are dealing with the same things, and it's really nice to kind of have them as support. Um I mean, I was talking to someone who was first diagnosed and was so overwhelmed and what if my kid, you know,

can't have pizza at a party. And I said, look, I said, Ali now can have pizza at a party. I was like, but the first time she did, even though it was pizza that I brought from a pizza place that I knew she could have, I cried at the party because I was like, she looks like every other kid eating pizza, Like I was so excited, you know. So it's emotional. It's hard. Gosh, I'm scary. It's your baby. It's so scary. Absolutely, I love that. Thank you and um Dr Lee, what are your advice tips for moms

who are facing kids with a lot of allergies? Yes, I think generally speaking, just facing them UM new moms or to to reiterate boisterized your kids from day one and UM, you know, I I like to advocate UM to my patients and that to to find that working relationship. And so, you know, if they see the first physician and they don't feel like someone listened to them, or they didn't feel like they were getting the answers UM that they were expecting, maybe it is worthwhile to sour

see another physician. UM. Interestingly enough, and surround touched on this when we first walked in the room, was everyone wants it to be foods, and actually the majority of the times is it's not foods, and so UM. You know, if you get to an allergist and they seem very well educated and confident in what they're saying and it's not food, then maybe it's not. UM, it's mostly what what's the other options? Sometimes it's just it's just it's

just not anything specific. UM. Generally speaking, skin testing and blood testing for foods is only good at predicting immediately threatening reactions. And so if you're coming in with very good questions in the sense of is this food causing my baby to be gassy or fussy or spitty or eggs and me, I don't necessarily have a great test to predict that, but if you don't eat the food, then we're putting that kid at risk of developing an

immediately threatened reaction. So I generally try to keep the food in the diet if we can, just in an aspect to sort of create alerance. While we can do that, because maybe later down the road when the skin is better, because it's just most kids are going to get better from eggsama, then now they've developed innimate like rent reaction to that food. UM. So it is a balance, um and and a lot of times it can take a little bit of time to sort of get to that point. Um.

You know. But there's good medicine out there and good people out there, but there's also not trust your gut. Um you guys, thank you so much for coming on Katie's Crib, for sharing your personal stories, your professional stories. I'm loving your relationship. I wish you the best in this beautiful marriage. And thank you guys so much for coming on Katie's Crib. Thanks guys so much for listening,

and if you liked the episode, please subscribe. Rate share it with all of your mom crew and do you have a topic or a guest you'd like on the show. Let me know by reaching out on social media at Katie's Crib or by email Katie's Crib at Shonda land dot com. See you next week. Katie's Crib is a production of Shonda land Audio in partnership with I Heart Radio. For more podcasts from Shonda land Audio, visit the I Heart Radio app, Apple Podcasts, or wherever you listen to

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