Comments on: About http://www.pediatricallergyindy.com Pediatric Allergist Frederick E. Leickly - Riley Hospital for Children - Indianapolis, Indiana Mon, 30 Aug 2010 14:27:44 -0400 hourly 1 http://wordpress.org/?v=3.0 By: FPIES Mom http://www.pediatricallergyindy.com/about/comment-page-1/#comment-791 FPIES Mom Thu, 08 Jul 2010 06:30:04 +0000 http://www.leicklystory.com/?page_id=2#comment-791 BTW, this diagnosis was confirmed (as much as that is possible) by the Children's Hospital of Philadelphia, where he was seen by the gastro and the allergy depts. BTW, this diagnosis was confirmed (as much as that is possible) by the Children’s Hospital of Philadelphia, where he was seen by the gastro and the allergy depts.

]]> By: FPIES Mom http://www.pediatricallergyindy.com/about/comment-page-1/#comment-790 FPIES Mom Thu, 08 Jul 2010 06:28:42 +0000 http://www.leicklystory.com/?page_id=2#comment-790 YOu have stated that the FPIES studies you have seen have not been able to find an exclusively breastfed baby that developed FPIES while exclusively breastfed. If you would like to hear our story, please contact us. My son was 3 weeks old when our constant visits to the doctors and even ER finally led to an "episode" in front of our pediatrician. Once I took the offending foods out of MY diet, my exclusively breastfed baby eventually stopped having episodes. This was not colic - he is 2.5 years old, and we have still had episodes when he or I have eaten something contaminated. (I"m still nursing.) He seems to have outgrown his allergies to corn and milk, but still suffers from others. Let me know if my story can help others. YOu have stated that the FPIES studies you have seen have not been able to find an exclusively breastfed baby that developed FPIES while exclusively breastfed. If you would like to hear our story, please contact us. My son was 3 weeks old when our constant visits to the doctors and even ER finally led to an “episode” in front of our pediatrician. Once I took the offending foods out of MY diet, my exclusively breastfed baby eventually stopped having episodes. This was not colic – he is 2.5 years old, and we have still had episodes when he or I have eaten something contaminated. (I”m still nursing.) He seems to have outgrown his allergies to corn and milk, but still suffers from others.
Let me know if my story can help others.

]]> By: fleickly http://www.pediatricallergyindy.com/about/comment-page-1/#comment-706 fleickly Sun, 13 Jun 2010 21:06:14 +0000 http://www.leicklystory.com/?page_id=2#comment-706 Thank you for those kind words. This website has been fun and I hope it provides a perspective that is straightforward, easy to work with, and informative as well as being evidence-based. I have has many families look at the site and decide that Riley was the place to go with their children for asthmaallergy care. Hopefully, it will help people sort through some of the stuff out there and be critical of what is valid and what is not. FEL Thank you for those kind words. This website has been fun and I hope it provides a perspective that is straightforward, easy to work with, and informative as well as being evidence-based. I have has many families look at the site and decide that Riley was the place to go with their children for asthmaallergy care.
Hopefully, it will help people sort through some of the stuff out there and be critical of what is valid and what is not.
FEL

]]> By: Christine Van Dam http://www.pediatricallergyindy.com/about/comment-page-1/#comment-705 Christine Van Dam Sun, 13 Jun 2010 17:34:49 +0000 http://www.leicklystory.com/?page_id=2#comment-705 Hi, Dr. Leickly! I feel silly that I just now logged onto your website. This is a wonderful tool for parents and people to use and study a professional and trustworthy site. I have referred several parents to your practice and now will use this as well to pas onto them. By the way, Adam is doing fabulous on the lower dose Pulmicort (90). Yeah! Maybe he will outgrow this disease one day? Thanks for your support throughout the years! Hi, Dr. Leickly! I feel silly that I just now logged onto your website. This is a wonderful tool for parents and people to use and study a professional and trustworthy site. I have referred several parents to your practice and now will use this as well to pas onto them. By the way, Adam is doing fabulous on the lower dose Pulmicort (90). Yeah! Maybe he will outgrow this disease one day? Thanks for your support throughout the years!

]]> By: fleickly http://www.pediatricallergyindy.com/about/comment-page-1/#comment-512 fleickly Tue, 20 Apr 2010 15:17:05 +0000 http://www.leicklystory.com/?page_id=2#comment-512 Not all cases of ezcema have allergy involved. It may be something else. Allergy tests for foods tend to be more commonly falsely positive, however there may be false negative results. If you observation is that milk makes it flare, you may want to consider a trial of milk avoidance. I would also suggest that a pediatric dermatologist be involved. They can help with a differential diagnosis (assuming allergy is not part of the picture). FEL Not all cases of ezcema have allergy involved. It may be something else. Allergy tests for foods tend to be more commonly falsely positive, however there may be false negative results. If you observation is that milk makes it flare, you may want to consider a trial of milk avoidance.
I would also suggest that a pediatric dermatologist be involved. They can help with a differential diagnosis (assuming allergy is not part of the picture).
FEL

]]> By: Candice http://www.pediatricallergyindy.com/about/comment-page-1/#comment-511 Candice Mon, 19 Apr 2010 21:37:44 +0000 http://www.leicklystory.com/?page_id=2#comment-511 My son is now 14 months old and has been suffering with what the dermatologists says is eczema since about 8 months old. He's been on oral steroids twice since Jan. Once in a two week taper and the next in a two month taper. He's also been put on numerous steoid ointments/oils as well as nonsteriod creams. He's been to an allergist and was tested for only things he's eaten or been exposed to and nothing showed. He didn't react to any of them. About 3 weeks ago, his face became particularly worse with both eyes swelling shut as it spead over his eyelids. His face is his worst location but he also has it in random circular patches on his torso, on his elbows and their creases, on his knees and their creases, down his legs, and at his ankles. Nothing seems to be helping him. His itching has increased drastically and his face oozes and bleeds from his constant rubbing and scratching. I don't know what else to do. I've also taken him off all dairy as it seems to aggravate his skin even though the allergist said he was not allergic to cows milk. I'm worried that the flare up over his eyes will cause scarring and malformation as well as on his cheeks. What would you suggest? My son is now 14 months old and has been suffering with what the dermatologists says is eczema since about 8 months old. He’s been on oral steroids twice since Jan. Once in a two week taper and the next in a two month taper. He’s also been put on numerous steoid ointments/oils as well as nonsteriod creams. He’s been to an allergist and was tested for only things he’s eaten or been exposed to and nothing showed. He didn’t react to any of them. About 3 weeks ago, his face became particularly worse with both eyes swelling shut as it spead over his eyelids. His face is his worst location but he also has it in random circular patches on his torso, on his elbows and their creases, on his knees and their creases, down his legs, and at his ankles. Nothing seems to be helping him. His itching has increased drastically and his face oozes and bleeds from his constant rubbing and scratching. I don’t know what else to do. I’ve also taken him off all dairy as it seems to aggravate his skin even though the allergist said he was not allergic to cows milk. I’m worried that the flare up over his eyes will cause scarring and malformation as well as on his cheeks. What would you suggest?

]]> By: fleickly http://www.pediatricallergyindy.com/about/comment-page-1/#comment-479 fleickly Wed, 07 Apr 2010 13:35:29 +0000 http://www.leicklystory.com/?page_id=2#comment-479 This sounds like FPIES, unfortunately this is a clinical diagnosis, there are no tests that confirm what is going on. According to the article that I posted on FPIES there are a number of foods that have been associated with this. A more recent article by Mehr was published in 2009. The history is strong for rice being the trigger. The secondary problem is the refusal to eat. I would suggest connecting with a pediatric gastroenterologist. Rice avoidance should be straightforward, but you will need guidance regarding when to re-introduce the food and most probably support and clinical guidance when it is determined that it is no longer a problem. I would guess that after a prolonged period of time of avoidance, the child could be admitted or be brought to the clinic for a challenge under close observation. The GI clinic also has experience with 'eating refusal'. Rice was the most common triggering food in the Mehr study (Australian population). This report indicated that during the reactions, the child also had a low temperature and an elevated platelet count. Mehr had 80% resolve the rice sensitivity by age 3. Another study by Nowak-Wegrzyn had only 40% no longer reacting to rice by age 3 years. I hope this gives some guidance. FEL This sounds like FPIES, unfortunately this is a clinical diagnosis, there are no tests that confirm what is going on. According to the article that I posted on FPIES there are a number of foods that have been associated with this. A more recent article by Mehr was published in 2009.
The history is strong for rice being the trigger. The secondary problem is the refusal to eat. I would suggest connecting with a pediatric gastroenterologist. Rice avoidance should be straightforward, but you will need guidance regarding when to re-introduce the food and most probably support and clinical guidance when it is determined that it is no longer a problem. I would guess that after a prolonged period of time of avoidance, the child could be admitted or be brought to the clinic for a challenge under close observation. The GI clinic also has experience with ‘eating refusal’.
Rice was the most common triggering food in the Mehr study (Australian population). This report indicated that during the reactions, the child also had a low temperature and an elevated platelet count. Mehr had 80% resolve the rice sensitivity by age 3. Another study by Nowak-Wegrzyn had only 40% no longer reacting to rice by age 3 years.
I hope this gives some guidance.
FEL

]]> By: Kelli http://www.pediatricallergyindy.com/about/comment-page-1/#comment-478 Kelli Tue, 06 Apr 2010 21:48:37 +0000 http://www.leicklystory.com/?page_id=2#comment-478 I am writing because my 7 month old daughter has had 3 episodes over the past month of severe vomiting to the point of vomiting bile and severe lethargy which has really scared us. We have brought her to the ER twice and she was treated with I.V. fluids and released. Both times she did not have a fever and we were sent home with the explanation that it was probably a virus. After the third time, I realized prior to each episode she had eaten Earth's Best organic rice cereal mixed with breastmilk about 2-3 hours before becoming ill. The vomiting lasts a few hours and once she is rehydrated she seems to bounce back and is fine. She is fine until she eats cereal. The second and third time she only had a very small amount of cereal barely a teaspoon probably 1/2 teaspoon. She is breastfed and we have introduced a few foods she did well for a couple of weeks but since getting sick has refused all food. In researching what could cause this since I wasn't getting any answers from the ER or the pediatrician I came across an article on FPIES that exactly described what has been happening with my daughter! Today, we saw the allergist and he seemed to dismiss the idea and repeatedly said while he was taking notes "ok so mild vomiting" I tried to explain it was anything but mild and the lethargy was horrible. She was completely limp and could barely lift her head or open her eyes and was making weird noises. I am extremely frustrated b/c I feel that no one is listening to me about her symptoms. I really want her tested for FPIES but I'm afraid her pediatrician and allergist are not taking me seriously. I am very worried for my daughter and just want answers. I was hoping you would be able to recommend a physician in Arizona that could test her or a course of action? I am writing because my 7 month old daughter has had 3 episodes over the past month of severe vomiting to the point of vomiting bile and severe lethargy which has really scared us. We have brought her to the ER twice and she was treated with I.V. fluids and released. Both times she did not have a fever and we were sent home with the explanation that it was probably a virus. After the third time, I realized prior to each episode she had eaten Earth’s Best organic rice cereal mixed with breastmilk about 2-3 hours before becoming ill. The vomiting lasts a few hours and once she is rehydrated she seems to bounce back and is fine. She is fine until she eats cereal. The second and third time she only had a very small amount of cereal barely a teaspoon probably 1/2 teaspoon. She is breastfed and we have introduced a few foods she did well for a couple of weeks but since getting sick has refused all food.

In researching what could cause this since I wasn’t getting any answers from the ER or the pediatrician I came across an article on FPIES that exactly described what has been happening with my daughter! Today, we saw the allergist and he seemed to dismiss the idea and repeatedly said while he was taking notes “ok so mild vomiting” I tried to explain it was anything but mild and the lethargy was horrible. She was completely limp and could barely lift her head or open her eyes and was making weird noises. I am extremely frustrated b/c I feel that no one is listening to me about her symptoms. I really want her tested for FPIES but I’m afraid her pediatrician and allergist are not taking me seriously. I am very worried for my daughter and just want answers. I was hoping you would be able to recommend a physician in Arizona that could test her or a course of action?

]]> By: fleickly http://www.pediatricallergyindy.com/about/comment-page-1/#comment-336 fleickly Wed, 24 Feb 2010 14:27:45 +0000 http://www.leicklystory.com/?page_id=2#comment-336 Greetings Eva, Thanks for the question. I punted this to one of my 'go to' dietary people. Laura tells me that Tums for kids- 2 per day in the age range 2-4 and 3 Tums per day in those who are 5 and older. This is the less costly way to supplement calcium. She also tells me that there are milk-free calcium supplements. She gave the Vitamin Shoppe's Nature's Plus Animal Parade Calcium tab and Hero Nutritional's Yummi Bears Calcium. She did warn that they are price. It is a theory that a certain acid level is needed in the gastrointestinal tract to help digest large molecules of food and that the use of antacids in the very young may allow large protein molecules to be absorbed through a developing gi tract. I do not think this has been proven. You would have to see a surge in new food allergy symptoms/sensitization after the Tums were started. That has not been my experience. In hopes that this helps, Warmest regards and thanks for sharing your question. FEL Greetings Eva,
Thanks for the question. I punted this to one of my ‘go to’ dietary people. Laura tells me that Tums for kids- 2 per day in the age range 2-4 and 3 Tums per day in those who are 5 and older. This is the less costly way to supplement calcium. She also tells me that there are milk-free calcium supplements. She gave the Vitamin Shoppe’s Nature’s Plus Animal Parade Calcium tab and Hero Nutritional’s Yummi Bears Calcium. She did warn that they are price.
It is a theory that a certain acid level is needed in the gastrointestinal tract to help digest large molecules of food and that the use of antacids in the very young may allow large protein molecules to be absorbed through a developing gi tract. I do not think this has been proven. You would have to see a surge in new food allergy symptoms/sensitization after the Tums were started. That has not been my experience.
In hopes that this helps,
Warmest regards and thanks for sharing your question.
FEL

]]> By: Eva http://www.pediatricallergyindy.com/about/comment-page-1/#comment-333 Eva Tue, 23 Feb 2010 03:40:05 +0000 http://www.leicklystory.com/?page_id=2#comment-333 Dr Leickly, My son is a patient of yours and I enjoy reading your blog. With a milk allergic 8 year old, I am always looking for good calcium supplements. Tums would be an option.. However, I remember reading somewhere ( and I cannot find the article again, of course!) that it is not good for food allergic children to eat anti acids. Might have been in context with probiotiocs/GI flora... Your thoughts on this? Thanks, (Andrew's mom) Greetings Eva, Thanks for the question. I punted this to one of my ‘go to’ dietary people. Laura tells me that Tums for kids- 2 per day in the age range 2-4 and 3 Tums per day in those who are 5 and older. This is the less costly way to supplement calcium. She also tells me that there are milk-free calcium supplements. She gave the Vitamin Shoppe’s Nature’s Plus Animal Parade Calcium tab and Hero Nutritional’s Yummi Bears Calcium. She did warn that they are price. It is a theory that a certain acid level is needed in the gastrointestinal tract to help digest large molecules of food and that the use of antacids in the very young may allow large protein molecules to be absorbed through a developing gi tract. I do not think this has been proven. You would have to see a surge in new food allergy symptoms/sensitization after the Tums were started. That has not been my experience. In hopes that this helps, Warmest regards and thanks for sharing your question. FEL Dr Leickly,

My son is a patient of yours and I enjoy reading your blog.

With a milk allergic 8 year old, I am always looking for
good calcium supplements. Tums would be an option..
However, I remember reading somewhere ( and I cannot find the article again, of course!) that it is not good for food allergic children to eat anti acids.
Might have been in context with probiotiocs/GI flora…
Your thoughts on this?
Thanks, (Andrew’s mom)

Greetings Eva,
Thanks for the question. I punted this to one of my ‘go to’ dietary people. Laura tells me that Tums for kids- 2 per day in the age range 2-4 and 3 Tums per day in those who are 5 and older. This is the less costly way to supplement calcium. She also tells me that there are milk-free calcium supplements. She gave the Vitamin Shoppe’s Nature’s Plus Animal Parade Calcium tab and Hero Nutritional’s Yummi Bears Calcium. She did warn that they are price.
It is a theory that a certain acid level is needed in the gastrointestinal tract to help digest large molecules of food and that the use of antacids in the very young may allow large protein molecules to be absorbed through a developing gi tract. I do not think this has been proven. You would have to see a surge in new food allergy symptoms/sensitization after the Tums were started. That has not been my experience.
In hopes that this helps,
Warmest regards and thanks for sharing your question.
FEL

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