Having just gone through the receipts in my wallet for December, I note that I have bought 23 lussekatter at Pressbyrån during this Christmas season, for a total of 338 kronor.
(The one in the photo below was made by Ingrid and not bought at Pressbyrån.)
Adrian is well over a year old, and it’s been a long time since I last tested dairy products other than butter (since spring, actually). I thought I’d try and see how his milk protein allergy is doing. Perhaps I can go back to a more varied diet?
By now I don’t miss milk products much, but it does complicate cooking, and eating out is a serious challenge. I’m glad if I find one milk-free meat-free option on the menu, and often have to ask the kitchen to skip the sauce, give me boiled potatoes instead of mashed potatoes etc. I’ve been eating a lot of sushi and pizza without cheese. (Which is a pretty poor alternative to real pizza.)
I know that there are two types of milk protein allergy. One is a true allergy, “IgE-mediated”, with a fast reaction and more classical allergy symtoms – hives, itching, vomiting. The other is an intolerance, still an immunological reaction but “non-IgE-mediated”, with a delayed reaction and more gastrointestinal symtoms – reflux, abdominal pain, abnormal stools. All signs point towards Adrian having the latter. (Which is great, because this non-IgE-mediated version is much more likely to disappear, and much less likely to widen to cross-reactions to other allergens.)
I also know that non-IgE-mediated CMPI often disappears on its own in kids and around 90% are allergy-free by age three. But I realized I have no idea how it actually disappears. Does it happen fast or gradually over many months? Do the kids tolerate larger and larger amounts, or do their symptoms just become weaker? Do the symptoms change? – because obviously Adrian’s gastrointestinal system is much more mature now than a year ago.
I now also know that there are four main types of protein in milk that kids can be allergic to. I’ve learned from the internet that they may react to one or several of those, and there’s no real correlation between the different types. But I have no idea which one(s) Adrian might react to.
When we first tested for CMPI we did an eliminiation/challenge test. I ate no dairy products for three weeks, and then ate normal amounts of milk again for one day. The result was unequivocal.
But I’m not so sure that this would be the right thing to test now. I could do a challenge, but if Adrian reacts, all it would tell me is that he reacts if I consume a lot of milk. But I don’t necessarily need or want to consume a lot of milk. If I can put parmesan on my pasta and cheese on my pizza every now and again, I’d be pretty happy.
So the alternative is to try with just a little bit. But that might also not be the right thing to test. Adrian might react, but not so much that it would be a clear signal. He might not scream with pain like he used to, just feel slightly sick and fuss a bit more than usual. We may just interpret that as ordinary fussing and I’d continue with milk, making him live with constant low-level stomach pain (for example) which I obviously don’t want.
A couple of weeks ago I had pizza for lunch. That seemed to go well. Then a cheese sandwich. That seemed to go less well – he slept like crap. Another week or so later I tried grilled cheese sandwiches, and he didn’t seem to react.
Around the same time we had him tested for milk protein allergy (skin prick test) and the test was a clear negative. Great, we thought, finally a clear answer! Let’s go!
So I ate home-made pizza on Saturday and pasta with feta cheese on Sunday. Adrian slept like crap again last night, and was crazy all day today. Hyperactive, racing around, unable to concentrate on anything, throwing things; grabs for food and then refuses to eat it; grabs for breast and then pushes it away… “crazy” is the best way I can describe it. What’s up?
What’s up is that the doctor needs to go back to school, it seems. I went back to the internet to learn more and immediately found out that skin prick tests are worthless in the case of non-IgE-mediated CMPI. They do not detect that type of reaction, they only work for IgE-mediated cow’s milk allergy.
The internet was less helpful in coming up with a plan for testing to see whether Adrian’s outgrown his CMPI. So it’s back to our own homebrew method, slow and steady. I will try a bit, wait a few days, try the same again and wait again. If everything is OK, I try with the next type of dairy product.
Right now it looks like I can consume small amounts of cheese that has been strongly heated. Cheese straight from the fridge is not OK. Next I should probably test whey products that contain no casein (the protein in cheese) to see if Adrian also reacts to the other milk proteins.
Useful resources:
Food Allergy and Food Intolerance on Patient.co.uk
The diagnosis and management of cow milk protein intolerance in the primary care setting on PubMed – only an abstract is provided but a search for the exact title will likely turn up some unofficial copies of the article.
Today I ate my first cheese sandwich since I went milk-free last November. It was good.
Now Adrian is sleeping like crap, waking all the time. Either it’s because of the cheese, or it’s because of all the commotion here today because of Ingrid’s birthday party.
To be continued.
I see other kids eat cinnamon swirls for their mid-afternoon snack and eat candy off and on throughout the day. And they still don’t gain weight or have trouble with their teeth.
With Ingrid we need to worry about both weight and teeth. Eric keeps an eye on his weight, and I have weak teeth, so I guess Ingrid inherited the worst from each of us. Se’s definitely got the Bergheden body type, broad and strong and tending towards overweight if you don’t pay attention. Adrian looks like he’ll be following in Ingrid’s footsteps.
The standard Swedish solution for keeping kids’ teeth healthy is lördagsgodis, “Saturday’s candy”, i.e. sweets on Saturdays only. And then they get lots, lots and lots and lots. Many of them really get to gorge themselves on sweets. The argument is that if you eat your sweets all in one go then your teeth get to rest from sugar in between Saturdays. (The whole idea was introduced by the worried public health authorities in 1957, according to an unverified source.)
It’s also supposed to instil in kids an understanding and a habit that sweets are a treat, to be limited, not everyday fare. If a Swede sees kids eat sweets on another day then s/he will probably comment on it, whether in his head or out loud.
But while mid-week candy turns heads, many Swedish parents exclude cakes, fika, ice cream and other such stuff from their definition of sweets, so those are OK on other days, too. And pancakes for dinner are not “sweets” either. Judging from the kids’ menus at restaurants, for many Swedish families pancakes is not a treat but a normal meal. And then there are all the other lingonberry-jam-accompanied kid-friendly everyday meals such as potato griddle cakes and black pudding and meatballs and so on. So the whole Saturday candy thing suffers from serious cognitive dissonance issues.
I also think it leads to an unhealthy attitude towards sweets, and eating in general. Many adult Swedes I know tell me that when they are offered sweets, they are unable to eat just a little, they feel compelled to eat lots. This is not an issue I’ve noticed among my Estonian friends. So instead of teaching kids to limit their intake of sweets, the Saturday candy thing teaches them to obsess about sweets all week long and then gorge themselves. (Pretty much the same problem that adults in many countries have with alcohol – but not in countries where there is a tradition of having wine with your dinner.)
So we don’t “do” Saturday candy in our home. We do “everything in moderation” instead. As a result Ingrid is limited to one small-sized treat per day on weekdays, and two on weekends, when she can have a sweeter breakfast (toast with marmalade, or a sweeter kind of cereal) as well as ice cream after dinner. And pancakes with jam most certainly count as a treat in our home. It seems to work; the long-term results remain to be seen.
Milk protein allergy experience of the day: apparently IKEA’s chips (French fries) contain milk. Or perhaps their bread does. I knew McDonald’s has gotten into trouble for having both milk and wheat in their chips but didn’t think that IKEA would do stuff like that. In any case Adrian threw up his entire lunch an hour after eating there. The only things he ate from their menu were bread, carrots, and a few chips.
Counter-intuitive allergy experience of the day: it is safer for me to eat butter than to eat margarine, even though butter is 100% made from milk (OK, water and salt, too). Butter is milk fat only and does not appear to have any significant amounts of milk protein left in it. Not enough to trigger allergic symptoms in Adrian, at least. Margarine on the other hand is an unpredictable mixture of stuff, often including skimmed milk powder or whey powder, both of which do contain milk protein. So when a restaurant serves margarine with their bread, I skip it; when they serve butter, I eat it.
The day before yesterday I ate a small chunk of goat’s cheese with my dinner. No complaints from Adrian. Yesterday I boldly ate a slice of cheese after breakfast, another small chunk of goat’s at lunch, and finally two slices of cheese in the afternoon. That was apparently too much; Adrian woke and cried a lot during the night. No cheese sandwiches for now.
Butter on the other hand is now tried and tested and works well. I love butter. Just plain good bread with butter on is delicious.
Today the builders finished their work, packed up their stuff and went home. Just in time for the weekend, and just in time for my vacation! (Today was my last day at work, I’m on vacation for the next four weeks.)
The very last thing they did was sand the floor in the old hall. When they started work in there, back in January, they tore up the laminate flooring, and the glued cork tiles beneath them, and uncovered the original pine planks at the bottom. The cork layer had been glued right on top of the pine and left ugly patches everywhere. For half a year the floor looked atrocious. But now after sanding it is pristine again, and looks lovely.
We now have pine plank floors in all three rooms on the ground floor, as well as that hall. In the old living room the floor is varnished; in the other rooms the new floors are untreated as yet. We have ambitious plans to leave them that way and simply care for them by scrubbing them with linseed oil soap, which both cleans and protects the floor, a bit like oiling it.
You can see this kind of floor in some old Swedish houses, and after a hundred years it both looks and feels wonderful – silvery gray and satiny smooth. This is especially nice if you walk around barefoot at home, like us. I’ve been told that it doesn’t take a hundred years to get there. Should the floors not turn out nice, we can always change our minds later and treat them with oil.
Today I gave the newly-sanded floor its first scrubbing. Now the hall smells of linseed oil soap. To me it smells like a very old but well-cared house, like an old rural schoolhouse that’s been turned into a museum, or an old Estonian farmhouse. A very cosy smell.
If you can read Swedish, you can learn about using soap for floor care from Skansen.
This summer’s favourite recipe is a rhubarb pie with sunflower seeds and almond paste. I love its flavourful chewy crunchiness. I think I’ve made five or six of them this summer already. Here it is:
4–5 rhubarb stalks
1/2 dl sugar (the original had more but came out too sweet for my taste)
3 dl rolled oats
1 dl sunflower seeds
100 g almond paste
100 g butter
Cut the rhubarb in pieces of 1 to 2 cm. Put them in a saucepan, add water so it barely covers the rhubarb, and bring to boil. Pour off the water. Spread the rhubarb in a pie dish and sprinkle the sugar on top.
Mix oats, sunflower seeds, butter and almond paste into a crumbly mass, and crumble it over the pie. Bake in 200°C for 15 to 20 minutes.
I had butter on my bread yesterday evening. Adrian has not yet reacted to it. Yippee!
A busy day: it feels like these remaining days are my last chance to get things done at home.
Some more painting of the play house while Adrian slept. Playgroup. Supermarket. Went to the hardware store to see if I could borrow their fan deck of NCS colours. (Unfortunately he answer was no, because they’ve lost too many of those expensive decks, despite taking down folks’ names and numbers.) Weeded and dug through the top layer of soil in two of our planting boxes with strawberries.
Adrian has, in the last few days, started to demand solid food. Previously I’d just put him in his highchair and give him some food when I wanted to eat, so he could get used to the concept, have some fun, and we’d keep each other company. But now he has been fussy and I’ve gone through my checklist (sleep? boredom? breast? nappy?) and then offered him food, and seen him wolf it down. His and my meal schedules are thus no longer in sync, so I’ve spent more time than usual preparing food and cleaning up him and the kitchen afterwards.
I’d planned to take Ingrid shoe shopping after preschool but she was not at all amenable to that. Too hot (it was another hot and sunny day) or too tired or hungry or thirsty, or all of that – in any case she was in a very precarious mood all the way home. Then we put a picnic blanket under the cherry tree, I made us both some smoothies with frozen raspberries and blueberries, bananas, and apple juice, and we relaxed together. She felt much better after that.
I noticed wasps on the kitchen windows on at least five separate occasions, and never in any other part of the house, or near the door. Now I’m wondering if they have a nest somewhere inside the walls there – there are gaps around and beneath the newly installed windows, and they could be coming out of those. If that’s the case we will have to plug those holes quickly.
(Actually I missed one wasps’ nest in my list yesterday – we also found an old, abandoned one above the ceiling of the old veranda. I guess wasps really like our house.)
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