It Has What?!? Milk Protein in Asthma and Allergy Medications

I learned something new this month and it scared me.

I have always heard reminders about the importance of checking labels for not just food but everything: soaps, bird feed, fertilizer, chalk, drugs.  And I thought I had always been good about reading through labels.  However, while checking my Facebook feed, I scanned over a status update from Allergic Living that highlighted its feature on milk protein in asthma medication.  I stopped.  I reread the sentence.  Uh oh.  I've never questioned whether my own asthma management medication could be a source of danger for my kids!!

In our emergency med pack, I was toting Auvi-Q epinephrine injectors for my kids and an inhaler
for me.  Little did I know my inhaler contained milk protein that could put my kids' lives at risk.

After reading through the whole article and scouring through more information online, I discovered that Advair and Ventolin do in fact contain milk protein in the form of lactose dry milk powder.  In addition to these two products, milk derivatives are also present in popular allergy and asthma relief drugs such as Singulair, Flovent, Claritin tablets, and Prednisone -- yes, Prednisone, the drug that is often given to prevent a biphasic reaction after anaphylaxis.  Seriously, how did I not know this??  How did I miss this all these years?

Here's how:  While 2004's Food Allergen Labeling and Consumer Protection Act (FALCPA) made it mandatory for all food products to be properly labeled to identify the presence of the top 8 food allergens, the same rules do not pertain to non-food products.  Prescription drugs, over-the-counter drugs, health and beauty products, and pet supplies (including pet food) are just several of "non-food products" that fall outside of the FDA's regulatory net.  (For a more in-depth look at what the act affects, check out Kid with Food Allergies summary on FALCPA.)

So drug manufacturers are not required to label food allergens on their packaging.  The FDA does require medications to be accompanied by patient package inserts.  These inserts are written in microscopic font on a one-page, single-spaced, double-sided document that is notoriously lengthy and technical.  This information is nearly impossible to get through without a medical degree and magnifying glass, even if you are looking for your kids' allergen buzz words with eagle eyes.  What's more, patient package inserts do not have to list ingredients or food allergens.  The inserts include sections on how the drug works, indications, contraindications, warnings and side effects, and dosage recommendations, and it is the drug manufacturer's discretion to list food allergens. 

I checked the package labels of my asthma management meds which I last filled in spring, the time of the year when I endure a full-on attack by grass and tree pollens.  No mention of milk ingredients.  There was a mention of a mysterious white aerosol and instructions to rinse my mouth thoroughly after each use...These warnings should have been red flags to me to dig deeper over the ingredients.

How to find out if your asthma medication contains milk:

1. Check out this list of asthma medications that contain lactose (milk) compiled by the Allergy Asthma Information Association (AAIA).  Please keep in mind that this list is from 2006 -- most certainly there is updated information out there.  
2. Remind your physician or child's pediatrician about their food allergies when they are about to be prescribed medication.  Contact your allergist about medications you or your kids are prescribed.  Are they free of your (children's) allergens?
3. Do your homework online.  Search your medication by name to see if it is milk-free.
4. Please, please have your kids wear some sort of allergy alert identification (medical bracelets, wristbands, dog tags).  If an emergency occurs and you or they cannot advocate for themselves, these medical alerts could prevent them from receiving treatment that will make an asthma attack or anaphylactic reaction even worse.

Do you manage asthma and a milk allergy?  When did you find out that asthma treatment medications contain milk products?

Getting Back on Track & Fish Tacos (No Egg, No Dairy)

During the summer, life slows down.  Without homework to complete, team sports practices to rush off to, or school volunteer commitments, you would think our lives are stress-free during the summer.  But as the weeks go on, a subtle regression takes place to a life where any semblance of a schedule is nonexistent.

Yep, sneaky little thing, the fall to chaos.  And then you're back dealing with the same old stuff you're dealing with during the school year: the repetitive dinner dishes, kids want to "help," but you have very little time to shop or prepare, and everyone's food allergies and disparate tastes exacerbate the situation.  Time for a change of pace.

First, get everyone back into a routine by making sure they understand their daily roles and responsibilities.  I am a true believer in incentives.  I found this website called Kidspointz where you can assign each child tasks/responsibilities/chores using a points and rewards system.  Kids can help develop their online charts, along with the rewards they are coveting (right now, the kids are really into computer time, online game subscriptions, special outings, etc).  We are into week two and beds are still made, daily reading time is still observed, and whining is down to a minimum.  Eventually their responsibilities will be habit and their rewards will come naturally--that's the hope, anyway.

As for the perpetual question, "What's for dinner?" we recently tried a simple recipe for fish tacos with much success.  The kids were able to help, the bulk of it can be made in advance, and the use of frozen fish sticks buys me an extra day or two between grocery store visits.

The key to making this recipe allergy-friendly is finding frozen fish sticks and a mayonnaise that work for your family.  We use Trader Joe's Lightly Breaded Fish Sticks Reduced Fat.  They contain wheat, but are dairy, egg, and soy free, which are the usual fish stick culprits.  If your kids are fish allergic, try substituting allergy-friendly chicken nuggets or grilled fish or chicken for a gluten-free option.

As for the mayonnaise, for this recipe we tried Nasoya Vegan Nayonaise.  It seemed to separate a bit in the jar and had a yellowish tinge, but when we made the coleslaw dressing, it was smooth as silk.

For picky eaters, try a plainer coleslaw (my 8-year-old swears by just cabbage, sugar, salt, pepper, apples, and raisins), and try creating a plate instead of putting it together into a taco.  Your kids might surprise you by piling everything together anyway (see exhibit A below).  Have the kids help you cook, or try adding in a favorite ingredient to make trying something new a bit easier.  I also added a bit more sugar to taste, and substituted apple cider vinegar for the red wine vinegar.

"Exhibit A:" She started off with everything separate, but quickly moved on to a taco.

Easy Fish Tacos (NO Dairy, NO Egg)

Ingredients:

Coleslaw, adapted from Tyler Florence's Ultimate Coleslaw Recipe

1 cup mayonnaise, like Nasoya Vegan Nayonaise
1 tablespoon Dijon mustard
Drizzle of extra-virgin olive oil
Juice from 1/2 lemon
Salt & Pepper, to taste
1 tablespoon apple cider vinegar
1 tablespoon sugar
1 store-bought bag of shredded green cabbage (8 oz)
1 store-bought bag or shredded red cabbage (8 oz)

Fish sticks (like Trader Joe's Lightly Breaded Fish Sticks Reduced Fat)

Corn tortillas
Drizzle of extra virgin olive oil

1. Pre-heat oven and pop the fish sticks in to bake on a foil-lined baking pan.  Bake as directed on box.

2.  Make the coleslaw by combining all the dressing ingredients in a large bowl, then tossing it with the cabbage.  Season with salt and pepper to taste.

3.  Pan fry the corn tortillas and set aside for serving.

4.  Allow kids to assemble the tacos and enjoy!

Bakery-style Chocolate Chip Cookies - free of the top 8 allergens

If you have followed Get Allergy Wise for awhile, you know that most of my recipes are adaptations of preexisting recipes.  I definitely need other recipes as road maps and realize how lucky I am to be able to search the web to find much of what I am looking for.  Recently acquired some parsnips but never cooked with them?  Search for recipes on the internet!  Only have carrots, onions, salsa, and a bag of rice in your cupboards?  Get meal ideas on the internet!  Seriously, we are spoiled with convenient, expansive information these days.

Despite the internet's bottomless pit of great recipes, I am still a fiddler by nature.  I can't help but play around with recipes -- sometimes a little and sometimes a lot -- to fit the needs of my milk-allergic, nut-allergic kids or to lower the sugar content, or to fulfill our family's lifestyle choice of eating more plants and less meat.

So it says a lot (and is pretty rare) when I do *not* find a thing to change about a recipe.  One such recipe is vegan author Dreena Burton's recipe for homestyle chocolate chip cookies.  The recipe is a favorite cookie recipe of mine.  When I first discovered it online two years ago, I think I made batches of it for three months straight, I was that addicted.  I love that the cookie uses oil rather than vegan margarine or shortening and also uses a good amount of maple syrup as the main sweetener.  Even Dreena's estimated bake time (11 minutes) was exactly right for my oven.  Okay, the one thing I did change was that I omit the molasses but that is because I never have any on hand.  Besides that, I couldn't find anything to change about this recipe!

I love Dreena's chocolate chip cookies but the tinkerer in me was curious.  I wondered if I might be able to do something about the wheat-based flour that the original recipe calls for.  Could I replace the flour with something that would be safe for those who are allergic to wheat or gluten-intolerant? 

I've tried the popular gluten-free flour blend of brown rice flour, potato starch, and tapioca starch.  But I seized the opportunity to go off the beaten GF trail and combine some flour alternatives that have accumulated in my pantry, flours that I must have bought after seeing recipes that I wanted to try but sadly haven't gotten to yet.  I opted for a more protein-rich mix of garbanzo flour (boy, I have a lot of that around!), potato starch, and quinoa flour.


The cookies turned out delicious!  Texture-wise and tastewise, they were very similar to the original recipe.  These cookies were able to attain a more golden brown color than when I make the original homestyle cookies.  (Perhaps the molasses that I always omit usually helps with browning?)  I think the quinoa flour adds a slight nutty flavor but this works fine with the chocolate.  And I don't know why, but big chocolate chunks elevates these cookies to another level.

Bakery-style Chocolate Chip Cookies - free of the top 8 allergens
Adapted from Dreena Burton's homestyle chocolate chip cookie recipe featured on her Vive La Vegan! blog and cookbook of the same name

Dry ingredients:
1 cup garbanzo flour
1/2 cup quinoa flour
1/2 cup potato starch
1/2 tsp xanthan gum
2 tsp baking powder
1 tsp baking soda
1/2 tsp sea salt
1/4 tsp cinnamon
1/2 cup turbinado "raw" sugar

Wet ingredients:
1/2 cup oil
2/3 cup maple syrup
1 Tbsp vanilla extract

1 cup Enjoy Life mega chocolate chunks or 1 cup of safe chocolate, coarsely chopped
Extra sea salt (flakes are great) for sprinkling, optional

1. Preheat 350 degrees Fahrenheit.  Grease or line 2 cookie sheets with aluminum foil.
2. In a large bowl, whisk together all dry ingredients.  Make sure any clumps of flour or starch are broken up to ensure even mixing.
3. Create a well in the center of the dry ingredients.  Pour oil, maple syrup, and vanilla extract into the well and mix the wet ingredients together.
4. Gradually combine wet and dry ingredients, stirring through the dough so that there are no pockets of dry ingredients left.  The dough will be a little thin, not as sticky and thick as a typical gluten-full cookie mix.  Then stir in chocolate chunks. 
   
5. Spoon out 1 to 1.5-inch balls of cookie dough on cookie sheet. Sprinkle with additional sea salt flakes if you so desire.  Leave 2 inches of space between each cookie -- these cookies do spread quite a bit!
6. Bake at 350 degrees Fahrenheit for 10-12 minutes or until cookies begin to turn golden.  Promptly remove from oven and let cool.

I find these vegan chocolate chip cookies -- Dreena's original or this gluten-free alternative -- very easy to prepare.  We are planning to do some cookie sales this summer to raise funds for the FARE Walk for Food Allergy.   Adding chocolate chunks versus chips is a fun touch to look more professional.

Baking Therapy--Chewy Chocolate Chocolate Chip Cookies: No dairy, egg, or nuts

I apologize for how quiet it's been around here.  May means both days and evenings are packed with various end-of-the-year activities and events that are fun and exhausting.  So even though it feels quiet out there, there's plenty going on around here.

Logan is finishing up his soccer season, Tristan is knee-deep into Little League playoffs, the kids are preparing for final rehearsals for their annual dance recital, and I am busy shuttling them around to all of these things.  I am looking forward to lazy summer beach and playground days, trips to the library and museum, and picnics and bike rides in the park; but before the reprieve of summer, there's still so much to do!

A few days ago, I was up all night with a migraine.  My headaches are the one thing that can slow me down.  My body is telling me to drink more water, eat regularly, get more sleep, and reduce the stress!  As moms, we know we frequently become last priority.  So the next day, I headed to the gym, then came home and decided to leave the messy house and piles of laundry alone--some baking therapy was what I needed!

I am always looking for a new and easy chocolate dessert recipe.  I love cookies in particular because they are easy to transport, package, and eat without too much fuss (if you have a four-year-old who only likes the frosting off of cupcakes, and two boys who don't like frosting at all, you know what I'm talking about).  They are perfect for bake sales, teacher's gifts, and cookie jar fillers.  And who doesn't like a good chocolate chip cookie?  Especially when it's a chocolate chocolate chip cookie, free of dairy, egg, and nuts.

I modified this Chewy Double Chocolate Chip Cookie recipe from food.com to make it egg and dairy free.  I feel like it would do well with a gluten-free flour mix, too.  Now if you have been really good at watching your diet in the hopes that your tropical vacation in a couple of weeks will include something remotely resembling a bathing suit (ahem...), you might want to forgo baking these cookies.  They're incredibly addicting, especially for the chocoholic.

Chewy Chocolate Chocolate Chip Cookies-- NO EGG, NO DAIRY, NO NUTS modified from food.com's Chewy Double Chocolate Chip Cookie recipe

1-1/4 cups Earth Balance

2 cups sugar

2 egg equivalent of Ener-G Egg Replacer (1 T. Ener-G plus 4 T. warm water, whisked together in a small bowl)

2 teaspoons vanilla extract

2 cups flour (or gluten-free flour substitute)

3/4 cup cocoa (I use Ghiradelli Unsweetened Cocoa)

1 teaspoon baking soda

1/2 teaspoon salt

2 cups chocolate chips (I use Trader Joe's Semi-Sweet Chips.  Try Enjoy Life mini chips or mega chunks for a variation)

Directions

1.  Cream together Earth Balance and sugar.  Add 2-egg equivalent of Ener-G Egg Replacer and vanilla extract.

2.  Stir in cocoa, baking soda, and salt.

3.  Add the flour and fold in the chocolate chips.

4.  Bake at 350 on parchment lined baking sheet for 8 - 9 minutes.

A Successful Marin Overnight

When Tristan left in the morning with his big duffle filled with sleeping bag, toiletries, and layering pieces--for which I had specific instructions lest he go out everyday in a t-shirt--I was in pieces.  There was never a doubt in my mind that we would make it happen, and figure out a way for him to be included in his class' first overnight stay.  I just hadn't anticipated how nerve-wracking it would be.  And little did I know how much of a learning and growing experience it would be, for the both of us.

Eighty third graders stayed two nights at the Point Bonita YMCA.  It is a clean facility, with separate boys' and girls' dorms.  Bunks are divided into several smaller rooms and one meeting room, and large bathrooms.  Their spacious dining hall includes a buffet and plenty of long cafeteria-style tables.  All the children were given an orientation about how the dining hall works, with an emphasis on composting and taking only what you can eat.  The food is mostly organically grown and healthful, with basic ingredients, which simplified things for us.  On top of it all, the meals were delicious.

So how does a multiple and severely allergic child eat in a dining hall in a camp-style setting?  With a lot of planning, foresight, and a bunch of faith thrown in for good measure.  Richard Holden at Point Bonita YMCA was a pleasure to work with.  We communicated via email, with a follow-up discussion with his chef when we got there.  Here are a few things that worked for us:

1.  I emailed Food Service Director Rich Holden well in advance of the trip.  We emailed back and forth until I came up with a modified menu for Tristan.  It would have been nice for these menus to have been posted in the kitchen upon our arrival, but Tristan brought two copies of the menu with him, both of which he ended up giving to the chefs for reference.  I made sure to introduce Tristan to the chef before the first meal.

Here is the dinner menu for day 1.  Rich was willing to do a modified menu, or a combination of a modified menu and supplements, depending on the food allergies. We needed to do minimal supplementation (just soy milk boxes and Oreos), as there was lots of variety.

Point Bonita Sample Dinner Menu

Pasta and Meat Sauce
or Vegetarian Pasta
Sauteed Vegetables
Dinner Roll, Salad Bar
Fresh Baked Cookies

Tristan ate a hearty meal of pasta with meat sauce and vegetables on day 1.  His food was either separately plated by the chef, or he was allowed to plate his food first to avoid cross contamination at the buffet.  We brought a stash of Oreos for dessert, and he ate those instead of their cookies.  Although I was very impressed by the kitchen's attempt to accomodate Tristan with allergy-friendly cookies, I decided against them after reading a "traces of dairy" warning on the package.

2.  Before the trip, I gave Tristan's third grade team a refresher on food allergies and Epi-Pens.  I used some of the materials from our Food Allergy Summit in NY (and later improved the presentation with a food allergy quiz).  Each teacher tried out a trainer pen, and I answered everyone's questions as best as I could.  We agreed that Tristan would carry his Epi-pen in his pack.  It was really valuable to reconnect with the teachers about the severity of Tristan's allergies.  During his stay, Tristan was grouped with the male teacher in the group for hiking and bunking.  Big thanks to Mr. H and the third grade team!

3.  On the advice of his allergist, Tristan brought Claritin to take nightly.  In an unfamiliar place with allergens all around, it was smart to have some antihistamine in his system.

4.  The naturalists were alerted of kids who had special needs or medications, so they were made aware of Tristan's allergies and medications in his pack.

5.  I tried to prep Tristan about managing his food allergies with a balance of trust and caution.  I needed him to trust that I had prearranged a safe menu for him, but I also warned him that adults could make mistakes, and that he needed to make sure he was getting what was on his menu.  I asked him to look at his copy before each meal, and make sure he knew what he was supposed to be eating.  I think that helped empower him and give him a sense of confidence.

6.  I packed safe granola bars in his pack, in case he wasn't comfortable with a meal, snack, or just got hungry.

When I went to pick Tristan up from school on day 3, he looked relieved to see me. In the car, he told me that he "just missed us so much."  I was so proud of him for having such courage and stamina to collect his worries and gain such a valuable experience.  Three days without him at home gave me a glimpse into the future, with a bit of worry, but a lot of optimism, too.

The day I was there, we hiked around and down to the beach, then back to the Y. The kids would approach the trail as a group, each with different responses and ways of coping.  Some would charge straight down the hill, without looking back.  A few would sidestep down, cautiously taking each step.  Others would look straight down, as not to brush against poison oak, or step into a hole.

My hope for Tristan is that he is cautious, but confident through life, and that he take the time to explore and take in his surroundings.  I hope that when he needs to, he will grab my hand for some extra support, and that he will let go when he's ready.  I may never be ready, but knowing that he will be is an awesome feeling.

Kale Mint Chip Ice Cream revisited -- dairy-free, soy-free goodness

St. Patrick's Day is this Sunday.  Do you celebrate it in a big or small way with your family?

My family has no Irish roots but we do use the holiday as a fun way to "get our green on".  I have been on a kale kick lately -- kale in our tacos, kale in our fried rice, kale in our pasta-- so I definitely want to make something with this vitamin-rich leafy green.

With warm temperatures arriving in our area, it was a great excuse to break out the ice cream maker.  I decided to revisit a kale mint chip ice cream recipe I had posted in 2011.  I love to tweak and remember having some issues with the texture of the frozen ice cream so I went right to tinkering with the original recipe.

I subbed in agave sweetener for the refined sugar so that I wouldn't need to heat the mix to dissolve table sugar.  I ended up reducing the amount of agave because it is sweeter than table sugar.  I omitted the extra oil that the original recipe called for since canned full-fat coconut milk provides enough fat to help with the creamy texture.  Adding arrowroot powder is absolutely key to getting a creamy texture.  It is expensive stuff but a little goes a long way -- the same bag of stuff will get you through many, many quarts of smooth ice cream, my friends.

I think it also helped tremendously to be working with a better blender (we have a Ninja) that could really grind up the kale leaves into tiny pieces.  The more the kale is ground up, the easier it is to hide any chewy leafiness among the mini chocolate chips!  And mini chips were much more appropriate in frozen dessert than regular-sized chips.  I love that Enjoy Life offers this size.

Kale Mint Chip - free of the top 8 allergens depending on the type of milk substitute you use

4 cups of packed curly kale leaves (stems removed), washed and dried
15 oz can of full-fat coconut milk
2 cups safe, milk substitute (I used almond milk but soy, rice, flax, or coconut milk should be fine)
1/3 cup agave sweetener
2 Tbsp arrowroot powder
1 tsp vanilla
1 tsp mint extract
dash of sea salt

1/2 cup Enjoy Life mini-chocolate chips

1. Except for the mini-chocolate chips, combine all ice cream ingredients in a blender.  Blend until kale leaves are cut into tiny flecks.
2. Prepare ice cream mixture (again, not the mini chips yet) according to your ice cream maker's directions.  Add the mini chips in at the last five minutes of the ice cream making time.
3. Serve immediately.  The ice cream will be a little more solid than soft serve.  Freeze for an additional hour for a more ice-cream-out-of-a-carton texture.
4. Freeze any leftovers in a freeze-safe container.  When serving on another day, let the ice cream container warm up on the counter (room temperature) for 30-45 minutes before scooping.

I completely misjudged how much ice cream to give the kids.  But they
sure enjoyed every last lick of their humungous cones!

The texture is a big improvement over the original posted recipe.  My eldest son, who had not been a fan of the 2011 kale ice cream, absolutely loves this new iteration as does his little brother.

Product Review: Trader Joe's Vegan Mozzarella Shreds

I was shopping at my neighborhood Trader Joe's yesterday when, what did my wandering eyes see?

Oh yes.  It's finally here.

I had hoped and asked through the company's online product comment form for Trader Joe's to start carrying vegan cheese.  (I hoped that other like-minded folks were doing the same from their home computers, too!)  Now, I realize that there is already an excellent vegan cheese substitute on the market.  I don't think it would be exaggerating if I said that Daiya has revolutionized the vegan and allergic worlds with its completely milk-free, top 8-free cheese substitutes.  It tastes great and it melts.  In my inquiries to Trader Joe's about vegan cheese, I specifically mentioned Daiya by name as a product that the company should consider offering.

This winter Trader Joe's finally started selling vegan cheese and, of course, took it one step further: they are selling vegan cheese until their own label.  I found Trader Joe's vegan mozzarella shreds selling for $3.29 for an 8-oz bag.  This is significantly less than the $5 that I pay for packs of Daiya.

General observations about TJ's shreds:  The shreds are thinner, drier, and more translucent than Daiya shreds.  They kind of reminded me of parmesan shreds.  TJ's mozzarella shreds come in a convenient resealable package, an improvement over Daiya's packaging.  To me at least, TJ's shreds smelled like real cheese when I first opened the package, so much so that I momentarily got a little nervous about serving it to my kids.  (I admit, I reread the ingredients after the smell check!)  I mention the scent because I have read that some people really do not like the smell of uncooked Daiya.

I decided to test-drive TJ's shreds on some homemade pizza.  I made a barbecue pizza and a sauceless vegetable pizza using Trader Joe's fresh, whole wheat pizza dough.  If your family is okay with wheat and gluten, TJ's pizza dough is a great option for tasty, thin crust pizza.  I baked the pizzas according to the dough directions.  I took the pizzas out when the crusts were golden around the edges at around 11 minutes.

TJ's shreds melted completely.  They melted well -- almost too well -- it was hard to tell that there was vegan cheese on the pizza.  It was definitely on the gooey side taking on a sheen like glazed donuts.  It would be nice to have a more whitish look to the cheese like real mozzarella but what I really cared about was the taste.  Would it be a worthy substitute for the real thing?

TJ's shreds were pretty good. They had a nice flavor that tasted more like the real thing to me than Daiya.  After my second time of making pizza with TJ's shreds, I did detect a slight powdery aftertaste.  I'd say texture-wise, TJ's shreds are on one end of the spectrum and Daiya is on the other, with real mozzarella shreds right in the middle.  Daiya melts and stretches to a point but not as readily as real cheese.  TJ's shreds melt more than real cheese would.  Beyond taste and texture I was ecstatic to see that TJ's vegan shreds are fortified with calcium.  They provide 25% of the RDA for calcium per 1 oz (about 1/4 cup) serving.  Daiya Vegan Shreds provide a mere 2% of the RDA for calcium.

Trader Joe's vegan mozzarella shreds will definitely be a regular in our carts!

With a very good taste, meltability, calcium-richness, and competitive pricing, I definitely recommend Trader Joe's vegan shreds to anyone who is looking for a milk-free mozzarella substitute.  Daiya's growing product line (including vegan pepperjack and cheddar shreds, wedges, and spreads) is still a lifeline for cheese-longing vegans and individuals with milk allergies.  I do love their products but I will now buy my mozzarella shreds exclusively from Trader Joe's.  What's more, I hope my frequent purchases will keep vegan shreds on the shelf and encourage Trader Joe's to expand their vegan cheese products to more flavors.

The Pure Pantry Saves Valentines Day

Until this year, I think the kids still truly believed that Valentines Day was all about spending a few weeks creating lovely tokens of friendship for their classmates, and not about candy.  We thankfully still had the homemade cards, which I was so grateful for.  In fact, it was Addi's first year exchanging Valentines cards, and when the morning came, she got a bit teary-eyed over the thought of parting with her 30 painted and glittered hearts.

Who can blame her for not wanting to part with her creations?

 

 

 

 

She begrudgingly brought her Valentines cards to school, but quickly had a change of heart--yes, a change of heart--when she realized she had received 30 lovely cards, many with candy attached. 

Back at home, with all of her cards scattered in front of her, some ripped open envelopes (why is it so difficult for children to open envelopes?), and a pile of lollipops, chocolates, and other confections, I finally relented and gave her a lollipop. 

And then there were two.  Two holidays she now associates with getting a piece of candy.

She's the lucky one without food allergies, but it was heartbreaking after so many years of a strict 'no candy rule' to see the kids wanting it more and more.

As for my MFA (that would be Multiple Food Allergic) boys, I was rushing around the kitchen at 8 am on Valentines Day trying to whip up chocolate cupcakes, only to discover I was low on pantry staples like flour and sugar. 

In a pinch, I dug out one of the mixes I'd picked up at the Gluten & Allergy Free Expo last weekend.  We are not gluten-free, but we do avoid egg, dairy, and all nuts (except coconut), and it was really eye-opening to sample lots of products that were free of the top 8.  I am a gluten-free novice, but found the cake at this booth so incredibly rich and delicious that I had to buy a bag to see for myself.

The Pure Pantry Mixes at the GFAF Expo were beautiful to look at but are even better to bake with.

 

In a blind taste test, I would've never guessed that the Pure Pantry Wholegrain Dark Chocolate Cake Mix was anything free.  How they managed to get such a moist, rich, and delicious cake with a true dark chocolate taste out of this mix is beyond me.  To prepare it without egg, I used Ener-G Egg Replacer according to the directions.  I also opted for coconut oil, as I had used it in Irene's brownies, and was impressed by the results.  I liked how the directions included dietary modifications, and some recipes for frostings.

I topped the cupcakes with an egg and dairy free cream cheese frosting that I made with soy cream cheese, powdered sugar, and vanilla extract, but quickly found that the frosting wouldn't hold up without remaining chilled.  Nevertheless, frosting-less cupcakes were a hit with the boys, as well as with my littliest sweets monster.  We've been frosting them and gobbling them up for dessert in the last few days.  I've managed to eat my fair share of the two dozen I baked, telling myself I'm doing it for the good of the team.  :)

In the end, I think the spirit of card-making and giving still won out over the candy.  Addi's lollipop was never even finished before it was dumped into the compost bag, and, even after the candy came and went (into the compost bag alongside a half-eaten lollipop), the cards and memory of a day filled with love remain.

I hope you and yours had a fabulous and safe Valentines Day.

Chewy Vegan Snickerdoodles--egg-free, dairy-free

Snickerdoodles are such a fond remnant of childhood.  I rediscovered them on our Sacramento trip on the Polar Express ride, as they served hot cocoa and snickerdoodles on board as a holiday treat for all of the passengers.  Since the boys couldn't partake in the treats because of their food allergies, I was immediately determined to bake my own version.  They were the perfect conclusion to our Christmas Eve dinner, and consequently served double duty as a delicious snack for Santa, alongside some baby carrots based on Tristan's insistence that Santa needed to eat a bit healthier (not going to vouch for that pairing).

When searching for allergy-friendly recipes, I usually search the Web for a top-rated recipe, and see if it's simple enough to try a few substitutions to make it allergy-safe for my kids (egg, dairy, nut, and shellfish free).  Since this snickerdoodle recipe has only 9 ingredients, it was easy to modify.  And because it's a chewy cookie, I didn't have a problem with a crumbly texture as with some baked goods when eggs are omitted.

I replaced the eggs with Ener-G Egg Replacer, and the butter with Earth Balance.  To make it soy-free as well, you may use soy-free Earth Balance.  I thought I had enough cream of tartar for the recipe, but because I only had half of what the recipe called for, I added double the baking soda.  I haven't had time to try it again with the right amount of baking soda, but plan to.

I do hope that Snickerdoodles become one of your children's favorites as they did mine.

Chewy Vegan Snickerdoodles--No egg, dairy, or nuts (can be made soy-free), adapted from Soft Snickerdoodles Cookies

1 cup Earth Balance (regular or soy-free)

1 1/2 cups sugar

1 tablespoon Ener-G Egg Replacer plus 4 tablespoons warm water, whisked together

2 3/4 cups flour

2 teaspoons cream of tartar

1 teaspoon baking soda

1/4 teaspoon salt

3 tablespoons sugar

3 teaspoons cinnamon

1.   Preheat oven to 350 degrees F

2.  Mix Earth Balance, sugar, and Ener-G and water mixture together.

3.  Combine flour, cream of tartar, baking soda, and salt in another bowl.

4.  Stir the dry ingredients into the Earth Balance mixture.

5.  Chill the dough and the baking sheets in the refrigerator for about 15 minutes.

6.  While the dough and sheets are chilling, mix the sugar and cinnamon in a small bowl.

7.  Roll the dough into one inch balls, then coat with the cinnamon sugar mixture.

8.  Place on the chilled baking sheet lined with parchment, and bake for 10 minutes.


After about 10 minutes, the cookies may not seem done, but if you give them a couple of minutes to cool on the hot baking sheets before moving them to the cooling racks, they will come out perfectly.  Try not to leave them in the oven longer than 12 minutes.  They will be nice and chewy while hot, but will harden too much after they have completely cooled.

Baked milk challenge - the results are (kind of) in

I posted last week about readying the kids (and myself) for a baked milk challenge.  Our hope was that passing the baked milk challenge would allow us to start gradually introduce baked milk in their diets, which research has shown, may open the door to outgrowing their milk allergy down the road.  So how did the kids do?

We came.  We scratched.  We reacted.  We didn't eat.  :(

Yup.  The kids did not even pass the initial skin test in which they get a tiny prick and the baked milk item is applied directly onto their open skin.  The kids had to pass the skin test  before it was deemed safe to proceed with the riskier eating of a known allergen.  So the kids didn't really get to take the "food" challenge. 

The outcome of the baked milk challenge was disappointing but informative nonetheless.  The kids' allergist had had the forethought to order skin testing for peanut and tree nut allergies since the kids were already going to be getting pricks for the baked milk.  So we did learn more about the kids' allergies from the visit. The results of Ryken's tree nut allergy tests were consistent with the history of his blood tests:  significant allergic reaction to walnuts and pecans.  He did not react to any other tree nut on the panel.  (Ryken did not undergo a scratch test for peanuts.  Our allergist explained that results of the IgE blood allergy test for peanuts are very predictive of whether someone is allergic to peanuts.  He registers as severely allergic to peanuts so there is no need to put him through an extra, risky test.)

Ryken: 5 and 6 are pecans and walnuts. Far right is the baked milk.

Callan's results were the most eye-opening to me.  According to our allergist, a wheal size between 0 and 2 is considered a negative reaction to the skin test.  While Callan did measure 1s and 2s for almonds, brazil nuts, hazelnuts, pecans, walnuts, pistachios, and peanuts, none were considered reactions.  He tested negative to peanuts and all tree nuts!  The numbers of Callan's previous blood IgE allergy tests had indicated mild allergies to most of these nuts.  Also significant to me was seeing that Callan developed a larger wheal in response to the baked milk than Ryken.  This info followed by a rash on his face from being touched on the face by a child eating a buttery cookie confirmed to my husband and me that Callan's milk allergy is growing more severe.

Callan: the upper left is the control histamine.  Far right is the
baked milk. All clear for the peanuts and 7 tree nuts tested!

The world of allergy testing is still a confusing one for me with different kinds of tests.  Our allergist thinks that we can look upon the skin and blood testing as complimentary but she does believe that the skin test is a better predictor on whether someone does indeed have a food allergy.  She was quick to point out that the skin test is still not 100 percent accurate and told about a patient who had a very strong skin reaction but ended up passing the food challenge without any incident.  Food allergies are such a complicated problem.

In light of Callan's results, we have scheduled a peanut food challenge for him for next month.  It certainly will be a challenge as Callan was very resistant of going through with the allergy appointment this time.  I hope he passes -- not that we would bring peanuts into his diet or into the house with Ryken's strong peanut allergy.  But it would give us some peace of mind if we knew he wasn't at a heightened risk for an allergic reaction when he starts grade school next year. 

My kids have both been consuming almond milk and store-bought almonds without problem.  I plan to continue this.  However I don't foresee introducing any other tree nuts into the kids' diets.  I feel better about not increasing the risk of eating something that may have had cross contact with nuts unsafe to Ryken.  Yeah, I know, I am taking a bit of a risk with almonds but I am hoping to keep this one source of nut protein available to us.  We definitely have our EpiPen Jr. sets with us at all times. 

Baked milk challenge - Here we go....

Today is a big day for us.  The kids will take a baked milk challenge under the care of our allergist. 

Yesterday I set out to bake muffins in preparation for today's challenge.  It was my first time buying cow's milk for our family in several years.  As my youngest sat in the cart with the groceries, he looked at the jug of milk with curiosity -- a forbidden fruit for so long -- and instinctively reached out to touch the cold plastic encasement.  I firmly explained to him that he still needs to be careful because (1) he has a contact allergy to milk and (2) he hasn't even taken the baked milk challenge yet so nothing has been proven safe yet.

After school I really dragged my feet with making the muffins.  Usually I love baking -- you can hardly keep me out of the oven for three days straight without me emerging with some piping hot, sweet goodie.  But yesterday I just wasn't feeling it.  Was it anxiety?  Was it the possibility of our regular avoidance routine being turned on its head, even though it would be for the good?  I wasn't sure.  But when I finally got cracking with the muffin task, I felt totally out of my element.  I realized I was missing a key ingredient (applesauce), ran dangerously low on another (flour), and I couldn't find any muffin liners.  I did remember that I had Halloween muffin liners in our holiday decorations box -- liners adorned with skulls.  SKULLS. Great.  Just perfect for holding a potentially dangerous muffin.

I kid you not about the skulls.

I should backtrack a bit.  


Earlier this year the kids' pediatrician recommended I see another allergist, Dr. Y, within our medical group to get a second opinion on the kids' allergies.  I was all for it.  After all, in the seven years since we first discovered Ryken's milk allergy, the recommendations on how to address and possibly head off full-blown food allergies have changed.  Seven years ago, strict avoidance was the rule and kids susceptible to food allergies were recommended to wait until the age of 3 to try certain foods such as nuts.  In talking with friends and families who are expecting or have food allergies, it sounds like many doctors are advocating the introduction of some common food allergens early on.  A cousin whose her eczemish son tested positive for a peanut allergy at 6 months was advised to expose him to small amounts of peanut butter.  Another doctor whose eldest had a dairy allergy introduced baked milk products to her youngest at an early age.  (Both kids are doing fine under these doctor-recommended courses of action.)  Make no mistake, there definitely isn't agreement on treatment.  There is no cure but much more promising studies that need more time, and research that suggests that for some people, gradual exposure to allergens in certain forms may help them overcome those food allergies down the road.

We went to see Dr. Y for the first time.  Dr. Y explained to us that individuals allergic to milk may often be able to tolerate milk when it is baked as the heating process as the extensive heat changes the shape of the milk protein and the body may no longer recognize the protein as a foreign substance to attack.  After discussing food allergies and a harrowing blood draw experience for both boys, we found the results of my oldest Ryken's IgE blood test for milk allergy at the lowest it's ever been, dropping below a 25.  At Ryken's and Callan's current IgE levels, they have around a 70 percent chance of passing a baked milk challenge.

I jumped at the chance of having the kids undertake the baked milk challenge.  I have had roughly 10 weeks between our last allergy appointment and today's food challenge to warm up the kids to the idea of taking it.  (Last appointment's traumas:  Ryken hid behind the examining table for 10 minutes to avoid a blood draw.  Brave Callan finally broke down in wails after being needled in both arms when the phlebotomist couldn't find a vein in the first.)  The kids are finally ready.  I am a firm believer in telling it like it us and not tricking my kids into thinking something is fun or painless.  So the kids are fully aware that there will be skin prick tests and, hopefully, the eating of something they have not eaten before.  They know we will be at the doctor's office in the care of many trained professionals that will do everything they can to monitor and minimize risk.  They also know there will be DVDs, books, drawing time, and a No School Day at the doctor's office.

The muffins are ready.  The kids are ready.  Am I ready?  I think so.  Avoiding milk has been such a big part of our lives that I'm not sure how I will react if the kids get to take that first bite.  Horror?  Excitement?  Tears of joy?  Whatever the emotions may be, I will embrace them in this bumpy journey living with food allergies.

Zachary's Pizza - milk-free options and a dream come true!

One thing that had always saddened me about my kids' milk allergy was missing out on Zachary's Pizza.  For those of you who aren't familiar with Zachary's, it is a Berkeley fixture, a Bay Area landmark that many diners believe serves the finest deep dish pizza west of Chicago.

Zachary's is celebration food for me.  It's one of my favorite treats that holds a lot of great memories for me.
I remember having Zachary's for the first time during a visit to the Cal campus in my senior year of high school.  Zachary's deep dish had won me over to Cal just as much as the beautiful campus, laid-back alternative vibe, and cast of crazy characters (including my favorite).  In subsequent years I shared many laughs with my brother, my college sweetheart husband, and friends as we dined on Berkeley's finest pizza amidst the colorful customer-made posters and constant chatter of college students.

My husband and I have always hoped to share the Zachary's love with our kids.  But with their severe milk allergies, it just wasn't meant to be.  We continued to visit Zachary's on date nights (I know, I know -- I am a simple gal.)  I have even tried my hand at making Zachary's-styled pizzas with mixed results: they were tasty but compared to the restaurant's impressive Zagat food score of 24 out of 30...well, there is no point in comparing.

When I found out earlier this year that Zachary's was now offering Daiya Vegan Shreds as a cheese alternative, I almost screamed out with joy!  Was it possible that my kids could now experience my favorite food in the world?  My excitement was soon muted when I talked to a server about cleaning practices.  She shared that Zachary's only washes their pans thoroughly twice a week (ewww) and she couldn't guarantee that cheese wouldn't bubble over from one oven rack and spill onto our pizza below.  I decided it was just too risky for the kids to try.

Last week we were expecting guests from out of town.  When we have visitors, I immediately think of the must-dos and must-eats for their trip.  My mind came to Zachary's because I truly feel that no visit to the Bay Area is completely without it.  I decided to call and inquire about their practices, just in case things had changed.  I spoke at great length with Christo in two separate conversations -- once for my initial questions and a second time for ordering -- about my kids' milk, peanut, and tree nut allergies.  Christo patiently and enthusiastically answered all my questions.  At times, he would put me on hold to run into the kitchen and make sure the staff could go the extra milk to avoid cross contact with cheese and milk.  (He was certain that nuts weren't a concern for the pizzas we ordered.)  I really appreciated that if he didn't just write down my order or concerns but he personally went over everything with the kitchen staff.

Here were my concerns and how they were met:

Are the pans safe to use?  I heard they are only washed twice a week.
Normally greased with butter, the pans are used repeatedly throughout the day for various pizzas.  (The server I had spoken with a few months ago was mistaken.  The pans are wiped and washed every night.)   Zachary's will thoroughly clean the needed pans if its staff is made aware of a severe food allergy.

How can you make sure the ingredients used in my pizzas haven't come into contact with milk?
This was a biggie for me.  Christo explained that Zachary's "encouraged its employees to wash their hands after preparing each pizza" but there was no guarantee this would be done.  Here is what worked for us:

(1)  Have the staff who took your order (hopefully, you can get a manager) explain to kitchen staff of your food allergies.  The pizza makers should thoroughly wash up and only use ingredients from their new stock-- chopped and sliced ingredients that can go straight from refrigerator storage to your pizza without touching cheesy surfaces.
(2)  Ask if your pizza can be baked on the highest rack to avoid any melted cheese dripping into your pizzas' pans.
(3)  Ask that your pizza not be cut along with the other pizzas.  I had completely forgotten about this but good ol' Christo remembered and had asked the kitchen staff to leave it whole.  We easily cut our pizza at home.  If you are dining at one of Zachary's three locations, ask for a clean pizza cutter and do the slicing yourself right at your table.

Is there milk in any of the other ingredients?
We ordered the Chicken Special which normally does not have any milk products except for the pizza's cheese.  We also wanted a milk-free Spinach and Mushroom, which is trickier as it is made with a pre-made mix of three dairy cheeses plus the two main vegetables.  Spinach, in fact, isn't even listed as a regular topping choice.  If your heart is set on the Spinach and Mushroom, ask if they can create a milk-free mix with Daiya Vegan Shreds, fresh mushrooms (from the new stock), and the chopped spinach that's usually reserved for their spinach salad.  This is what Christo had employees do, and the pizza still turned out delicious!

If you plan to order sausage, pepperoni, salami, or other meat, ask if the staff or you can check the label.  Deli meats may contain milk products such as nonfat milk powder, whey, or cheese.  We learned this the hard way!  If there is no ingredient label, please take precaution and order something else.
 
How can I be sure the people prepping the pizzas understand that this is a pizza for milk-allergic diners, not just people who eat dairy-free by choice? 
It is of utmost importance to thoroughly explain your child's milk allergy.  Just ordering a vegan pizza alone will not do because of the risk of cross contamination from the cheesy hands reaching into other fresh ingredients, the shared cutting boards, pizza pans, and pizza cutters.  I always pull out my food allergy alert cards.  These are handy for enabling wait staff to show kitchen staff exactly how serious the allergies and the great need to check labels and avoid cross contact.

Have other milk-allergic people eaten had the Daiya substitute and emerged unscathed?
We have!  I am so excited to report that my kids had no problems eating their Zachary's deep dish pizzas.  While veggie-abstaining Callan couldn't reconcile with the tomato topping, Ryken enjoyed the pizza more and more with each slice.  We had some extra slices that lasted us three days.  Woo hoo!

I make it a point to share with my kids all the details of how I make food or choose food in restaurants to prepare the safeguard against accidents and cross contamination when we eat out.  Start getting them involved in what they eat when they are young -- it will help build this awareness so that they can ask the right questions and make safe choices when they are adolescents and beyond!  After my initial conversation with Christo, I shared with Ryken the steps that Zachary's would take to avoid cross contamination with milk.  I told him I felt comfortable with trying it -- we have our Benadryl Allergy and Epi-Pen Jr. set at the ready should things look bad.  Ryken felt okay with this so we placed the order. 

Remember, though.  It was not so simple to get a truly "vegan pizza".  Being completely upfront about the kids' allergies and asking many, many questions -- these were key to ensuring that the safest practices were used.  We are so grateful to Zachary's enormously responsive staff and our personal pizza guardian angel Christo!  We definitely will order milk-free Zachary's again.

Product review: Good Karma Flax Milk

For those with dairy allergies, lactose intolerance, or a preference for avoiding animal products, there are many options in the market for milk-like beverages.  The amount of new products is awe-inspiring and encouraging. 

I recently found a new kind of milk in the dairy case of Sprouts Farmers Market:  flax milk.  I was really excited to see a new type of milk, especially one that attempted to harness the health benefits of flax seed.
For those readers who are unfamiliar, flax seed is touted as a good source of Omega-3 fatty acids.  Omega-3s are the "good fats", or the essential acids that promote brain function and reduce the risk of heart disease.  In addition, flax seeds are high in fiber and in lignans which scientists believe play a critical role in preventing cancer.

My milk-allergic son, Ryken, is content just to drink soy milk.  I, on the other hand, have been on a continuous journey to lower our family's overall consumption of soy after learning of research on the effects of excessive amounts of isoflavones on hormones and the implications on reproductive development.  If we can eliminate some highly processed soy products from our diet, my worries will be somewhat allayed.  After confirming that Callan was not allergic to almonds, we integrated almond milk into our family's diet with Ryken being the last holdout in the conversion.  Ryken hates almond milk and continues to drink his beloved Soy Dream.  We as a family also eat tofu, soy yogurt, occasional Tofutti products, and sometimes use soy milk in recipes as a substitute for cow's milk.  So overall, Ryken is eating a big dose of soy every week.

Good Karma, the company behind this new flax-based beverage, offers three varieties: original, vanilla, and unsweetened.  Our family tried out the original-flavor flax milk.  Everyone seems to like it, especially Ryken who has been the toughest to wean from soy milk.  The flax milk has a creamy taste -- not as rich as soy milk but fuller than Rice Dream milk.  This is probably due to the fact that soy milk has a little more fat per 1 cup serving than flax milk.  The flax milk had a slight, salty aftertaste much like almond milk.  This might give someone pause if they were drinking flax milk straight up from a glass.  However, for our family's purposes, the slight mineral taste of flax milk didn't affect our enjoyment.  We have had flax milk in cereal and in dessert recipes and it's been a pretty good alternative.

The original flavor has 7 grams of sugar per 1 cup serving.  (Editor's note:  When I first posted this, I had incorrectly stated the original flavor as having 11 grams of sugar,) Although Good Karma original flax milk does have more sugar than Soy Dream Original (4 grams), it is the same as Trader Joe's or Silk almond milks (around 7 grams of sugar).  Good Karma original flax milk has 60 calories per serving while Rice Dream Original has 120 calories per serving.  Interesting to me because I thought the bigger flavor of Good Karma would naturally mean it was higher in calories, which is not the case.  The vanilla flavor has 11 grams of sugar per 1 cup serving, which is on par with Horizon Organic cow's milks. 

Dairy-free, egg-free chocolate pudding made with flax milk.  Not too shabby!

Good Karma has come up with a solid line of milk alternatives.  Overall, I still like the creamy, mild taste of Soy Dream Original best for cooking in sweet or savory dishes.  But if you have to avoid soy due to allergies or intolerance or simply want to like our family, Good Karma flax milks are very good alternatives full of health benefits.  I definitely plan to integrate flax milk more into all areas of our foods (baked goods, sauces, drinks) although for savory dishes, I will opt for the unsweetened variety.

Good Karma's product line includes rice milks and frozen desserts much like its competitor Taste The Dream.  For more information about Good Karma products and where to find them, check out their website.  You'll also find a handy coupon there to enjoy.

Coconut Chocolate Chocolate Chip Scones

Stephanie Stein is the mastermind behind egg-free baking at the Happy Girl Kitchen Co. in Pacific Grove.  Because of her, fresh blueberry scones are now a breakfast staple at our house.  Not only is she an incredible baker, her creativity and approach to baking inspires any novice to experiment and bake with her instincts.

I've been a bit obsessed over the chocolate coconut combo, and came up with the idea of doing coconut chocolate chocolate chip scones.  Sounds decadent?  Utterly!  Mmmm...

Using Stephanie's basic scone recipe, I made a few alterations to make it dairy-free, and tried out my interpretation of a coconut chocolate chocolate chip scone.

Here goes:

Coconut Chocolate Chocolate Chip Scones (NO egg, dairy, nuts)

Ingredients

1 cup all purpose baking flour
1 cup pastry flour
1/2 cup oat flour
1/2 cup coconut flour
1/2 cup sugar
3 tablespoons cocoa (I use Natural Unsweetened Hershey's Cocoa)
1 teaspoon baking soda
2 teaspoons baking powder
1 teaspoon salt
1 cup of Earth Balance
2 cups rolled oats
1 cup chocolate chips (I use Trader Joe's semisweet chocolate chips)
1/2 cup sweetened shredded coconut
1 cup soy milk plus 1 tablespoon apple cider vinegar (the vinegar acts to curdle the milk--mix together and set aside)
1.5 teaspoons vanilla extract

Preheat oven to 375.
1. Add all of the dry ingredients (all the flours, sugar, cocoa, baking soda, baking powder, and salt) except for the rolled oats.  Combine.
2. Work in chilled Earth Balance using a pastry cutter or your hands.  Should resemble small pebbles.  Don't overwork the dough.
3. Next, stir in the oats.
4. Add in chocolate chips and shredded coconut.

5. Pour in the soy milk and apple cider vinegar mixture, and the vanilla extract, and combine with your hands.
6. Cut dough into two even pieces and flatten them so they form 2 round discs, each 2" high.  Sprinkle with sugar and cut into 6 wedges.
7. Place on parchment lined baking tray, and bake 18-25 minutes.  They will be sturdy on the outside but still soft on the inside.

These scones provide a wonderful chocolate fix, any time of day.  The crunchiness of the oats and coconut, with a crisp outside and moist and gooey inside is the perfect balance.  Any chocoholic's dream!