Sunday, November 8, 2009

Masto and the Histamine Restricted Diet

Now that Rohan has started solids, we're learning slowly and (we hope not for him) painfully what foods are fine and what we may need to avoid. I suppose it's the same process ALL parents use when introducing new foods, since you never know what your child might be allergic to. Only with Romo it's less allergies I'm worried over and more reactions. In particular, there is a pretty extensive and limiting list of 'histamine' foods that we may have to avoid and at very least need to watch for reactions to. Chief among them (and my first bit of evidence that food MAY be a trigger for him, which we didn't know until the solids were started) are certain fruits which we LOVE to consume in this family.

His first ever reaction I am 99% sure was triggered by food came thanks to a bit of pineapple he was fed this morning. More correctly, it was juice from a piece of pineapple we put in one of those Munchkin Mesh Feeders for him to gnaw. A little later, I was changing his clothes and his spot caught my eye. I didn't take a picture, but it was very puffy and the skin was lighter colored than usual. It looked very similar to this reaction he had when he was about 2 months old:

He didn't seem super bothered by it, except that the rest of the day he would periodicially shake his head side to side and when he was lying on my chest at naptime trying to fall asleep he kept making little mewing noises and kicking out his legs or pushing against me with his hands. I can only guess at this point since he's obviously not able to tell me, but I think he may have been feeling uncomfortable. I've heard some kids with Masto feel itchy as well when they have a reaction, so maybe that explains the head shaking? I really wish I knew.

We try not to medicate Rohan unless we have to, i.e. when he's clearly having a reaction based on the appearance of his spot. That thing's like a mood ring for us. Typically when he's not reacting it's flat and a darker color than the rest of his arm, close to the color of his lips. When he IS reacting it can get darker or lighter, puffy or bumpy like the skin of an orange. It can look like one BIG spot (as it did today) or it can be a dark circle with 1 or more (a few times as many as 5) little bumps in it. Usually when we do medicate it, we only give meds before bedtime because we've been told his Doxepin can cause drowsiness and dizziness, and I don't want him going through the day like that. VERY rarely, when the spot's looking really irritated, we also use the steroid cream on it. Tonight, we did both. Here's hoping tomorrow he's all better. And a fond farewell to pineapple as part of his diet.

If you're curious, below is a list I copied from, which lists the foods they recommend you cut out of your child's diet and introduce one at a time under close watch for reactions. I REALLY hope he does't react to many of these, or his diet's going to SUCK.

Histamine Restricted Diet for Control of Urticaria/Angioedema


All seafood including shellfish or fin fish, fresh, frozen, smoked or canned
Egg (a small quantity in a baked product such as pancakes, muffins, cakes is usually tolerated)
Processed, smoked and fermented meats such as luncheon meat, sausage, weiner, bologna, salami, pepperoni
Leftover meat: eat freshly cooked meat ONLY (side note from Jackie—After meat is cooked, the histamine levels increase due to microbial action as the meat sits.)

Milk and Milk Products
All fermented milk products, including cheese (any milk product that is curdled rather than fermented is allowed, such as cottage cheese, ricotta cheese and panir)
Cheese products such as processed cheese, cheese slices, cheese spreads
Yogurt, buttermilk, kefir

Fruits and Vegetables
Tomato sauces

Food Additives
Tartrazine and other artificial food colors
Preservatives, esp. benzoates, sulfites and BHA, BHT
Note: Many medications and vitamin pills contain these additives, especially colors. Ask the pharmacist to recommend additive-free supplements and medications.

Chili powder
Curry powder
Hot paprika (cayenne)
Fermented soy products
Fermented food
Tea—herbal or regular
Chocolate, cocoa, and cola drinks
Vinegar and foods containing vinegar such as pickles, relishes, ketchup, and prepared mustard


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