My big boy OIT patient has a three month (post graduation) check up on June 1st, so I knew I had to get in gear trying new forms of dosing (otherwise I’d have no real reason for a f/u appt). It’s nerve wracking, which is why I’d been dragging my feet a bit. Also, Kyle travels a lot for work and I prefer testing new things when I know I have back up here at home just in case we have to jet off to the emergency room. I know it’s a bit paranoid, but you never can be too safe.
Anyway, I’m happy to report he ate a teaspoon of peanut butter (inside a sandwich with sunbutter and honey) without any issues!
I’ve since dosed him this way a few more times and he hasn’t had any problems – psychological (due to the flavor) or physiological (immune response). It’s pretty amazing. To go from gagging and barely swallowing the peanut powder in whatever concoctions I invented to this…
Emboldened by his non hatred for the peanut butter, a few days later I just went for it AND GAVE HIM PEANUTS STRAIGHT UP. I measured out 4 g with my jewelry scale (recommended by Dr Jain) and put them on his lunch plate and he didn’t even complain or get all freaked out. I did have a few minutes of concern after he was half way through and said his throat was scratchy and hurting but he had no other symptoms (rhinitis is usually symptom number one that lets us know he’s having a reaction) and after more food to clear his throat he was 100% ok. Phew! We have only done plain peanuts twice now and it did get better the second time around so now I’m going to try to vary the way I dose him with peanuts just like I do with dairy (milk, cheese, yogurt, etc). I haven’t given him Reese’s Pieces in almost two weeks and that is super exciting because as you can imagine, the idea of feeding him Nestle candy on a daily basis wasn’t my favorite. But of course there are worse things and if it gives him OIT protection then I am allllll for it. The UNREAL peanut gems are also a great option but they are hard to find here in Davis. I went to my parents’ last week but didn’t get a chance to pop into WF (it’s where I found them the first time), but I’m going again this weekend so hopefully I can get some then. Buying 6 packs on amazon seems a little ridiculous, but never say never?!?
For now we are sticking to lunch as his peanut dose time which has worked out great with the following “quiet time” while Valley naps. But I bet breakfast would be the easiest place to sneak peanut butter in while still giving diverse options (in oats, on toast, muffins or banana bread, in yogurt, smoothies, etc). I suppose I could still give those foods for lunch though.
It’s one big learning curve. I’m sure I’ll look back on this time in a year the same way I look back on the start of OIT…it was all so new and complicated then, but it’s such a routine part of our lives now…
Miss V is super into peanuts too, btw.
So there’s the latest in our allergy journey for those following.
So awesome he made the switch and likes (tolerates?) them! We have to wait a year and complete a challenge before we can try new dosing. Stuck with m&’m’s (or plain peanuts if he’d eat those) for now but like you said, whatever keeps them safe. Curious, when you started peanut after diary did you have to initially dose those 30 or so minutes apart? We started sesame a couple weeks ago and for now we have to do sesame first, then peanut 30 mins later and THEN observe 2 hour rest period. It’s fine now but wondering how to fit this all in once he starts Kinder. Rest periods have proven to be the trickiest part. Our office says we can dose an hour before bed to cut the time in half.
Yes, we were always told to separate his dairy and peanut dosing by 30 minutes. Before switching to lunch time peanut doses I would give him peanut at dinner and then we would have to wait 30 minutes (or more) and have him drink milk (or cheese or whatever) before bed. Since we were already in maintenance for dairy, I was less worried about putting him to bed so close to his dairy dose, but I would still check on him all the time. We only switched to lunch time recently and it’s been much better because he has to observe quiet time anyway, so he is calm anyway (or as calm as any 5 year old is). I’m going to ask at his follow up if we can dose together eventually, although I’m not sure he’s quite ready to do so yet. We’ve had to do zyrtec a few times when he’s gotten too active (twice in hawaii) after peanut, so it’s still a pretty fragile tolerance.
Another benefit of lunch time dosing is anticipating kinder. Hopefully he will get into the AM class which ends at noon and then we could keep the same schedule until he’s further into maintenance. I can’t imagine trying to do it all in the morning before school. Does he have full day kinder? It’s so hard making them stay calm during the rest period! Night time is definitely the next best option, despite having to schedule out all the different spaced apart doses because sending them off to school after a dose is a little nerve wracking. Is sesame one a day like peanut or twice like dairy?
Awesome wonderful fabulous amazing news!!!
Yeah, sesame dose is once a day. One of his docs has said we can do 15 minute spacing which I have been doing because it’s soooo much time for a five year old to be still! I wish they did half day Kinder here. We moved to CT a couple years ago from CA and the whole state does full day Kinder! I got pretty cozy dosing for peanut so we’ve been able to sometimes squeak a dose an hour before preschool, but that’s because I know the routine there and they aren’t active for the first hour beyond free play indoors and no running. Kinder is a whole different beast! I will say the extra layer of comfort I feel now because of OIT makes me slightly less worried for him to be away from me all day. A friend had her little boy over the other day and quickly assured me she would wash his hands because he’d just eaten a PBJ and I was like, “Nah, it’s cool. He ate four peanut m&m’s today!”
I didn’t realize dairy was twice a day! That’s a lot of time to be resting, too. I know some of the recent research is showing some have become completely tolerant and others can get down to dosing a few days a week after a couple of years of OIT. Fingers crossed! We have a couple more years of OIT with sesame and then tree nuts but overall it is so worth it.