(This is a continuation of a series of posts on our experiences as we trial our son who has multiple food allergies with oral food challenges at home. Oral food challenges should always be performed under direct medical supervision based on each patient's individual reaction history. Please do not try oral food challenges at home on your own without medical approval.)
Having a child with multiple food allergies means double checking every ingredient label. But what do you do when you see a new ingredient. Google it? What if you Google a new ingredient to see if it is safe for someone with multiple food allergies and it's comes back safe, not a nut and not a seed itself, but instead the pericarp (or pulp) surrounding a seed. Do you still try it? Or automatically avoid it completely to protect your child with multiple food allergies? Here's what we learned about the connection between annatto and food allergies.
Annatto and Food Allergies
After successfully drinking real cow's milk for over a week, our allergist suggested we try cheese and yogurt next with Mitch. We happened to have cheddar cheese on hand so we tried that first.
Mitch took the slightest nibble of cheddar cheese (seriously, about the size of a splinter), and immediately he reacted. He started itching, his eyes began to swell, hives showed up under his eyes, his skin started turning blotchy, and he started coughing. All I could think was ‘Oh crap! Was this the day I would have to stick my child with his epi-pen for the first time?'!
But he's been drinking milk with no problems for over a week, what could have caused the reaction?
If you have food allergies, do you need to avoid Annatto?
If you don't know what Annatto is (heck I didn't before this) you're not alone. Only one person I asked after this incident had ever heard of Annatto and food allergies (and that person happens to be allergic to annatto). Despite this, Annatto is a very popular ingredient.
Historically, Annatto has been used as a coloring in many kinds of cheese, cheese products, and dairy spreads including butter and margarine. Annatto can be used to color a number of non-dairy foods as well such as rice, custard powder, baked goods, seasonings, processed potatoes, snack foods, breakfast cereals and smoked fish. Annatto is commonly used in Latin American and Caribbean cuisines as both a coloring and flavoring agent, and Central and South American natives use the seeds to make body paint and lipstick.
There hasn't been a lot of research done into the connection between Annatto and food allergies. The protein within the Annatto seed is the likely reason for an allergic reaction, but it may also be a case of cross-reactivity since Annatto grows on Achiote trees, sometimes called the lipstick tree. There may be the possibility for cross-reactivity between the Achiote tree and a type of tree nut, but because the status of Annatto as a tree nut is uncertain, food manufacturers are not required to put a nut warning label on foods that contain Annatto. They are, thankfully, required to list Annatto in the ingredient list.
We've made great strides adding safe foods back into Mitch's diet and it's emotionally difficult when you have a setback like this, but thankfully we know about Annatto and food allergies now. When dealing with food allergies, always remember to keep medicine within reach of your child with food allergies. It only takes seconds for a reaction to occur.
Source and image courtesy of Wiki: http://en.wikipedia.org/wiki/Annatto
DISCLAIMER: I am not a doctor or healthcare professional. This is simply a recount of our personal experience. Always check with a doctor about any allergy-related issues.