Oral Food Challenges: Try Allergenic Foods at Home vs. the Doctor's Office? with @allergykidsdoc David Stukus, MD

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If you are a type A super planner like me, you love getting organized about what Solid Foods your baby ISS going to eat. I have a free feeding guide for you. You're gonna love this one. It's called the Baby led weaning Pantry Planning Guide. It's a 10 page checklist divided by categories of foods, many of which you probably already have on hand. Plus there's tips in there on how to modify those foods so there's safe for your baby. You can download the baby led weaning pantry planner for free. If you go to my website, baby led weaning dot co slash resources. Again, that's baby led weaning dot co slash resources. Click on the pantry planner and it's free. Are you trying to squeeze the starting solid food stuff into your already busy schedule? Well, I have an all-in-one done for You solution that's going to take the guesswork out of feeding your baby. My online program is called Baby led weaning with Katie.

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There's no reason to space this out with one new food every 3, 5, 7 19 days. Those recommendations are highly conservative, completely made up because the odds are they're not gonna have a reaction to anything that you feed anyways. So you might as well introduce like four or five new foods all at the same time. Let 'em have fun with it and then if concerns arise we can go back and figure it out afterwards.

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Hey there, I'm Katie Ferraro, registered dietician, college nutrition professor and mom of seven specializing in baby led weaning here on the baby led weaning with Katie Ferraro podcast. I help you strip out all of the noise and nonsense about feeding, giving you the confidence and knowledge you need to give your baby a safe start to Solid Foods using baby led weaning. Picture this, your baby just started Solid Foods and you wanna offer them the potentially allergenic foods. We call those the top nine. They're the nine foods that account for about 90% of food allergy. 'cause there's data to show that early introduction of these potentially allergenic foods has the potential to reduce the risk of food allergy down the road.

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But you are terrified. I mean there is the potential that your baby could have an allergic reaction. So you decide to drive to your local hospital and you're sitting in your minivan or your cool mom car and you're going to offer that new food sitting right outside of the emergency room just in case your baby has an allergic reaction. Is this a good idea? No, absolutely not. Completely unnecessary. And my guest today is going to tell you a lot more about why his name is Dr. David Skuas. He's board certified in allergy and immunology and pediatrics. Dr. Skuas is the director of the Food Allergy Treatment Center at Nationwide at Children's Hospital.

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I love interviewing him because he is one of the few doctors that takes a food first approach in working with families of children with food allergies. He's not only an incredible pediatric allergist but he's also a realist. He's a dad of two kids. He runs a clinic where he works with very allergic children and there are occasions where doing an oral food challenge in the office or in the clinic is indicated. But in this interview, Dr. STIs is gonna talk about Oral Food Challenges and why it's totally different the way we do them here in the United States versus other countries and why he thinks that should change. He's gonna talk about this idea about trying out allergenic foods for your baby at home versus the doctor's office if you are on Instagram.

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Dr Stu is there at Allergy Kids Doc. He has been on this podcast like probably too many times to count at this point, but he's always so gracious with his time. He's our country's leading pediatric allergist. He is a wealth of knowledge and I love that he gets right to the point. So here he is talking about Oral, Food, Challenges. Should I try allergenic foods at home versus the doctor's office with Dr. David

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SI

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Meet families every day that for better or worse I've been scared to death to feed their babies. And that's why I love my job. It's part of what we do is we spend time with them. We talk about how things have changed. You know, we used to think that it was, it was harmful, but now we know that it's not. It's actually the best way that we can try to prevent food allergies from developing. So I, I listen to them. There's different flavors. Sometimes they have a older child that has a history of food allergies so they have a little bit of post-traumatic stress from watching that happen. Sometimes the family history, sometimes they just don't know what to believe. And so I listen to their concerns and I address them and we have a conversation and then we ultimately come up with a plan of like, you know, what's the best way to have fun feeding your baby? We don't want this.

2 (4m 39s):

It's not a medical procedure, it's fun.

0 (4m 41s):

Well I like that you mentioned, you know, things have changed. So can you explain, you know, real high level what food allergies are and how they develop in infants, but then a quick rundown of current guidance to introduce potentially allergenic foods and how that's different from 15, 20 years ago?

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Absolutely, yeah. Food allergies are when the, the body forms an an immune response against a food. So they're reproducible every single time you eat this food, usually within a matter of minutes, rarely longer than a couple of hours later you're going to have symptoms. And symptoms can range from things like big red itchy hives on the skin. You can have swelling of the face or elsewhere in the body vomiting or anaphylaxis, which is a severe reaction involving more than one part of the body. The best test to, to figure out if somebody's allergic is what happens, you eat it. So if you're eating the food not experiencing those symptoms, you're not allergic to it. And then we know that there are eight, you know, really nine foods that cause more than 90% of all food allergies. That would be things like milk, egg, wheat, soy, peanuts, tree nuts, fin fish, shellfish and sesame. We used to think that if we would delay introduction, that we could protect all these wonderful babies from developing food allergies.

2 (5m 41s):

That was based upon expert opinion and the best guess at the time, which was about 25 years ago. And that's when the guidelines said, no milk till one, no eggs till two, no nuts receive food till three and if you're pregnant or breastfeeding, don't eat anything at all. And then just eight years later the same people said, wait a minute, we don't actually have evidence to support that. And you know, maybe it's okay, but it wasn't an active introduction. And then in 2015, almost 10 years ago, can you believe it, we had the LEAP study, which is the first like best study of randomized control. Half of the babies ate peanut three times a week for up to five years. The other half avoided it. The group that ate peanut had like an 86% reduction in peanut allergy. And then we have additional studies on top of that. So now our best advice is introduce allergenic foods, all foods into baby's diets once they start eating Solid, Foods usually around four to six months of age and most importantly, keep it in their diet consistently, which is the best way we can try to prevent food allergies from developing.

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So okay,

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That's the most comprehensive like two minute answer ever. And I do wish that we could take that two minutes and put it in medical school curriculum and have future pediatricians and family practitioners. It's just a great summary because I think we've covered this too. Not a lot of doctors are actually aware of this and I know it's your specialty area and you do this all day every day and pediatricians have a lot to deal with, but not all parents are getting this message. So that was a very beautiful synopsis.

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Oh, thank you. In case you can't tell I've practiced that spiel a couple of times, but you're right. So yeah, it's part of my job and that's what I do. I love medical education so I get to teach pediatricians about how to have these conversations, how to, you know, promote confidence and and help families, you know, feed their babies.

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And today we wanna talk about some of the challenges that parents face and their fears so that we can address them. Is there any science behind them? I love that you mentioned that the old recommendations. I know back when I was in dietician school it was no milk till one, no eggs till two, no sea field till three turns out that was just like someone's opinion totally made up. And now that we have better science to support the earlier introduction, could you tell us when it's the best time to start introducing these allergenic foods to a baby?

2 (7m 39s):

Ideally around four to six months of age, there's, there's a window of opportunity that doesn't close that fast. But if, you know, we really wanna try to do this by seven, eight months if we can to

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Start the introduction. Right. Sorry to interrupt, but you've, we've talked about the closing of that window around 11 months. So is, would you say somewhere between you know, six, seven months of age but get 'em all in by 11 months? Is that still a good rule of thumb?

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Yeah and the earlier the better, you know, and it's not, you know, don don't wanna scare people either. 'cause if you miss that window it doesn't mean you should not introduce it 'cause it's still gonna be safe for the vast majority of infants regardless of when you introduce it. But you know, for those at highest risk we really want to, you know, try to capture this and take advantage of it.

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Now I know you said earlier the better and that probably just rolls off your tongue, but that's actually very confusing to parents because they hear four to six months of age. But as a registered dietician and all of us as credentialed feeding experts, we know that breast milk is sufficient to meet baby's needs for the first six months of life. Every major health body now recommends holding off on the introduction of Solid Foods until six months of age. But parents here four to six except for that very small group of babies who are at high risk for peanut allergy. And maybe you could cover what that means. Is there really a benefit to starting, let's say you're low risk for peanut and you wanna start at four or five months of age, but your baby's not sitting up on their own, which means they can't support a safe swallow, parents wanna do it four or five months of age. What do you tell those families who are not in that high risk category for peanut allergy?

2 (8m 58s):

It's a little bit of common sense and we need to meet babies in their developmental stage. And you're absolutely right. There are some babies who aren't ready to even do this till they're seven months old or eight months old and that's okay. We can't force them to eat and you know, breastfeeding, we wanna promote for as long as possible for those that want to do that and and are able to do that. Yeah, so you know, it's ideally we wanna start getting these foods in once they start eating like purees and cereals and oatmeal and the typical things that they're gonna introduce. And then that's when you start to add in the other foods as well. So when you really think about high risk, it's those infants that have truly moderate to severe persistent eczema. It's not like little spots of eczema that go away with some moisturizer and then pop back up again. It's those that are really have a large part of their body covered by it or it's, you know, more severe that requires more potent topical steroids and things like that.

2 (9m 42s):

Those are the ones raising their hands saying I'm the highest risk to develop food allergies. Family history actually isn't a very high risk factor, you know, and specific food allergies don't get inherited and there's actually some evidence that shows that y younger siblings of you know, have lower risk if they're older siblings that have food allergy, they actually have low lower risk. We can talk about microbiome and all kinds of stuff like that, but really it's eczema. But it's interesting because we still see food allergies develop in children who don't have eczema. So if we look at risk factors of, you know, can we predict it's really that moderate to severe persistent eczema, those are the ones we wanna start feeding it and keeping their diet.

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But is there any data to show that starting at four or five months of age is any more protective than waiting until six months of age in the non-high risk for peanut allergy group of babies?

2 (10m 29s):

There is, yeah. So there's been, there's been different trials like the EAT trial where they introduced multiple different allergenic foods. The data are strongest for things like milk. So if you're doing cow's milk formula supplementation, it shows that if you introduce that earlier in infancy, that that may have a protective effect. So you know, the signals are there that yeah, the earlier the better, but there it doesn't have to be by, you know, four months of age or five months of age. So it, we we get caught up in this like general guidance versus, you know, these babies aren't research study participants so there's aren't these strict criteria to worry about

0 (10m 59s):

And it's not ethical to design a study whereby you would make a four month old eat shellfish and see what happens versus waiting till six months of age. Right,

2 (11m 7s):

Right. Yeah. And and we're also to the point now where the, the, the body of evidence is, is showing that the earlier the better. So right, if we randomize kids and said don't eat anything till 12 months of age when they may actually then develop food allergy and we know better. Like that's, that's not a good study. That's, that's not ethical.

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Hey, we're gonna take a quick break but I'll be right back.

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Let's talk about introduction of these allergenic foods at home versus under medical supervision. Can you talk about the pros and the cons of introducing allergenic foods and in what situation should parents consider introducing allergenic foods under medical supervision?

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It depends on where you live. So in Australia there are public health campaigns that they wanna nip allergies in the bub and it's, it's the messaging is introduce all of these allergenic foods at home just as we talked about including peanuts and, and milk and fish and things like that. And they have not seen a significant rise in food allergies or more severe reactions than these infants. So there's really very limited indications to do this in the medical setting. We really wanna promote that it's very safe to do this at home. You don't need to drive to the parking lot of the emergency room or sit outside, you know, or have epinephrine prescribed or anything like that. We just wanna make this a part of the normal feeding. So there's really very few indications now every once in a while when inappropriate allergy testing is done and people do these large screening panels and they get a lot of false positives.

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If you have a an elevated result then sometimes we're stuck and yeah let's do that in the office and make sure it's okay. But you know, waiting for that, that's gonna delay introduction even further by weeks to months. So we wanna promote people to, you know, feed at home, which is very safe to do.

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And when you say inappropriate allergy testing, I just wanna remind our listeners that Dr. Duke has did a whole episode all about the food allergy testing and why false positives are so common. And I'll link to that in the show notes as well because if you have been advised, you know, go, if you're or you're worried, I'll just go test for everything, that's not actually how it works. In his recommendation along with other professionals in the food allergy space is you never test for a food that your baby hasn't reacted to. So there's no benefit to go blanket testing 'cause half of those results are gonna be false positives. But talking about that risk assessment, how do parents assess the risk of an allergic reaction and 'cause there are some cases when introducing allergenic foods in a doctor's office would be advisable. Could you share what that criteria would be?

2 (13m 56s):

So honestly that's all changing. So the, in the US the guidelines are outdated. So it's the US is the only country in the world that still includes screening for peanut only in infants with truly severe or moderate persistent eczema, that's it, just peanut, not other allergenic foods. And then based upon that result, then you either introduce at home or in the office setting. But that is not mirrored by any other society. I already mentioned the Australia approach to it and things like that. So that's even changing just in the last few years as well. So really we're trying to, to do our best not to screen and to test, but that's when we do it in the medical, in the medical setting is when you're stuck with that allergy test result, dunno what to do with it.

0 (14m 34s):

And can you talk more, I know you're very involved in the international allergy societies and associations, you mentioned Australia. If we're the only ones who are screening for peanut only, does that imply that the other countries are then screening for all of the top whatever number it is, allergenic foods in their country or just not screening at all and saying introduce it early and often

2 (14m 54s):

Not screening at all. Right, so there's no medical indication

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Just eat the food.

2 (14m 57s):

Yeah, yeah. That that's the way and that's the way it, it really should be here in the United States. It's just, you know, the last guidelines we did, which I was a part of, those are seven years ago. The evidence has changed dramatically in that period of time. So it just, it just hasn't been updated yet. But that doesn't mean that is current best edit. Okay.

0 (15m 11s):

When you're in charge of this public health campaign in the United States, it's gonna be called just offer them the food. I would like to be involved because that's what we're trying to teach parents. 'cause they are, they're so scared of food or they get a lot of marketing messages about these kind of gimmicky supplement programs that are making them think that it's not safe for their babies to eat food or it has to be so, you know, it's over pathologized. It's such the medicalization of food and you, you need these little stick packs, you need this many grams. It's like, dude, just offer your baby the food, but do it in a safe manner when the time is right. I think that would be a great public health campaign.

2 (15m 40s):

Let the babies eat,

0 (15m 41s):

Let the babies eat. Okay, so what are the signs and symptoms of an allergic reaction that parents should look out for? And then what should parents do if their baby has an allergic reaction at home when they're offering all of these potentially allergenic foods?

2 (15m 53s):

Yeah, this has also been well established. So the fear is always that, you know, babies can't vocalize or verbalize if they have any symptoms on the inside or they have little tiny airways so their airway's gonna swell, shutter, things like that. That's not actually what happens for the vast majority of infants when they do experience an allergic reaction, you know, it's not anaphylaxis. That's, that's pretty rare. Does it happen? Absolutely. And there are people watching right now that, that are gonna say, that's not my baby's story. And yeah, I meet those families all the time. But in the greater context, you know, if we're telling a hundred thousand parents to be worried about it when only maybe you know, 10 out of that a hundred thousand actually have a severe allergic reaction the first time they eat it, that's a huge disservice to the vast majority of those people. Typical symptoms are gonna be, you get some hives that usually spread on the body.

2 (16m 35s):

So big Reddit, you know, itchy bumps, they get fussy and irritable. So their behavior matters. If you have a happy baby that has a rash that's much less concerning for a food allergy reaction. Rashes happen all the time. You can also have vomiting. So most commonly it's gonna be hives and vomiting will be the initial manifestation. Infants can be more subtle, they may do more like tongue thrusting, they may just be more squirmy and irritable. But they can do that for a whole host of reasons as well. So, and it also goes back to what did you just feed them? Like if you fed them something that's very benign like fruits or vegetables, grains and stuff like that, those are very unlikely causes of food allergy reactions. But if you notice that you know, you just fed peanut butter for the first time or second time and they start breaking out in hives within 15 minutes, you need to talk to your doctor about that.

0 (17m 15s):

I feel like all these questions are softball and you're like, that is very well established. But you also know that parents still are freaking out. So we're talking about the same group of parents that have so much anxiety, even though experts like you are constantly saying like, listen, this is already really well established. This is just what you gotta do. And I wanna remind parents that the only thing that you can do to actually lower your child's risk of food allergy is to offer them these foods early and often. So for parents getting prepared, Dr. DUIs, what steps can they take to get prepared to introduce allergenic foods at home safely? Acknowledging that lots of parents have lots of anxiety about this, so this is scary. Even though this is what you do day in and day out, they're freaked out to do this at home.

2 (17m 53s):

Yeah, no, I get it 100%. You're absolutely right. That's why I'm glad to be here. Thank you for having me back. Yeah, so we wanna promote confidence. Like if you're worried about it, choose a time when you're not rushing out the door or dropping your child off at daycare with another, you know, you know somebody else's gonna wash them or something and then, you know, give them a couple small bites. Don't rub it on their skin first. 'cause you're gonna get non-specific rashes that'll, you know, cause anxiety and things like that. That's also how we sensitize people of, you know, putting it through the skin, like let them eat it. We want to, you know, ingest it and promote it, you know, to the immune system that way. So give a couple of small bites, take a break for five or 10 minutes. If they look happy and playful, then give a little bit more and a little bit more. And then once they tolerate whatever a half serving size or serving size is, then you can keep giving it to them on a regular basis. There's no reason to space this out with one new food every 3, 5, 7, 19 days.

2 (18m 38s):

Those recommendations are highly conservative, completely made up because the odds are they're not gonna have a reaction to anything that you feed anyways. So you might as well introduce like four or five new foods all at the same time. Let 'em have fun with it. And then if concerns arise, we can go back and figure it out afterwards.

0 (18m 53s):

DRAs, what is an oral food challenge? What does it look like in your office? And then who do you advise this for? If most of the babies that we're talking about should be eating these foods at home?

2 (19m 3s):

Yeah, Oral, Food Challenges is the best part of my job. So we, we happen to, I, you know, I work at a, a food allergy center where we can do about a thousand of these a year. There are multiple reasons to do Oral, Food, Challenges. There's very little medical indication to like, you know, introduce a food in a medical supervis, you know, supervised setting during a food challenge for the first time. You know, we, we help parents though we do see a lot of parents with high anxiety or they have older children that have food allergies or we have false positive testing or whatever. So we're happy to do that and we offer that. But traditionally Oral Food Challenges are great if we're not quite sure what the diagnosis is. So if the history is kind of wishy-washy, the testing is in determinate, come to the office, hang out with us for a few hours in a very safe place, we'll have you eat the food. As I mentioned before, food allergies are reproducible. So if you eat an entire serving and nothing happens, you're not allergic to that food.

2 (19m 45s):

When people with known food allergies, we think that they're outgrowing it or developing tolerance, come to a food challenge. That way we can demonstrate that you're actually still, you know, tolerant or still allergic. And then we even do like threshold challenges. If there's a lot of anxiety surrounding certain foods or allergies, come eat very small amounts. It's not gonna prove that you're not allergic to it. But we're gonna show you that you're not gonna have a severe life-threatening reaction if you eat trace amounts or cross contact. So there are multiple reasons to do them. Oral, Food, Challenges get a very bad wrap on social media and the public level for various reasons. But you need to look at the upside. So this is the best way to gain knowledge even if symptoms occur, you learn what that looks like. You learn how much food your child needs to eat to cause those symptoms. If treatment is necessary, you see what treatment we give you see how fast it works.

2 (20m 28s):

Especially with epinephrine. Families are actually thankful when we, when we have them give epinephrine, they say, I, I was always scared of the needle and now I see how fast it works and when symptoms don't occur, that's a game changer. You don't have to worry about it anymore. So Oral, Food, Challenges are all about support, gaining knowledge and using that to, you know, guide your decision making. Hey,

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We're gonna take a quick break, but I'll be right back.

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0 (21m 27s):

Okay. I know you spend more time on social media than you would probably want to, you're doing it for professional reasons, but like what's the bogus stuff about Oral, Food, Challenges going on on social media? Like why do they get a bad rap?

2 (21m 35s):

Yeah, well people talk about how they're inhumane or you know, and there's a lot of anxiety surrounding, so we prep families and we help them with this. We have psychologists here to help people, you know, deal with these things. So yeah, it's very anxiety driven. If you're not given that information and support upfront, it can be a very nerve wracking experience. And even when you do have that, so there's that aspect of it and people talk about how, you know, they, they can take a few hours and it's really scary to watch your child to eat a food that either previously caused a reaction if you're not sure. So the anxiety surrounding it really drives a lot of negativity towards this experience. But I'm telling you, it is such a positive experience when handled in the appropriate way and it's the best way to assess for food allergy.

0 (22m 12s):

Okay. Every time you mention the psychologist on your team, I gotta check in. How are you doing with getting the dieticians on the team there too? Oh,

2 (22m 18s):

I'm working on it. Nobody like physically here, but we have a nice pipeline to, to get referrals seen ASAP, but I'm still working on that. Katie, you are not looking for a topic.

0 (22m 26s):

Okay. I'm not looking for a job. I'm just looking to advocate for my profession. I think it's really important that psychologists are part of this, but like, so our registered dieticians, if we're talking about teaching parents how to actually make the food safe, 'cause that's my concern is that parents, you're, you know, you're up against these big multinational corporations that are promoting supplements and scaring parents into actual eating food. Like as a practitioner of food, let me show you how to make the food safe because you can introduce all of these top nine allergenic foods safely to your baby in a way that's developmentally appropriate from the time that they're showing you that they're ready to eat Solid, Foods and don don't want parents to be scared of food because the way you find out if your child has a food allergy is to feed them that food. I think we're kind of all saying the same things, but, but the food sometimes is the missing piece for the parents. They're looking for that magic bullet just, you know, what's the pill that I can pop to count off all the allergenic foods and that, that's not how it works.

0 (23m 10s):

And I think all of us as credentialed professionals need to be reminding parents that this is about food.

2 (23m 14s):

Yeah. And you know, our minds are so powerful and our cognitive biases impact these decisions because all of us sort of artificially say, well the potential negative outcome far outweighs the, the likely benefit of the outcome, right? So we know that most babies are gonna do really well and it's gonna benefit them, but that just that fear of well what if, what if they're the one in a million that's really powerful and that impacts people in their decision making at least to delaying these foods and introducing them and things like that. So we have to, you know, address that upfront and help people.

0 (23m 43s):

And I can tell you as a new parent, when I heard you say death from anaphylaxis from a food allergy or a food related incident in infancy is almost all but unheard of. Like, that resonated with me. It's like, yes, there's probably one or two case studies out there in the literature, but there are not tiny babies all over the country whose throat is swelling up in, they're dying because they ate peanuts. And it's like, it's that like, what's the worst thing that could happen? The worst thing happen, your baby could die. But the reality that actually happening, I think it's important to know that relative risk, and for some parents that really helps. I know it doesn't help all parents with their anxiety 'cause they hear that, oh my gosh, they could die and I'm not gonna do it. But also remember, it's the only thing you can do to help lower your child's risk of food allergy. And I think we need to talk more about that message too, rather than just like, what's the bad stuff that could happen?

0 (24m 26s):

It's like, actually what's the bad stuff that could happen if we don't do it? And so we, we need to make this part of the protocol. But you know, just to normalize babies eating real food is kind of part of the mission of the work that I'm doing. So it, it is very much aligned with what you guys are doing there as well. And I was curious if you had suggestions for parents who want to learn more about, you know, food allergy prevention. 'cause I know you work a lot in, in the maintenance and the management of it, but a lot of this is, you know, you could essentially be working yourself out of a job. If we could just get parents to implement this stuff in infancy to help lower the risk of food allergy, where do they go to learn more about your work and the work that your team is doing? Yeah,

2 (25m 1s):

I, I would love to not have a job. Oh my gosh, that'd be amazing. Same. So, you know, unfortunately nothing we do in medicine is a hundred percent effective. So despite our best efforts, you know, some of these children are gonna still have reactions. You know what the cool thing is? We can do something about that now. So we have treatment options available, especially in infancy that works really well with Oral Immunotherapy. There's folks offering sublingual immunotherapy. We have medication called Xolair that can help, you know, increase the threshold to cause reaction. So it's a different world. So let's do everything we can to prevent food allergies. If they actually do develop, we can help you. We can, we can, we got this. It's doesn't have to be nearly as scary as it used to be. These are really exciting times to learn more. You know, hopefully you have a good, trusted relationship with your pediatrician, if not if you, you know, if you don't have an allergist or anything like that.

2 (25m 44s):

So always go to them with specific medical questions. But there's great resources online through the advocacy organizations related to food allergy, the professional organizations as well be, be careful what you read on social media and through influencers. I think we've addressed this before, but yeah, and you know, anecdotes are, are very powerful. But if you know somebody or somebody in your social media group had a a different experience, that's their story. That that's not necessarily your story.

0 (26m 9s):

I like your stories on your Instagram. I think you do a really nice job of, of meeting parents where they're at and acknowledging, you know, what they're going through, but then also bringing the medical perspective in as someone who does this, you know, day in and day out on, on a very high level. So what are your thoughts about Instagram these days? Are you, are you still digging it? Are you over it?

2 (26m 26s):

I took a break over the summer. I posted one time in three months. That was when the, how'd that feel, the nasal epinephrine spray got released. It felt great, you know, so I, I've taken a deep dive in learning more about the algorithms and how they control all of us and how our minds were really not, you know, developed to deal with all these hacks that they have. So I, I recognize when I'm doing like mindless scrolling and when I'm on my phone, when I should be paying attention to my family or nature or just being, you know, in existence. So I, I've cut way back in my interactions with it and I've replaced that time with great things like being out in nature, exercising, reading books, spending time with my family. So I, I will still engage in some manner. don don't know what that's gonna look like, but you're not gonna find me posting every day or even going checking every day, that's for sure.

0 (27m 8s):

Well, thank you so much for taking the time to do this interview. I always appreciate your insight and your expertise and I think you have just such a wonderful way of making this very complicated and, and sometimes scary situation of introducing allergenic foods to our babies. Like it feels very doable. So thank you.

2 (27m 23s):

It's my pleasure. Thank you.

0 (27m 25s):

Well, I hope you guys enjoyed that interview with Dr. DUIs. I felt like all the questions I asked him, he's like, you know the answer to that. I was like, I know the answer to it, but parents still ask questions like, should I go to the ER and sit in front of the hospital and do the allergenic foods? And I hope, I know you're anxious and he knows you're anxious too, and we're not poking fun at parents who do that. But it's these ideas that get perpetuated on social media that really have no basis in science. And so I love to bring Dr. Skuas on because he has a very nice way of consolidating the science and explaining I think exactly what you need to know to get the thing done, which is introducing allogenic foods to your baby in order to help lower the risk of food allergy. Dr. Skuas is on social media very infrequently though. He told me that he took a three month break during the summer when he was traveling with his kids.

0 (28m 9s):

And he's really into, I think we were talking a lot about the book, the Anxious Generation, and he's now like doing all this research about the algorithm and how it messes with your mind and our kids' minds. And I totally get it too. He's someone who's definitely pulled back a lot on posting on social media as I have myself for many of the same reasons. I really enjoy talking to him. But baby led weaning is not going anywhere and pediatric food allergies are not going anywhere. Just the way that we connect with parents might be changing a little bit. And so I enjoy having those conversations with him as a professional, but also as a parent. And I hope you guys enjoy learning about baby led weaning here on the podcast, but learning about pediatric food allergies from Dr. DUIs. He's over there at Allergy Kids Doc.

0 (28m 50s):

I will put the links to some of the references that he talked about as well as a lot of the other interviews that he's done because if you like hearing from him on this topic of Oral, Food Challenges, you're gonna love, we've done other episodes on why food sensitivity tests are bogus and why food allergy testing has so many false positives and why you should try to get these allergenic foods in by 11 months of age. He's again, always so gracious and always willing to do any episode I ask about, and I'm usually asking him because other parents are asking me. And I'm not a pediatric allergist, but I like having professional conversations with him. And we're doing a future episode all about nightshades and eggplant because don don't know what's going on on TikTok, but parents are asking tons of questions about their babies being allergic to eggplant and it is not a public health crisis.

0 (29m 32s):

So stay tuned for that. Check out the show notes for this episode@blwpodcast.com slash 4 6 8. Thank you so much for listening. And a special thank you to our partners at at AirWave Media. If you like podcasts that feature food and science and using your brain, check out some of the podcasts from AirWave or online@blwpodcast.com. I'll see you next time.