As we prepared to go to Sophie's wheat challenge a few days ago, a scene replayed through my mind again and again...Sophie first wheat challenge. She was 1 year old. Her blood tests indicated that she was likely to be able to pass a challenge. At the time, I was desperate to have her dietary restrictions loosened, since I had very few recipes that worked with her long list of allergens.
We did the challenge at the doctor's office, of course. Sophie cooperated readily with eating the Cream of Wheat. She ingested several doses without a problem. About an hour into the challenge, she was tired and falling sleep in my arms. This seemed natural, since it was mid-afternoon, nap time to a toddler. Just as the nurse was preparing her next dose of Cream of Wheat, Sophie lifted up her head, vomited all over me and herself, and hives broke out all over her arms and face. As suddenly as her reaction occurred, this wasn't the scary part.
Several hours later, after we had endured observation, picked up her sisters, and made it home, I noticed that Sophie's bottom was red and tender looking when I changed her diaper. Thinking that a bath was in order, I ran some water and stuck her in the tub and then realized that we had a real problem. Sophie had red welts on her abdomen as well, and when I put her into the water, she tried to lay down, like she was going to sleep. This may be normal for some toddlers, but not for Sophie—giving her a bath usually means I get a shower too from all of her splashing and playing.
I later learned that Sophie was experiencing part two of a biphasic reaction to the wheat she had earlier ingested. I don't know a lot about what causes biphasic reactions, but the timing of the second phase suggests that it was triggered by wheat remaining in her system after the Benadryl she was initially given had worn off. Some 24 hour Zyrtec and a nebulizer treatment quickly got Sophie back to wiggling free and running to play, but when we prepared for a second wheat challenge, I kept coming back to this second phase of that reaction. Surely an older, more vocal Sophie would tell me before things got so bad, right?