Warning: This article contains information that is not suitable for children. Article updated April 19, 2019.
A California family has been left devastated after their dairy-allergic daughter and sister died of a severe allergic reaction. Denise Saldate, 11, suffered a fast-moving anaphylactic reaction to milk protein from an unexpected source: a new prescription toothpaste.
“She was my sunshine, she was the light of my life,” Monique Altamirano said of her daughter in an interview with Allergic Living. Denise was 11 and the baby of the family, as the youngest of four sisters.
On April 4, Monique had taken Denise to the dentist. Since the girl had some spots on her teeth, the dental office suggested the MI Paste One brand of medicated toothpaste, saying this should help to strengthen the girl’s tooth enamel.
After years of reading toothpaste labels when Denise was a little girl and never seeing milk present, neither mother nor daughter had the least suspicion that milk exposure could be a risk. Because of that, “I did not think to look at the product ingredients,” said Monique. Neither did Denise: “She was just excited to have her special toothpaste,” said her grieving mother.
“Contrary to what everyone’s telling me, I feel like I failed her!” Monique said through tears.
Monique said the family has worked with an allergist since Denise was first diagnosed with a milk allergy as a 1-year-old. This mother has always diligently read food labels for Denise’s allergens (she had outgrown a few), and taught her daughter and her siblings to do the same.
A Mother’s Warning
Denise’s experience is every food allergy family’s worst fear. Amid the 24/7 vigilance required to manage food allergy, there was that one oversight, that one exposure from an unexpected source. And it led to a child’s fatal reaction.
As it turns out, there is a small warning that this brand’s paste contains the ingredient Recaldent and milk protein on the front of the small tube. There is also cautionary wording on the back.
Monique asked Allergic Living to stress this point to other food allergy families: “Read everything. Don’t get comfortable, just because you’ve been managing for several years.” In all situations, she says: “You can’t get comfortable or be embarrassed or afraid to ask and ensure that ingredients are OK. Be that advocate for your child.”
Allergic Living also reminds dental professionals to ask patients, on a regular basis, whether they have allergies. As well, we hope allergists and pediatricians will inform patients of any food or latex allergen risks at the dentist’s office or of other unexpected exposures.
Reaction Turned Bad Quickly
Denise had had some allergic reactions over the years, but nothing to compare to this one. The evening of April 4, she began brushing her teeth with her new toothpaste, with her 15-year-old sister in the bathroom. The sister said Denise had almost immediately begun crying, then ran into her mother’s room.
“She said, ‘I think I’m having an allergic reaction to the toothpaste,’ and her lips were already blue,” says Monique. “I picked her up and put her on my bed. I ran to the living room,told my daughter – ‘Call 911!’ – and I grabbed the EpiPen.” She administered it, and also gave Denise her asthma inhaler.
“She was saying, ‘Mommy, I can’t breathe.’ I was saying, ‘I love you, yes, you can ….” In desperation, Monique was going to run outside with Denise to meet the paramedics on the street.
Then the 911 operator asked her daughter: “Does your mother know CPR?” As a former school bus driver trained in CPR, “I immediately shifted gears and got her on the floor,” said Monique. She began compressions, and soon heard the sirens. The paramedics arrived and took over, working on Denise for several minutes before putting the child and her mother into the ambulance.
But Denise didn’t make it. Her father Jose Saldate and her sisters were at the hospital when they got the bad news.
Repeating her reminder of never making assumptions about labels or ingredients, Monique said: “This is your child’s life, and God forbid you have to go through what I’m going through.”
A Legacy of Love, Compassion
Denise was in the 6th grade and her school recently held a vigil, which Monique says showed how many lives her youngest had touched. “She wasn’t just the light in my life, her smile didn’t just brighten my day, that was just who she was. Multiple kids were saying: ‘She was my best friend; she gave the best advice; she helped me get my grades up; she always wanted me to be happy when I was sad.’ That was Denise.”
In the eulogy she has written for her daughter’s funeral service, Monique notes:
“Her family implores those who are aware to share their knowledge and to inform those who are unfamiliar with anaphylaxis of the seriousness of this condition. They hope that in sharing her story, families, caregivers, school staff, and people in general will take this condition more seriously and that all items will be checked for ingredients, even those that may seem irrelevant.”
She wrote that her daughter’s “legacy of love, compassion, and generosity” will carry on through organ donation. Denise’s uncle has started a Gofundme page here to help the family with funeral costs.
Update: 7-Year-Old’s Allergy/Asthma Death
Allergic Living unfortunately reports a second tragedy a week later, also related to dairy allergy and asthma. On April 13, 2019, Keagan Steele of Toronto, who was 7 years old, passed away. Her mother’s cousin told Allergic Living that while the cause of death is still being confirmed, it appears related to her allergy or her asthma, or both.
Grieving parents are Desiree & Shawn Steele, and Keagan had three siblings. The cousin shares this Gofundme page, saying the family appreciates assistance at this time.
Allergic Living reminds our readers who have children with food allergy and asthma to:
• Be sure you’re following both an asthma action plan and an anaphylaxis emergency care plan.
• Be mindful of both good asthma control and familiar with steps to take in suspected food allergy reaction.
• Visit an allergist for diagnosis and return for discussion of any control issues or retesting as recommended.
• Read all labels for allergens, which currently are not required to be labeled on personal care products.
• FARE’s medical advisers recommend using epinephrine for any severe allergy symptom or more than one mild symptom. See more here.
Related Information: A Canadian dentist has written a helpful blog post about allergies and visiting the dentist.