Monday, 20 April 2015

The 'May Contain' Thing... an attempt at explanation!

I don't know about your little ones, but 'Baby' is a sucker for fancy drinking cups - the wackier the better! she especially loves curly wurly straws - an absolute no-no for me! Despite my protestations, she is gradually gathering a small collection of them!

I can't stand the fact that I can't clean them out properly - all the way though - none of them can go through the dishwasher and just you try posting a bottle, or even a smaller brush down the straw. It just can't be done! The best you can do, is to flush with warm soapy water, rinse, and hope for the best. Thankfully (from my point of view) 'Baby' tends to drink water - fab! It's not sticky (unlike milk),  and it's easy to clean!

Where am I going with this? Well it's that thorny old issue of 'may contains' summed up for me recently by Chun-Han Chan's pithy comment on Twitter asking whether anyone had ever tried cleaning chocolate from a straw! (Chun-Han Leads on Food Allergy Policy and Risk Assessment at the Food Standards Agency and was tweeting on the subject of 'may contains', during one Allergy Hour.)

'Exactemente!' thought I! 

'Geronimo!! Precisely THAT!'

'May contains' is a frequent topic of discussion on allergy forums. What on earth does it mean? It may not always be specifically expressed as 'may contain,' it might be, 'not suitable for allergy sufferers' or something along similar lines! 

Newcomers to allergy life are quite rightly bewildered about what to do with this information and in a sense quite rightly so, for the following reasons:

1) May contain on an ingredients label is not a legally recognised term, within the EU. 

Because of this, manufacturers are not required to use it, even if there is a risk of cross-contamination. If the 'May contain' statement is there at all, it's because the company don't want to run the risk (in the event of a reaction following the consumption of their product) of being sued because they haven't disclosed enough information - the onus is on the sufferer themselves to make the right call. However, that doesn't really help bewildered allergic customers (except in the case of Unilever, who have stringent allergen testing - according to Dietitian Julia Marriott, if they say 'May contain', it should be taken seriously), because... 

2) May contain can mean various things!

It might be added because the product has been made in the same factory, or on the same equipment as the allergen, or because although the factory itself might not use the allergen, it cannot be sure about what their raw ingredients were exposed to, before they reached their premises. This is particularly true in the case of nuts - if you are only allergic to almonds, you might have to avoid other nuts as they may have been which may be processed alongside them. The same is also true of grain products like oats and wheat. These products produce dust particles than can rise into the air and remain there for some hours - and from there settle into other products made in the same space. Milk needs to be considered slightly differently. The problem with milk is that the proteins are quite sticky and can be hard to clean out of fiddly places - as I will try to demonstrate later.

3) May contain might not affect every allergic person!

Everyone's threshold* of tolerance of an allergen (like milk) is individual to them - what affects one, who might be quite sensitive to tiny traces, may not affect another who needs much more than a trace to spark a reaction. Moreover, thresholds can be affected by how processed that allergen has been (as processing/baking can cause allergens to be better tolerated by some - apparently they need to have been heated up to 180C for about 40 minutes) and also the individual's current state of health (reactions tend to be worse if you're ill). In addition, for some people it may take a slow build up of a trace amount to lead to a reaction...

4) The may contain risk may vary each time you eat the same product.

In terms of products containing milk, at certain stages of production, there is likely to be more risk than others. If you have just started a new batch of 'milk free' chocolate or yogurt, having just made some that does contain milk, even if the equipment has been cleaned, some traces may remain and become absorbed into the new mixture. You will never know at which stage of production the product is made, so you are kind of playing Russian Roulette.

BOO! You see the problem? Which is why, it is so difficult to frame in law - although I believe the powers that be are continuing to work on this. 

For us personally, we have tended to avoid the majority of 'May contain' products, because 'Baby' has been so sensitive in the past. For us, 'May' has often translated into 'Does', even when the companies involved don't think so, and tell us that their equipment has been thoroughly cleaned! 

Now, I don't have a problem with certain food preparation equipment like knives, spoons, plates etc. being bunged in a dishwasher and cleaned, it's the products made on more fiddly machinery that presents more difficulty for me. Think back to cleaning that straw containing chocolate - some machinery has parts that with the best will in the world just can't be reached, can't be scrubbed, will just be sluiced - hey presto... cross contamination risk!!

By way of illustration, take, for example, this home appliance - The Hub's beloved coffee machine. Et voila:

Exhibit 1

Looks smart, huh? BUT I have a complete love/hate relationship with this thing!

I love the fact that it makes gorgeous cups of coffee for The Hub and guests to drink... but I absolutely HATE cleaning the milk frothing compartment! This hatred is based on the fact that it has hard to reach places (like my little one's cups with straws) that cannot be placed in the dishwasher!!

Here's the lid - see the rubber seal? Milk can get stuck behind that, if you overload the frothing chamber and it's pretty tricky trying to clean it off, once it gets stuck there!

Exhibit 2

And here's the frothing device! Just you try cleaning every nook, cranny and coil on that!

Exhibit 3

Then there's the fact that you can't immerse the actual chamber in which the frothing takes place, in order to wash it thoroughly - it's an electrical appliance! 

Exhibit 4

The previous coffee machine also had its problems! See here:

Exhibit 5

See that milk frothing spout on the front (just like those you see in coffee bars) it was great for frothing milk, but impossible to clean, and is constructed very much like the aforementioned straw! I really thought I was cleaning it - I'd wipe the outside, and 'froth' into clean water (which, by the way, would then go 'milky'). I would then froth my dairy free milk and wonder why my, at that time, much younger 'Baby' (who was frequently being breastfed), was suffering reactions! At that stage, I hadn't yet twigged that milk proteins are quite sticky and can cling in all kinds of places!

Fortunately, for 'Baby', it didn't take me too long to make the connection! Hence, for her, or any other allergy sufferer with a severe milk allergy, frothy soya milk in normal cafes is quite out of the question - unless they keep one machine totally devoted to dairy free milk! 

Again, we  had to learn from bitter experience! Doh!

Now extrapolate what we've learned from appliances in the home up to machinery in factories... different size/shape, but same set of problems - fiddly bits that can be hard to reach. Disinfectant solutions are insufficient - they might kills germs, but not allergen proteins! That said, I discovered (through conversation via Twitter with Adrian Rodgers - @ad_rogers, on Twitter) there are, apparently, some solutions which can neutralize proteins, but even these are insufficient if something has just been sluiced through - apparently a good soak is what's really required - just like when you clean the teats on your little one's formula milk bottles. You're advised to sterilize teats, because milk proteins cling where you can't reach and where milk proteins cling, bacteria can form. Of course, sterilization will kill the bacteria, but not the protein!

So where does all this leave us?

Well there has been a fair amount of research into the subject, which may help guide allergic consumers as to what risks can reasonably be taken. The FSA surveyed a range of 'may contain' products and concluded that on the whole controls were good, but that gluten and milk cross-contamination was a lot harder to control than that of most other allergens. Staggeringly, milk was detectable in over 80% of the 'May contain' products they examined, although official advice, from the FSA (see here) is that it was not in sufficient quantity to cause a problem. (For the whole report, see here.)

However, that said, interestingly enough, research has been conducted which suggests loose products sold in bakeries as 'milk free' may not be as milk free as one might wish (see here). Apparently, although staff in these shops felt they were knowledgeable about their products, nearly half of the products tested contained detectable amounts of cow's milk.


One piece of research says this, another that. No wonder that even Healthcare Professionals (Allergy Consultants/Dietitians) do not always agree on this subject. At the end of the day, it all comes down to individual circumstances and personal risk assessment. The only way to be entirely sure is to avoid all 'May contains' and stick to products that are specifically labelled as 'dairy free'. Mind you, having said that, even THAT isn't quite as clear cut as one might suppose... you actually need to look for products that are not just labelled but guaranteed to be 'dairy free'... 

More on that, another time!

In the meantime, see below, for further posts, on this subject!

Further Reading:

Why Vegan is not always Dairy Free: Part II - Health Journo Alex Gazzola investigates

Is there a threshold dose for Cow's Milk Allergy? - Foodsmatter interview with Dr Janice Joneja

No comments:

Post a Comment