Food Allergies and Children
It is certainly a daunting task protecting children from the possible misfortunes of everyday life, but add a potentially life-threatening food allergy to the equation and the task becomes monumental.
According to the Food and Drug Administration, approximately 4 percent of children appear to suffer from food allergies. An allergic reaction occurs when the body mistakenly believes that a normally harmless substance (i.e. food) is harmful and so creates massive amounts of chemicals and antibodies. Reactions may range from as mild as a couple of hives on the face to as severe as anaphylaxis. Symptoms may also include swelling, nausea, coughing, vomiting, drop in blood pressure, breathing difficulty, wheezing or blackouts.
Dealing with Reality
Heather Woodward's son, Cullen, was only 1 year old when he had his first severe reaction to food. "I gave him part of an egg," Woodward says. "Eggs are one of the highly allergenic foods, so I waited until he was a year before I gave him his first taste. I did everything the baby books said to do." She boiled the egg and separated the yolk from the white, giving Cullen the yolk. The yolk is the least allergenic of the two. "I turned around for a second and when I turned back his face was all red and swollen, and it seemed like he was having trouble breathing. I was about to call 911 when the swelling went down and he began breathing a little easier. He had only taken one bite."
The next day Woodward took Cullen to the pediatrician and explained what had happened. The pediatrician immediately referred her to an allergist, where her son received a battery of tests. Within the next year she was to find out that her son was deathly allergic to peanuts and eggs. "Our lives were drastically changed from that day on," Woodward says. "All eggs and peanuts were thrown out of the house; I had to change the way I cooked, where Cullen was allowed to play and the restaurants we could go out to eat in. We have to carry an EpiPen with us everywhere and I have to call restaurants ahead of time to find out what oils they cook their foods in and if they use egg in the kitchen. When we go to birthday parties I make egg-less cupcakes ahead of time and take them with us. It can be overwhelming."
In her article, "Navigating the Food Allergy Minefield," Linda Coss examines childhood food allergies and their impact on families. "There is currently no cure for severe food allergies," she says. "The only treatment is complete avoidance of the allergen." If you suspect that your child may suffer from a food allergy, Coss recommends an immediate visit to an allergist. "The physician will take a complete medical history, including detailed information about your child's previous allergic reactions, and will perform allergy tests to determine the diagnosis," Coss says. "If your child is at risk for anaphylaxis, the allergist will give you a prescription for EpiPen and teach you when and how to use it."
The Family Life
How do you care for a child with a life-threatening food allergy? How do you keep the busy toddler from putting a harmful food in his mouth? How do you keep the social school-age child from exchanging lunch food with a friend? The potential for harm can be endless.
The best place to start is in your own home. Woodward did a total kitchen makeover. "We had to completely clean everything out," she says. "Not only did we have to get rid of eggs and peanuts, but any food that possibly contained one of the two. There was no room for error, so we pretty much tossed everything and started from scratch."
Grocery shopping and meal preparation become more difficult as the parent wades through labels and recipes to spot hidden ingredients. Childhood staples like pizza, peanut butter and birthday cake are now constantly monitored and potentially "nixed" out of the diet. Something as simple as a friend's birthday party is now a recipe for disaster. Woodward started making cupcakes to take for Cullen to eat at birthday parties. "At least we knew our cake was OK, but we were still constantly having to monitor what he was putting in his mouth," she says.
According to Coss, getting family and friends on board may be a challenge. "Many people may refuse to believe the seriousness of the diagnosis, and may even do things that are potentially harmful, such as offer the child allergenic food," Coss says. It is important that all family and friends watching a child with a dangerous food allergy be taught how to use an EpiPen. "We were constantly giving lessons on how to use the EpiPen," Woodward says. "Everyone was really great about making sure they knew exactly how to handle a dangerous situation."
As a child with a food allergy begins school, parents must gain the cooperation of school personnel in creating a safe school environment. There can be no switching food with other students or sharing a cake during a class party. Woodward had several meetings with school administrators and teachers to discuss Cullen's needs. She also made sure Cullen understood his food limitations. "Now that he's older he understands a little better what he can and cannot eat," she says. "It helps some, but we still have to be careful."
There are several recommendations for parents when beginning a partnership with a school to provide a safe environment for their child:
- Meet with the school nurse, principal and teachers.
- Set up an emergency action plan.
- Bring educational materials that explain the severity of the allergy.
- Find out who is responsible for administering the EpiPen in the event of an emergency.
- Make sure anyone coming into contact with the child is aware of the emergency action plan and EpiPen.
- Give the child's doctor permission to share medical information with the school.
- Decide where the EpiPen should be stored.
- If your child rides the bus, make sure the bus driver is aware of the allergy and knows how to use the EpiPen.
There are also ways to ease a child's mind when beginning school. Here are the recommendations:
- Never share food.
- Say no when offered food you are not sure about.
- Wash hands before and after eating food.
- Wear your medical alert bracelet at all times.
- Ask what is in every food before eating it.
- Know the symptoms of an allergic reaction.
- Never feel embarrassed if you have a reaction, and don't try to administer the EpiPen on your own.
Becoming a Lifestyle
There does seem to be light at the end of the tunnel for those families just beginning to navigate the food allergy minefield. "The food allergy thing is so much a part of our life now – food no longer controls my every thought," Woodward says. "It took a while, but shopping, eating out, going to friends' houses, everything is easier."