WebMD Health - Allergies

May 3, 2011 3:41 PM

Food Allergies: Protect Your Child at Home and Away

Whether eating at home or dining out, Rhonda Lewis of Toronto, Canada, has completely removed nuts from her family's meals and snacks. She discovered that her daughter, diagnosed at age 4, is allergic to them.

Lewis recalls the frightening moment when food allergies changed her family's life. Three years ago, while on vacation, her daughter ate a pistachio. She threw up immediately afterward and then broke out in hives. Fortunately, her daughter recovered after taking Benadryl. But at the time, Lewis didn't realize how serious her daughter's reaction to that pistachio really was.

Lewis talks about how frightening having a child with a food allergy can be. "Many people don't necessarily understand the potential severity of an allergy", she says. "There's a huge risk here. Anyone who has an allergy has the potential to go into anaphylaxis, which is a very serious condition."

Sami Bahna, MD, DrPh, professor of pediatrics and medicine, chief of the Allergy/Immunology Section at Louisiana State University Health Sciences Center, and president of the American College of Allergy, Asthma & Immunology (ACAAI), says most food allergy reactions occur within minutes to a couple of hours after exposure to an allergen.

Common signs of a reaction to a food allergy include:

  • Gastrointestinal symptoms, such as vomiting, colic, diarrhea, or bleeding
  • Skin reactions, like hives, swelling, or eczema
  • Respiratory distress, such as upper respiratory congestion, throat swelling, or wheezing

In the most severe cases, a food allergy can even lead to anaphylactic shock, which is a life-threatening condition that should be medically treated immediately.

Working together with your child's pediatrician and/or allergist is very helpful to correctly diagnose and manage food allergy, says Bahna.

Preparing Safe Meals and Snacks

Families with food allergies often have to change the way they eat and the way they shop for groceries."Finding safe options that children are willing to eat can be a challenge," says Marion Groetch, RD, a dietitian at the Jaffe Food Allergy Institute at Mount Sinai School of Medicine. "Families have to learn how to prepare safe meals and snacks from whole foods and also how to find allergen-free convenience items."

Reading product labels is also an important habit in attempting to avoid reactions to food allergies. The FDA requires that the 8 major dietary allergens (milk, eggs, wheat, soy, peanuts, tree nuts, fish, and crustacean shellfish) be fully disclosed on product and ingredient labels. But other minor ingredients may not appear on packaging so clearly. If you have questions about something your child might ingest or eat, you should call the manufacturer before you serve it to them.

"There's always a risk of hidden ingredients," says Bahna. "Labeling is not always complete, nor clear."

Preparing meals and snacks at home allows you to have greater control over the ingredients used in your child's food. There are many cookbooks and web sites that can help you design an allergen-free diet for your child.

For special events, like birthday parties, Rhonda Lewis will call ahead of time to ask whether the cake is from a nut-free bakery. If not, she'll send an amazing dessert so her daughter "doesn't feel like she's missing something if she's eating something different."

Avoiding Cross-Contamination

Though there is a greater awareness about food allergies today, parents still need to be careful to avoid allergy triggers, especially when dining out.

Inform the dining staff that your child has a food allergy, says Marion Groetch. Don't just ask if a menu item contains your child's allergen. Speak directly to the manager or chef who will be preparing the food, and ask detailed questions about the ingredients used and the methods of preparation.

Cross-contamination is a major concern when eating out. "Ask that your food be prepared using clean hands and clean cooking surfaces, utensils, and equipment," says Groetch. "You don't want the hamburger for your child with milk allergies to be prepared on the same grill as another customer's cheeseburger."

Lewis frequents a handful of establishments where she feels confident in their ability to handle cross-contamination issues. "When I get to the restaurant, I tell the waiter, 'We have food allergies in our family'" she says. "Sometimes I give them a chef card, which is a card that says we have life-threatening allergies to nuts."

Avoid high-risk establishments, says Groetch. For instance, those with a peanut allergy should avoid Asian restaurants where peanuts or peanut sauces are served. Likewise, people with allergies to shellfish should avoid seafood restaurants where the risk of cross-contamination is much higher.

Safety Trumps All

Most allergic reactions occur away from home, says Groetch. Make sure that you always have emergency medications on hand. Rhonda Lewis always equips her daughter with a self-injecting epinephrine pen and shows other responsible adults how to properly use it in an emergency.

"I try to take every precaution," Lewis says, "but if there is a reaction, I need to know that someone can administer epinephrine and they know exactly the process to follow in case of emergency."

Lewis, who runs a web site called AllergySense to educate others about food allergies, tries to cover all the bases when it comes to her daughter's food allergies.

"We didn't want to stop our lives," she says. "It's all about preparedness. Every time I travel, whether it's by car or by plane, I make sure I have a plethora of allergy-friendly foods that I know are safe for us."