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More than a Nuisance: Managing Your Child's Food Allergies

By : Haydee Camacho

Food allergies are not just a nuisance. It can be unsettling to find out that a food your child enjoys can cause a serious illness or even death without the proper treatment. There is no known cure for a food allergy, so strict avoidance of the food is critical to avoiding a potentially life-threatening reaction.

A 2008 report from researchers with the Centers for Disease Control and Prevention's National Center for Health Statistics estimates that 3 million children under age 18 (3.9 percent) in the United States have at least one food allergy. The biggest sources of food allergies are milk, eggs, peanuts, tree nuts (pecans and walnuts), fish, shellfish, soy and wheat.

“It can feel really overwhelming and really big,”? said Dr. Michael Pistiner, pediatric allergist and instructor in pediatrics at Children’s Hospital Boston, Harvard Medical School, and author of "Everyday Cool With Food Allergies," which teaches basic food allergy management skills to preschool- and early-school-age children. “It does involve maintaining food allergy management at all times and in all circumstances," he said. "You want to prevent an allergic reaction and be prepared at all times to treat it.”?

Sensitivity to an allergen food can range in severity from a mild headache, or hives at the site of contact, to life-threatening anaphylaxis. In some cases, a child may be able to eat a small amount of a particular food, but will not tolerate larger amounts. For some children, simply touching or inhaling the allergen food will trigger a reaction, so in these cases, parents should take precautions by reminding allergic children to wash their hands frequently and avoid allergen foods, either prepared or as they're being cooked.

“The age of the child will play into it,”? Pistiner said. “Little ones explore their environment with their hands and mouth. They can get the allergen into their nose, eyes and mouth. Older children can wash their hands and be responsible for self-preparedness.”?

Although a parent’s first instinct may be to ban the problem food from the home, this may not be necessary. Parents should consider such factors as the severity of the allergy, ages of other children in the home, and how they will be affected by the ban. An allergen food such as peanuts can be banned completely without causing too much hardship for the rest of the family. Other foods that are diet staples, such as milk, eggs or wheat, may be more difficult to eliminate.

“It’s important to realize that the most severe food allergic reactions occur from ingestion," said Dr. Todd Green, assistant professor of pediatrics with the Division of Allergy & Immunology at Children’s Hospital of Pittsburgh. "And with vigilance and appropriate steps taken to prevent ingestion, it should be possible for other family members to continue to eat a food that another member of the household is allergic to."

In most cases, accommodations are easily made for the allergic child without interrupting normal family life. “Parents can prepare foods that most of the family can eat and supplement for the family member who is affected,”? said registered dietician Debbie Mouser, the owner of Cook for Life in Dallas, Texas. “If the child has a gluten restriction, you can simply prepare your vegetables and meat without any bread coating and then everyone in the family can enjoy them. You can supplement a gluten-free bread or rice product for rolls."

Keeping Safe at Home

Mouser recommends consulting a dietician to learn which foods can be substituted for the allergen foods, and then taking lists of those foods when shopping. She also suggests searching out products on the Internet.

Another important line of defense against unsafe foods is reading labels on all food products. “You’ll have to become a label-reading machine,”? Pistiner said. Allergens can be hidden ingredients in foods, so label-reading is essential in the family’s prevention strategy, he noted. Children also need to be taught to read labels in age-appropriate ways. If they cannot read, they can be taught to ask an adult to read the label. Pistiner advises his young patients and their families: “If you can’t read it, then don’t eat it.”?

Because even the most minute contact with allergen foods can trigger a reaction, cross-contamination must be avoided. Eating utensils, dishes and cups, measuring cups, mixing bowls and other food prep equipment must be thoroughly cleaned after use. Separate containers must be used to store safe and allergen foods. Tabletops, counters and high chairs must be wiped down with soap and water, commercial cleaners or commercial wipes.

Parents also need to have an allergy action plan from their child’s health care provider handy at all times and an EpiPen to treat serious reactions. Communicate with your doctor about exactly which emergency medications can treat reactions, and ensure that both you and your child not only understand exactly what needs to be done in the case of a reaction, but that you have exactly the right medications at your disposal at all times.

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