What are food allergies?

A food allergy happens when your immune system sees a certain food protein (an allergen) as harmful and reacts by causing symptoms. Symptoms of food allergies in kids can include itching of the mouth and throat, throat tightness, nausea, vomiting, abdominal pain, sneezing, wheezing, itchy skin, hives, and, in rare cases, death. In the United States, the eight most common food allergens are milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish. Taking proper precautions and having a plan of action can aid in effectively managing this chronic condition.

"By definition, accidents are always unexpected," said Dan Atkins, MD, Medical Director of the Allergy and Immunology Center at Children's Hospital Colorado. "Having a personalized Food Allergy Action Plan and teaching children and their caretakers how to respond quickly to an accidental ingestion is an important part of keeping them safe."

A Food Allergy Action Plan is best developed with your child's primary care physician and distributed to all of your child's caretakers. The following information should be included:

• Foods that present a risk
• Possible symptoms
• Which medicines and the dose to administer based on observed symptoms
• Emergency contact information (physician and parents)

Living with a food allergy

Food allergies are more common than ever — there's at least one in nearly every classroom. For the families of kids who have them, they're a constant specter that hovers over nearly every aspect of daily life.

"When you get a diagnosis, you meet with a dietitian and talk about reading labels," says David Fleischer, MD, Director of the Allergy and Immunology Center. "Then you go into a store and try to avoid milk and egg, and you're excluding a lot of things. Shopping goes from 5 or 10 minutes in the store to maybe hours."

And that's best-case, most informed scenario. Restaurants are a terrifying unknown. Travel, particularly to foreign countries with language barriers, can be harrowing.

But for many parents, that's nothing compared to sending kids to daycare or school, where every other kid's peanut butter sandwich or blueberry muffin is a potentially life-threating hazard, where kids or toddlers might share food not knowing of the danger. It's even scarier with adolescents, who are susceptible to peer pressure and prone to taking risks.

"It's that constant fear that I think many people just don't understand," says Dr. Fleisher. "Some families are so gripped with anxiety that they need to see our psychologist to get to a healthy level. We want them to be cautious, but we also want them to have a good quality of life."

Managing food allergies in children

"For some families, learning your child has a food allergy can be extremely anxiety-provoking," says Jane Robinson, PhD, a clinical pediatric psychologist in Children's Colorado's Allergy and Immunology Center.

Thankfully, this stress usually decreases with time. Here are ways to help parents and kids cope with a food allergy:

1. Know what your child can handle for their age and development

   Determining what your child can handle will help you decide where you need to be involved and what you can teach them. The goal, Dr. Robinson says, is that by the time they are a young adult, they will be able to manage their allergy on their own.

   Parents can assess their child's ability to manage their allergy based on three questions:

   • Can they be responsible for having their medication available at all times?
   • Can they assess their own symptoms (and tell someone, if needed)?
   • Can they self-administer their auto injector (i.e., epi pen)?

    
   For example, a 5-year-old is probably not old enough to tell their teacher where their medication is located. But a 10- or 11-year-old should be mature enough to carry their auto injector with them wherever they go.

2. Role play with younger children

   Teach children how to communicate with others about their allergy. Say something like, "If I'm Michael's mom and I bring cupcakes for his birthday, what will you do to be safe?" You can create practice scenarios for many situations, like what to do if the child accidentally ingests the allergy-inducing food.

3. Engage with your school about a food allergy plan

   As soon as possible, discuss with your child's teacher how to create a safe environment in the classroom. This doesn't always mean an allergy-free room; it might mean that your family gives a classroom presentation or sends a letter to other parents making them aware of the allergy. Also make sure you give the teacher a Food Allergy Action Plan, which your child's doctor should provide to you.

4. Encourage your child to tell others that they have a food allergy

   The more people in your life who are aware of your child's allergy, the safer your child will be. Dr. Robinson encourages children to tell teachers, friends and other parents about their food allergy. It can be simple as, "I can't have any food with peanuts in it because I'm allergic to them."

5. Teach kids with food allergies to read food labels

   By the time your child is around age 8, you can teach them to check labels for the food specific to their allergy. Set the expectation that once they know how to read a label, they should read them every time they try a new food. If there is no label, and they don't know what's in the food, they shouldn't eat it.

6. Include the other siblings

   Sometimes other siblings have strong feelings about the food allergy. They might be mad that you don't keep peanut butter in the house or don't eat at a certain restaurant. Sometimes they might feel left out. Model flexible problem solving by trying alternative products such as coconut milk (for a dairy allergy) or packaged, frozen peanut butter and jelly sandwiches (for a peanut allergy). You could also have one parent take just that sibling to the restaurant of their choice for a special meal.

7. Keep an eye on your own stress

   When you're stressed, your kids will be stressed, and that can make it more difficult for everyone to feel confident about managing food allergies. Recognize where your anxiety lies. Are you afraid that something will happen to your child? Are you angry at the way others respond to your child's allergy? Are you frustrated because you and your partner don't agree on the best way to manage it? Identifying the source of your stress will help you figure out ways to tackle it. Be proactive about educating yourself and your family. Keep communication open with doctors, school personnel, family and friends.

Food allergy resources

It can also help to connect with other parents through a support group, such as FARE.

And remember, Dr. Robinson says, "There's a huge group of people out there managing their food allergies perfectly."