Allergy Shmallergy

Simplifying life for families with food allergies.

The Fire Drill – 5 Key Lessons from an Intensely Scary Night February 22, 2017

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I had been home from the restaurant only ten minutes with my preschooler almost tucked into bed when I got the call.

 

“Miles isn’t feeling well. He’s nauseous and is having terrible asthma. We’re heading home early,“ my husband informed me calmly. My husband and two sons left our regular sushi dinner to attend a tennis lesson, still chewing as they walked out the door.

 

My oldest son has suffered from asthma since he was 10 months old, but this just didn’t sound like the typical onset of asthma for him. Something about Eric’s voice suggested something “other.” “Do you think it could be a food allergy reaction?” I asked.

 

“I don’t know; but we’re getting home as quickly as possible.”

 

Completely abandoning my daughter in her bed, I walked to our emergency medication and unsheathed the freshest EpiPen. I was reviewing our emergency action plan as headlights tore into the driveway.

 

Calm but focused, I greeted my son at the door. He was red and hot and choking out words as I tried to check in with him about his symptoms. He could barely speak. He felt nauseous and clutched his stomach as he made his way into the bathroom, afraid he would throw up. His description of his symptoms came out in – sometimes inaudible – spurts. He was fighting for breath. He felt and looked worse than I had ever seen him.

 

While my hand calmly rubbed his back and my eyes scanned his face assessing the situation, a million thoughts raced through me in a nanosecond. Was it something he ate? Was he possibly reacting to a new allergen? Was this anaphylaxis or pure asthma…or both? The flu and other upper respiratory viruses were spreading so rampantly that nearly a third of my son’s class was out that week. And, he had mentioned having a headache and feeling a little nauseous after school – something that had seemingly subsided by dinner.

 

No matter how I weighed my options, a few small words reverberated in my brain: two systems. Most emergency action plans state that if two or more essential systems (gut/stomach, lungs, skin, heart) are affected in an allergic reaction, epinephrine should be administered immediately. I held up the auto-injectors behind my son’s back, signaling to my husband that we might need to use them. Neither of us have had to use an auto-injector on my son before (knock on everything wooden). We knew it was probably the right call now. We were both looking for the other to validate that decision.

 

As with all things, I wanted the use of the auto-injector to be the absolute right decision. I called my father-in-law, a doctor of more than 40 years, for one last vote on how to proceed. It was a brief conversation. “Get him breathing! Give him albuterol, I’m coming right over.”

 

Having caught sight of me waving the EpiPen in the air to my husband, my son had now begun to sweat with panic – making everything much worse. I sat him on the couch and tried to cool him off for just a moment – considering the facts again. Asthma. Nausea. No throat, mouth, or tongue swelling. No hives. No clear relationship between this reaction and food – but always a real possibility.

 

I looked at my sweet boy once again, suffering for breath, and noticed his pallor wasn’t quite as red any longer; it was now tingeing blue. I grabbed the epinephrine and pulled off the safety cap. At that very moment, my brother-in-law (another doctor) and father-in-law walked through the door. With stethoscope in hand and exuding a calm and caring in doses that make me tear up in appreciation even now, they examined my son and set him up on a nebulizer – a machine that delivers asthma and other respiratory medications as a penetrating, breathable mist.

 

We monitored Miles’ pulse (which was steady) and his breathing (which was labored and difficult). It took a lot of medication and effort, but Miles began processing air more efficiently. I didn’t realize until the second hour of treatment that I had been clutching his auto-injector the entire time.

 

As Miles’ color returned and the dust began to settle, he began to recall details about his day – clues that might have been helpful earlier. Like, the fact that he experienced asthma during recess at school. As he continued to improve, we noted that he was simultaneously experiencing a migraine, which can bring about nausea. Together, we determined that this was likely an acute asthma attack and not a result of his food allergies.

 

All four adults watched Miles for another several hours (well into the night) before anyone was willing to even entertain sleep. And, by then, sleep didn’t come so easily. I awoke in a gasping sweat several times that night and slipped into my son’s room to check on him. At around 5:45 am, I placed my hand on his back and he broke the quiet of the pre-dawn, humorously stating, “Mommy. Your hand is like a furnace!” Smiling and with great relief, I knew the sun would come up that morning and all would be well.

When I relayed these events to my own father, he captured it perfectly. “You had a fire drill last night.” We certainly did. And, as with any good training exercise (intentional or not), we learned some valuable lessons that night.

 

  1. Trust your instincts. I knew we needed to use epinephrine. Had there not been two doctors in the family within arms’ distance from me, I would have absolutely used it. And, so would my husband. Even though it was not anaphylaxis and everything turned out well, I STILL regret not having used the auto-injector sooner. I had my doubts about a food allergy reaction for a number of reasons. The afternoon nausea as well as the absence of hives and swelling gave me pause – which is why I called my father-in-law. But, did being right about his diagnosis make me feel better about my hesitation? No. Severe food allergic reactions can present themselves with a number of symptoms and they can escalate very quickly.

 

  1. Always, ALWAYS carry your epinephrine auto-injector with you. EVERY TIME. And, make sure that your friends, family and/or whoever is caring for your child knows how to use it (procedures are slightly different for Auvi-Q, the Adrenaclick and the EpiPen, so I recommend reviewing often). In our case, we accidentally forgot to transfer the auto-injectors from my purse to my husband’s bag, taking for granted that he’d no longer be around food; out only for an hour to play tennis. Thankfully, we live two minutes from the tennis courts. But had they been further, my husband would ABSOLUTELY have needed those auto-injectors.

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  1. As if you needed an extra reason to carry your auto-injectors: Those who have asthma are more likely to suffer from severe food allergic reactions– particularly if that asthma is not well-controlled. Asthma can complicate food allergies. Asthma occurs when there is narrowing of the airways, making it difficult for an individual to take in the proper amount of air. In my son’s case, his lungs were taking in so little air that initially my father-in-law couldn’t hear any movement with his stethoscope. No wonder he was turning blue. In an emergency situation, epinephrine can be used to treat a severe asthma attack. We were milliseconds from using it.

 

  1. If you use an epinephrine auto-injector you must go the nearest emergency room immediately. This is not because you gave the injection. Rather, those having severe food allergic reactions need additional medication and treatment. Furthermore, patients can suffer something call a bi-phasic reaction – that is, a second, delayed bout of anaphylaxis. It is estimated that up to 20% of patients suffer such a reaction.

 

  1. Once Miles went to sleep, we recapped the night with my father-in-law, who’s served in some fast-paced emergency rooms. I’ve been repeating something he said that night to everyone who will listen:

“We used to tell surgical residents,” he began, “‘If you’re considering performing a tracheotomy, then you need to do a tracheotomy.’”  The same holds true for anaphylaxis. If you think you might need to use an auto-injector, then you DO need to use one. If you’re considering it, then the time is now.

 

I’m beyond grateful that our story ends happily.  I pray you all never have to experience the intensity of a severe reaction (whether that be from food allergies or acute asthma).  But I hope that by sharing our experience and the lessons we learned, your story will end happily, too.

 


 

Essential Resource:

I can’t recommend enough this informative piece on when to give what medication during a severe allergic reaction. The information contained in this article echoed in my head during the above incident.

 

From the Food Allergy Treatment Talk blog:

Putting the Fire by Dr. Brian Schroer

 

Show Them the Love this Valentine’s Day with Non-Food Fun for your Home or Classroom February 2, 2017

Filed under: Uncategorized — malawer @ 9:30 am

Valentine’s Day is around the corner!  Who doesn’t LOVE that?!  But food and candy-centric holidays pose a challenge to teachers and parents alike.  Balancing fun with food allergy safety (not to mention sugar consumption) is a tight rope walk to be sure.  In addition to safety, teachers also strive for inclusion.

Luckily, there are plenty of clever crafts and games to be played for Valentine’s Day!  Thanks to Oriental Trading, here are just a few that we LOVED!

Now is a great time to order for delivery before the 14th!  Plus, here’s a link to Oriental Trading’s coupon page so you don’t break the bank:  Oriental Trading Promo Page.

First, set a festive tone with this pin-punched foil heart garland.  It’s long enough to string against an entire classroom wall.  Or, double up for impact. My 4 year old daughter loved that they twinkled against the sunlight.  What preschool girl doesn’t love a little sparkle?!

Here is this Valentine Garland  and here are some similar options.


We ALL loved decorating these adorable Color Your Own Monster Valentine Boxes.  My son, daughter, niece and I all traded markers while we swapped stories and talked about our weekend.  This would be a great in-class activity – I forgot how relaxing easy art projects can be.  And, both boys and girls like the fun design!

And, how cute are those Valentines?!  Both the Inch Worm Valentine and the Mini Finger Valentines were HUGE hits!

This adorable fingerprint craft was simple enough for my preschooler to do.  Plus., she loved getting a little messy in the process.  Not only did this keep her attention for JUST the right amount of time, but clean up was a breeze with soap and water.  The Valentine Tree Thumbprint Poem Craft is a kit that includes supplies for 12 trees – great for a classroom activity and a keepsake parents will cherish!




To get the kids moving, why not have a airplane race?!  Whose can go the furtherest?  The highest?  Can anyone get theirs to loop?  You could keep a class busy all afternoon with these fun and sturdy Peanuts Valentine Gliders.

We’re currently working on these sweet, mobile project to bring to the grandparents. The Color Your Own Heart Mobile kit is a set – great for occupying play dates, a group of students or your own kids for an afternoon.  They are so cheerful!

If you must serve something, aim for natural foods outside the top 8 allergens (dairy, eggs, peanuts, tree nuts, shellfish, fish, wheat, and soy).  Think: popcorn (read labels, some contain milk) and colorful fruit kabobs.  You’re going to want to serve something once you check out these cute dessert plates and cups:

Red Beverage Napkins

Frosted Fun Dessert Plates

Valentine Heart Snack Cups

Happy Valentine’s Day everyone!

**This is a sponsored post. However, I only write about and recommend products that I actually use and that I believe are beneficial to the food allergy community.**

 

Understanding the New Peanut Allergy Prevention Guidelines January 31, 2017

**Not a medical professional.  As always, please discuss specific recommendations for your child with your doctor.  The below is to inform you of pediatric guideline changes and their purpose.**

 

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Earlier this month, experts from the National Institute of Allergy and Infectious Disease (NIAID) issued new recommendations to help families prevent peanut allergies.

 

While there are a lot of intricacies involved in the research and its findings, the results are clear:  early introduction of peanuts can help prevent the development of a peanut allergy.  And, that’s big news!

 

Background:

Peanut allergies (and food allergies in general) are a growing problem.  The rate of food allergy has doubled in the last 10 years alone.  And, only 1 of every 4 children allergic to peanuts will outgrow their allergy.

 

Prior to 2000, doctors didn’t give new parents much advice about feeding their infants allergenic foods (such as milk, eggs, peanuts, fish, etc).  Beginning around 2000, the general consensus was that delayed introduction might help developing immune systems handle these proteins more efficiently.  In 2008, doctors didn’t really give parents a strong direction either way.  However, that same year, researchers compared the rate of peanut allergy among Jewish kids in the UK (where they delay introduction), to those in Israel (where they feed a peanut-based snack as some of their babies’ first foods) and were stunned to see the difference.  Children in Israel had a far smaller rate of peanut allergy than their counterparts in the United Kingdom.  It became clear doctors and researchers needed to revisit their guidance.

 

Thus, began the 5 year LEAP study (Learning Early about Peanut Allergy), one of the most successful allergy trials that has been conducted to date.  It took children with severe eczema or egg allergy and broke them into two groups: one group was fed peanuts early and one avoided them.  Published in the New England Journal of Medicine, the study revealed that early introduction of peanut reduced the incidence of developing a peanut allergy by up to 80% and had lasting effects.

 

Current Recommendations:

Based on their findings, the NIAID broke down their recommendations into three categories:

 

Guideline 1:

If the baby has an egg allergy (which is inexplicably related to peanut allergy) or has severe eczema (a persistent, scaly rash associated with allergy), speak with your doctor or a specialist about testing for peanut allergy.  And, speak with her/him about best ways to proceed with introduction.

 

In their own words, the NIAID states:

“Guideline 1 recommends that if your infant has severe eczema, egg allergy, or both (conditions that increase the risk of peanut allergy), he or she should have peanut-containing foods introduced into the diet as early as 4 to 6 months of age. This will reduce the risk of developing peanut allergy.

Check with your infant’s healthcare provider before feeding your infant peanut-containing foods. He or she may choose to perform an allergy blood test or send your infant to a specialist for other tests, such as a skin prick test. The results of these tests will help to determine if peanut should be introduced into your infant’s diet and, if so, the safest way to introduce it. If your infant’s test results indicate that it is safe to introduce peanut-containing foods, the healthcare provider may recommend that you introduce peanut-containing foods to your infant at home. Or, if you prefer, the first feeding may be done in the healthcare provider’s office under supervision. On the other hand, testing may indicate that peanut should be carefully introduced at a specialist’s facility or not introduced at all because your child may already have developed an allergy to peanut.

Follow your healthcare provider’s instructions for introducing peanut-containing foods to your infant.”

 

Guideline 2:

If your child has mild to moderate eczema, peanut-containing products can be introduced beginning at 6 months of age.  Check with your doctor or specialist to confirm that his/her case of eczema is considered mild to moderate and discuss introduction.

From NIAID:

“Guideline 2 suggests that if your infant has mild to moderate eczema, he or she may have peanut-containing foods introduced into the diet around 6 months of age to reduce the risk of developing peanut allergy. However, this should be done with your family’s dietary preferences in mind. If peanut-containing foods are not a regular part of your family’s diet (and your infant does not have severe eczema, egg allergy, or both), do not feel compelled to introduce peanut at such an early stage.

Your child’s healthcare provider can tell you whether your child’s eczema is mild to moderate. You may then choose to introduce peanut-containing foods at home. However, if you or your healthcare provider prefer, the first feeding can be done in the provider’s office under supervision.”

 

Guideline 3:

If your child does not have an egg allergy OR eczema, you may freely introduce peanuts with other solid foods.

 

The flow chart and summary from Science News, spells it out clearly if you need a visual.

 

 

How DO you introduce peanuts to an infant?  Do I need to look out for anything special?

  • First feeds should be offered after you have tried other first foods (such as rice cereal) so that the baby learns to suck and swallow these news textures and to ensure that your baby tolerates these typical foods.
  •  DO NOT feed babies whole peanuts as they pose a choking hazard.  Babies lack both the teeth and the development to properly manage peanuts.
  • Once introduced, watch for 10 minutes and up to 2 hours for signs of a reaction.  In a baby, you might see: hives, cough or gasping, vomiting, you might notice they are more cuddly and needy.  If you suspect a reaction, seek immediate medical attention.
  • Once tolerated, aim for regular ingestion.  The recommended frequency is 2g of peanut protein three times a week.

 

What does 2g of peanut protein look like?

In Israel, parents feed their children a snack called Bamba – a dissolvable, airy snack that contains peanut protein.  Shaped like a Cheese Doodle, 2/3 bag of Bamba equals 2g of peanut protein.  To begin, you can crush the Bamba and mix it with water to feed.

 

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photo by robinmcnicoll via Flickr – unaltered and posted according to Creative Commons Attribution 2.0

If you’d like to use peanut butter, 2g of peanut protein is equal to 2 tsp or 1 household spoon (as in, from your utensil drawer).  Mix SMOOTH peanut butter with hot water and COOL.  You can then mix it with fruit or vegetable puree before serving.

 

Two grams of peanut flour or protein is equal to 2 tsp.  Again, these can be mixed with fruit or vegetable purees.

 

(Peanut containing cereals were not specifically recommended because of the varying levels of peanut protein as well as sugar and sodium content by brand.)

 

A few notes: 

For those of you, like me, whose children are already allergic.  This is not instruction to begin feeding them peanuts.  DO NOT!

 

And for those of you, like me, who read these guidelines and felt guilty about eating peanuts during pregnancy and breastfeeding… or NOT eating peanuts during pregnancy and breastfeeding…  or delaying introduction (as we were instructed at that time):

 

You did not cause your child’s food allergy.  There IS no single cause of food allergies.  As Dr. Matthew Greenhawt of Children’s Hospital Colorado kindly offered, “This was nobody’s fault.  You followed the best data at the time.  Your avoidance didn’t cause [your child’s] peanut allergy.”  I’ll be honest, I welled with tears hearing this from an allergist.

 

This exciting news represents a paradigm shift in the prevention of food allergies.  Here’s hoping that future generations won’t be plagued by the same number and severity of cases!

 

Download NIAID’s full recommendation report here:  Addendum Guidelines for the Prevention of Peanut Allergy in the United States.

 

Auvi-Q’s Returning to Market With an Innovative New Approach January 23, 2017

Oh, happy day!

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Auvi-Q is coming back to market on February 14, 2017!

As many of you already know, Auvi-Q is an innovative, FDA-approved epinephrine auto-injector that is about the size of a deck of cards.  Auvi-Q was invented by twin brothers, Eric and Evan Edwards, who suffered from severe, life-threatening food allergies as children. Eric Edwards, an MD, and Evan Edwards, an engineer, teamed up as adults to invent this unique and effective life-saving device.

 

This product has a very valuable place on the market:

  • It fits in your pocket – making a great choices for dads, preteens and teens;
  • It speaks the instructions, step-by-step – reducing the worry over training and operation;
  • Auvi-Q’s needle retracts immediately after injection, mitigating the possibility of lacerations and making it safe to handle.

 

But that’s not even the best part.  Not only are Eric and Evan patients, they’re also food allergy parents who understand the needs of our community from a unique, first-hand perspective.  After speaking to patients and considering their own family’s needs, they wanted to ensure all families had access to and could afford their product.  So they are introducing AffordAbility, a first-of-its-kind program under which the vast majority of patients (including those with high deductibles) can obtain Auvi-Q for $0.  And, not only will the product be free for so many patients, but Auvi-Q will also be available for direct-delivery to your home (in most cases, in less than 48 hours in insulated packaging).

 

The makers of Auvi-Q, kaléo Pharma, wanted to remove as many of the barriers families face in order to ensure that the patients who needed this life-saving medication would be able to obtain it.  No family should have fear they are unprepared to help in a life-or-death severe allergic reaction such as anaphylaxis.

 

The Auvi-Q website is a wealth of information: Auvi-Q.com.  Please refer to it for further questions the device, prescription, the AffordAbility program, and direct delivery service.

 

 

 

MLK Day: Inclusion and Action January 13, 2017

Filed under: Advocacy,Uncategorized — malawer @ 12:01 am
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One week ago, I found myself chaperoning a large group of 6th graders on a field trip to the National Cathedral.  You could tell right away we had a great guide.  She was 84 years old and wore a headset microphone that was clearly turned off but still commanded the kids total attention.  A former educator, she wasn’t just a teacher (and a student) of history.  She was part of it.  She lived it.  She was woven into story after story about the cathedral and its visitors.  As our guide led us to the pulpit where Martin Luther King, Jr gave his last sermon, she described the mood of the sermon as solemn – almost as if he knew he may not make it. And, she would know.  She sat and listened only a few feet from the man himself.

 

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As we approach Martin Luther King Jr. Day, there are two things that stand out on my mind.  Two things that are universally important – but especially critical to food allergy families whose worlds are fraught with uncertainty.

 

The first is INCLUSION.  The effort of inclusion is an act of kindness and humanity.  Everyone wants to be welcomed by their peers, their parents, the people around them. Inclusion is an act of thoughtfulness.  So much of coming together involves food:  in times of happiness and celebration, sadness and consolation.  Food is a hallmark of society, tradition and culture.  When we don’t make accommodations to include a member of our group, we’re sending a message that they are not a valued member of our society.

 

I know I’m preaching to the choir here.  As food allergy parents and those with food allergies ourselves, I know you understand.  It nearly brings me to tears of appreciation when someone goes the extra mile to include my son – even in the smallest way.   It’s not lost on him either.  He feels seen, validated.

 

Efforts of inclusion, of focusing on ways to connect with each other, is more important today than it’s ever been.

 

The other sentiment that keeps circling around my brain is ACTION.  If we want to improve life for us and our kids, we need to live actively.  The path to a better, more understanding community is involvement.  While we wait for extended family, friends, peers, teachers, and school administrators to understand and support the needs of our particular community, let’s connect with one another and actively help each other out.  When you’re sending in a birthday snack, call the other food allergy parent in the classroom and find out if your snack is safe for their child.  Decorate the peanut-free table and make it THE place to sit in the cafeteria.  Talk to your child about what to do if they see a friend having a food allergy reaction.  Help educate a friend who recently received a food allergy diagnosis.  Check in with them and let them know you’re there to vent frustrations to and to celebrate victories with.

 

Martin Luther King Jr. once said,“Life’s most persistent and urgent question is: ‘What are you doing for others?'”  This is why we celebrate the memory and influence of Dr. King by engaging in service.  When my kids are involved in being charitable with their time and creative with their energy while helping others, they take ownership of and are active participants in their community.  Their world becomes less uncertain and more able to be shaped by their direct actions.  Let’s be inclusive of one another.  Let’s be kind and supportive of each other.  Maybe others will pay that kindness forward.  And, maybe, just maybe, that kindness will find its way back to you.

 

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Photo taken by Sharon & Nikki McCutcheon

 

 

 

Help Fund a Cure for Food Allergies January 10, 2017

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“Why can’t I just be like everyone else?”

If you have a child with food allergies, you’ve likely heard this heartbreaking sentiment from your kid.  We’ve all had to console this same child who just wants to put aside his/her food allergies and anxieties even if only for a single day.

Parents would go to any length for the sake of their kids.  Food allergy parents often do by preparing safe food, educating others, strategizing for school, holidays, play dates, and celebrations.

 

But how many of us have done 3,000 burpees for them?

 

That’s what fellow food allergy parent, Mike Monroe, plans to do on January 25th in order to raise money for ongoing research for a cure for food allergies.  Mike’s goal is to raise $50,000 to support cutting-edge research examining novel applications of cellular therapy for the millions of kids with food allergies being explored at Children’s National Medical Center in Washington, D.C.

 

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marines_burpee by U.S. Embassy Tokyo via Flickr

 

What’s a burpee, you might ask?  It’s a combination of push-up/plank, squat and jump performed in combination.  Try one right now!  Do another.  I think you’ll agree: it’s NOT easy!  Mike plans to complete 3,000 of these in under 12 hours.

What can you do to support Mike?

 

1.  Watch this video about Mike’s incredible motivation – his son, Miles:

 

 

2.  Consider a donation:  Every little bit helps get us all closer to a cure for food allergies.

3K Burpee Challenge for Food Allergies

3.  Share this post!  Please share this with your family and friends, share via Facebook, Twitter, Instagram and other social media channels.  Let’s support Mike and researchers to help our own kids and the millions who face life threatening food allergies every day!

 

 

Donate:

http://childrensnational.donordrive.com/campaign/BurpeeProject

Blog:

http://www.3kburpeechallenge.com/

Facebook Page:

https://www.facebook.com/3KBurpeeChallenge/

YouTube Video:

https://www.youtube.com/watch?v=KSVGTkFtnyk&feature=youtu.be

 

Take the Reins in the New Year: Food Allergy Goals and Resolutions January 4, 2017

Filed under: Holiday,Uncategorized — malawer @ 8:00 pm
Tags: , , , , ,

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It’s a new year!  A time to look ahead and move ever forward with our lives.  And with the beginning of each new year comes hope and possibility.

 

We’re moving forward into this new year with food allergies, so let’s do it with intention.  Let’s set some goals to color our journey and enrich our lives!

 

Here are some of my personal food allergy resolutions this year:

 

– Continue to foster a strong sense of self in my son. Empower him to speak up and stand strong.

– Arm him with enough information to help him make good, sound decisions – even as he approaches those risky pre-teen and teenage years.

– Teach my son cooking skills and creative work-arounds.  Balance his love of adventurous eating with a sense of both ingredients and process used to create various cuisines.  Asian fare with a sesame seed allergy?  Yes!  Dairy-free baking?  Of course!

– Continue to advocate for food allergy families everywhere – to make life easier and less stressful for everyone, ourselves included.

– Move forward in helping at-risk families with food allergies.  Learn more about ways to improve the lives of low income families, food insecure families, as well as those affected by natural disaster or other extenuating circumstances.

-Focus on food allergy education in schools and the greater community as well as positive parenting for food allergic families.

 

What are your food allergy goals for this year?  Let us know what you have on your radar for the year ahead.

  • Traveling with food allergies
  • Recipes and party ideas
  • Advocacy efforts
  • Latest research and treatment options
  • Empowering your child
  • Food allergies at school

 

What do you want to learn more about?