Allergy Shmallergy

Simplifying life for families with food allergies.

The Impact of Adult On-Set Food Allergies March 25, 2019

People often think of food allergies as a childhood disease, where 1 in every 13 kids have a food allergy.  And, much attention DOES need to be paid to the developmental years to keep young food allergies patients safe.

 

But recently, Dr. Ruchi Gupta and her research team reported that 1 in 10 adults have a food allergy in the United States – that’s 26 million adults.  This more than doubles previous estimates putting the total number of patients with food allergies over 32 million people in the US.

 

Beyond the fascinating information presented in her study.  This has tremendous implications outside of the medical field.  This number changes the discussion in a variety of industries who should now be taking food allergies into account in a way they may not have before.

 

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To put it in all in context, food allergies affect:

  • 1,500 passengers that fly Delta daily
  • 260,000 passengers that the FAA serves daily in and out of U.S. airports
  • 520,000 visitors to Disney World annually
  • 15,000,000 guests at Hilton Hotels annually
  • 10,000,000 diners at fast food establishments annually
  • Almost 2,900 ticket holders at each and every Major League Baseball game
  • 72,000 fans annually at AT&T Stadium watching the Dallas Cowboys play
  • 400,000 teachers in primary and secondary schools
  • Nearly 95,000 people working as chefs, cooks and other food preparation employees

 

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But, these numbers aren’t exactly representative of all those who are affected by food allergies.  Parents, siblings, co-workers and friends all make decisions based on their companion with food allergies.  And, when handled well, those experiences flying, visiting amusement parks, staying at hotels, eating in restaurants, attending events, etc, leave a lasting impression that breeds customer loyalty.  Companies need to carefully consider food allergies and implement best practices to gain and retain this kind of loyalty.  If 32 million Americans suffer from food allergies directly, it may be safe to assume that as many as 120 million Americans are affected by them indirectly by enjoying time with allergic friends, family and co-workers.

 

Mistakes with food allergy do not only lead to uncomfortableness (such as hives), as many who do not have food allergies sometimes believe.  They can lead to serious emergencies as reactions vary from simple hives to fainting, throat closing, respiratory distress and cardiac issues and need to be taken very seriously in order to be managed properly.  This requires education across the board and thoughtful policies that offer patients a safe experience.

 

What can companies do to offer safe options to those with food allergies?  Where can they be more transparent?  What can they do educate their employees?  How will they prepare for a food allergic emergency?

 

It will be interesting to see which companies embrace these statistics and what they do to do be sensitive to this epidemic.

 

 

 

 

Including Food Allergic Students at School September 17, 2018

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It’s the beginning of the school year!  Now is the perfect time to discuss best practices to keep kids with food allergies included in the classroom and beyond.  What are the best ways to keep a child safe at school?  How is teaching a food allergic child different from one without dietary restrictions?  How can teachers and parents better communicate to ensure a productive year together?

 

One of the most difficult and important places to manage food allergies is at school.  Parents, faculty, staff and administrators want and need to keep food allergic students physically safe during the school day – a place children spend the largest portion of their time outside the home. Inclusion at school is the “safe place” they need to develop psychologically and socially.

 

Where do schools begin and what factors should they consider?  

 

Education:  Not surprisingly, it all begins with EDUCATION.  Faculty and staff should be educated and reeducated about food allergies each year.  They should not only know:

but they should also learn about the perspective of their food allergic students who experience anxiety and exclusion at higher rates than their peers.

 

I urge all schools to consider adding Food Allergy Education to their Health curriculum.  Students are exposed to the idea of food allergies without understanding exactly what that means. Understanding food allergies is shown to build inclusion and community, stoke empathy and protect peers in students pre-K through high school.  In less than 20 minutes, a teacher can cover a basic lesson plan on food allergies and reap all of the above benefits in his/her classroom for the entire year.

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Exclude the FOOD (not the CHILD).

Eating In the Classroom:  Parties, holiday celebrations, and special events should be as inclusive and safe as possible.  I’ve heard from many families across the country whose children have been sent out of the room during class parties because their allergen was being served;  children who are sent to eat with the school nurse instead of their friends; children who are told to stay away from the group who are eating an allergy-laden snack while they watch.  When such a thing occurs, the message that student receives from their teacher is that their classmates’ enjoyment is more important than they are.  At such times, the student will struggle with feeling of self-worth and the [correct] impression that their teacher doesn’t know how to handle food allergies.

 

Eating Outside of Class:  Prepare for field trips by remembering food allergic students.  Snacks and lunches need to be safe.  And, don’t forget to bring emergency medication (and store it with a chaperone AT ROOM TEMPERATURE).  The best way to keep these special learning experiences special is with advanced preparation and by communicating with parents and the students directly to address concerns and implement solutions.

 

Think through the full school day for an allergic student.  How will they fare on the bus ride home?  What is the school’s policy on eating on the bus?  Is it enforced?  Is the bus driver trained and prepared to deal with an allergic reaction?  Is an allergic student allowed to carry their own epinephrine?  How does the driver handle bullying on his/her bus?  Addressing the entire school day from door to door will make a child with food allergies feel protected and looked after.

 

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Bullying by Peers or Adults:  Exclusion, name-calling or verbally doubting sets an example for the other students that such behavior is acceptable and results in stigmatizing the food allergic student. Bullying is another serious problem for all students but can have serious and even deadly results for students with food allergies.  Read the statistics here to understand the scope of the problem which is often based at school.

 

Uninformed Teachers:  Students with food allergies are savvy about their condition and quickly note when others aren’t as knowledgable.  Teachers who demonstrate a lack of knowledge do not instill confidence in even the youngest food allergic child.  Students who are concerned about surviving the day in their classroom, cannot learn.  Creating “safe zones” is psychologically beneficial to students with food allergies.  One such example is a peanut-free table or a classroom that bans a certain food for the health and protection of a student’s life. Another method is to establish a special line of communication between the teacher and student so they can express their concerns privately.  I recommend that teachers meet with a food allergic student and their parents to acknowledge that they understand the parameters of that child’s allergy, that they take it seriously, and agree upon the best method of letting parents know about upcoming events so that the family can prepare.

 

Solid and Protected Food Allergy Policies:  Schools must create a safe environment for students with life threatening food allergies. This protection begins with a comprehensive food allergy policy – one that balances safety with an emphasis on maximum inclusion.  The policy and procedures regarding food allergies need to be widely communicated, easily accessible, consistently applied and protected.

[Read: Food Allergy Policies at School (Aug. 14, 2018) – Considerations and Perspectives for more on what goes into a well thought-out policy.]

 


 

Inclusion means everything to food allergic students who already feel different from their peers.  Inclusion gives students a supportive platform from which to conquer the world.  Schools need safe places for kids to learn, socialize and play.   They are more than a place to grow academically; schools should be a space for students to blossom psychologically as well.  A lot of thought should go into how to include every child in the classroom – it might make all the difference for your students AND their families.

 

 

 

Food Allergies: Overcoming Disagreements November 27, 2017

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The holidays are a magical time – filled with hope and kindness.  But when you have food allergies, holiday gatherings are sometimes filled with the possibility of being excluded, disappointed, or the fear of having a food allergic reaction.

As parents and patients, we feel like we are constantly educating others about food allergies.  Our extended families and friends surely should know by now how real and severe a food allergy can be – shouldn’t they?!  Unfortunately, many times our family and friends don’t understand.  They underestimate the severity of a reaction and the amount of time and energy we put in to preparing for a regular day – never mind a holiday!  We often feel let down and angry when others don’t take food allergies into consideration or are set on upholding their traditions at the expense of someone else’s health and safety.

These disagreements around the holidays can set off a chain of unhealthy interactions that could cause relationships to strain.  Don’t end your relationship with family or friends.  Try the techniques outlined in the article below first and see if you can teach them about what your life with food allergies is really like.

Please read this article I wrote, published in the magazine Allergy & Asthma Today by the Allergy & Asthma Network, for more information.

http://bit.ly/2ncAJHY

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The Dangers of a Dairy Allergy November 17, 2017

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Three year old, Elijah Silvera, was attending a regular day of preschool in New York City recently, when preschool workers fed him a grilled cheese sandwich despite school papers which formally documented his severe dairy allergy.  Elijah had a severe allergic reaction and went into anaphylaxis.  Standard procedure for anaphylaxis is to administer epinephrine and call 911 immediately.  Instead, the school called Elijah’s mother, who picked up her child and drove him to the hospital herself.  Doctors in the emergency room tried but were unable to save him.

 

Dairy allergy is the most common food allergy among young children.  And, although the peanut can produce some of the most severe allergic reactions (as well as some of the most tragic headlines), an allergy to milk products can be life-threatening.  The myth that a dairy allergy is not serious and doesn’t require as much vigilance causes great frustration to many who are allergic to milk, as does the idea that a food is “allergy free” if it does not contain nuts. To those who live with it, a dairy allergy requires an enormous amount of preparation and education since milk is an ingredient in so many products.

 

Dairy is cow’s milk and found in all cow’s milk products, such as cream, butter, cheese, and yogurt.  Doctors sometimes advise patients with a dairy allergy to avoid other animals’ milk (such as goat) because the protein it contains may be similar to cow and could cause a reaction.  Reactions to dairy vary from hives and itching to swelling and vomiting, to more severe symptoms such as wheezing, difficulty breathing, and anaphylaxis.  Strictly avoiding products containing milk is the best way to prevent a reaction.  The only way to help stop a severe food allergy reaction is with epinephrine; patients should always carry two epinephrine auto-injectors with them at all times.

 

Just like other allergens, cross contamination is a concern for those with a dairy allergy. Even a small amount of milk protein could be enough to cause a reaction. For example, butter and powdered cheese (like the kind you might find on potato chips) are easily spreadable in a pan, within a classroom or on a playground.  And, as with other allergens, hand sanitizer does NOT remove the proteins that cause allergic reactions.  Doctors recommend hand washing with good old soap and water – but wipes work in a pinch.

 

Those allergic to dairy must not only avoid food; they often have to look out for health and beauty products too.  Dairy can be found in vitamins, shampoo, and lotions.  It is critical to read the ingredient labels of every product you buy each time you buy it as ingredients and manufacturing procedures may change.

 

In the United States, any food product containing milk or a milk derivative must be listed as DAIRY or MILK under the current labeling laws (see The Ins and Outs of Reading Food Labels, Aug. 2016).  If you are living or traveling elsewhere, this list of some alternative names for dairy may be useful:

 

milk (in all forms: goat, whole, skim, 1%, 2%, evaporated, dry, condensed, etc)
butter (including artificial butter and margarine)
cream
buttermilk
sour cream
half and half
yogurt
cheese
ice cream
custard
sherbet
pudding
chocolate
ghee
whey (all forms)
casein
caseinates (all forms)
casein hydrolysate
lactose
lactulose
lactoferrin
lactalbumin (all forms)
diacetyl
rennet casein

 

Let’s spread the facts about dairy allergy so that our schools and teachers better understand how to accommodate and care for students with food allergies.   Any allergen can produce severe, life-threatening allergic reactions and all food allergies should be taken seriously and managed with attention.  I sincerely  hope that by informing others we can prevent another tragedy like the one the Silvera family was forced to experience.

 

Food Allergy Retrospective: How Far Have We Come? May 17, 2017

When the term “food allergies” was first mentioned in our lives in 2005, my son was only a few months old.  Already suffering from severe, body-encompassing eczema and a family history of food allergies, my pediatrician mentioned that we’d have to approach first foods very carefully with him.  I thought she was being WAY overcautious.  Like a ridiculous amount.  I was told to avoid feeding him anything with peanuts, tree nuts, milk, egg, wheat, soy, shellfish, fish, strawberries, pork, and corn in it.  I remember thinking, who had ever heard of anyone allergic to corn?!  And, so much for Cheerios as a finger food!

 

Now twelve years later, I think about what a genius that same pediatrician was and what a long way we’ve come since that first discussion about food allergies.

 

In 2005, there were approximately 11 million Americans living with food allergies.  Today, there are 15 million. And that number is growing.  Back in 2005 there may have been 1 child with food allergies per class; now there are at least 2 in every classroom.

 

In 2005, there were no food allergen labeling laws.  Manufacturers could “disguise” ingredients under a variety of names.  If you were allergic to dairy, for example, you had to memorize over 45 different names of ingredients that contained milk protein (whey, cream, casein, lactose, curd, rennet, ghee, flavoring… read the complete list here).  There were no suggestions to include voluntary “may contain” statements.  And, manufacturers were not well informed about how to respond to customer service questions about the safety of their products.

 

In 2005, consumers had less choice of emergency medication but it was far more affordable.  A pair of EpiPens cost only about $50. Other epinephrine auto-injectors were hard to come by and Auvi-Q wasn’t even invented yet.

 

In 2005, I felt alone with my son’s condition.  I started writing about food allergies, in part, to reach out to other like-minded parents experiencing the same daily struggles and triumphs that I was.  There was no research about the psychological impact of growing up with food allergies.  I was figuring out how to parent a confident, competent kid AND how to safely navigate the world with food allergies all at once.

 

I am so thankful to you all today for being part of the Allergy Shmallergy community – for giving me feedback, reminding me that we’re not alone running into and overcoming food allergy-obstacles, and for supporting each other, helping to make each other’s lives simpler and happier.

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6 Sensational Books for Kids with Food Allergies December 19, 2016

The holidays are just days away!  Try giving a book that a family with food allergies will treasure.  Or, donate a book to your child’s classroom or school library!

 

Despite the growing number of cases, food allergic kids often feel alone with their allergy. It is so important for kids with food allergies to see this aspect of themselves reflected in literature and elsewhere.  Plus, these books are great teaching tools for both a child with a food allergy as well as their siblings and classmates!

 

1.The Bugabees – Friends with Food Allergies, by Amy Recob
Ages: preschool – 7
bugabees-book
Beautifully and colorfully illustrated, The Bugabees is a story about eight insect friends who each have one of the different Top 8 food allergies.  They talk about their need to stay away from various treats and lightly touch on allergic symptoms they might experience.  Importantly, the bugs each repeat a mantra for kids with food allergies which reinforces that they can have fun without their allergen!  My daughter immediately noted that her brother has food allergies and was singing along with their rhythmic mantra by the end!

 

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2.  The BugyBops – Friends for All Time is the sequel in which the Bugabees friends learn about why their friends avoid certain foods, what an EpiPen is and why it’s important, and what they can do to keep their friends safe.  This is a fantastic companion book to The Bugabees!  I would highly recommend for a classroom visit and school library.
Ages: preschool – 8

 

3. Joey Panda and His Food Allergies Save the Day: A Children’s Book, by Amishi S. Murthy, MD and Vivian Chou, MD
Ages: Preschool – 8
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Written by two pediatric allergists, the story of Joey Panda – a kid with multiple food allergies who is nervous about his first day of school, a situation that many food allergy families face.  To Joey’s surprise, not only does he find out that many of his new friends are already familiar with food allergies but that he has the knowledge and power to become a superstar.  This is story that acknowledges a child’s fears about going to a new school with food allergies and turns it into a story of empowerment.  Just the kind I love!

 

4.  The Peanut Pickle, A Story About Peanut Allergy, by Jessica Jacobs
Ages: 3-8

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Ben has a peanut allergy.  Sometimes he finds it hard to talk about.  But now that he’s six, he’s finding ways to tell family and friends about his food allergy.  Kids with food allergies will recognize themselves in Ben and the situations he faces – important for children who often feel alone with their allergy.  This is a great book for your child to practice what to say to keep him or herself safe.

 

5.  The Princess and the Peanut Allergy, by Wendy McClure
Ages: 5-9
The Princess and the Peanut Allergy

Centered around two best friends, Paula and Regina.  Regina wants a nut-laden cake for her birthday.  Her friend, Paula is allergic to peanuts – causing problems for them both.  The girls have an argument that is ultimately resolved when Regina realizes that having her nut-filled cake may compromise her friendship with Paula.  And, Regina surprises her friend by ordering her birthday cake nut-free.  The princess and pea analogy used to enlighten Regina works as a way of explaining that even the smallest bit of peanut could be extremely harmful to someone who is allergic to them.  Importantly, the book addresses some of the social issues that can arise from having a food allergy and helps articulate conflict resolution in an age-appropriate way.

 

6.  The Peanut-Free Cafe, by Gloria Koster
Ages: 5-9Grant is a new student at the Nutley School – where everyone enjoys PB&J at lunch. As a result, he’s forced to eat by himself at a peanut-free table.  In an effort get to know him, the school offers an irresistible peanut-free cafe for anyone willing to give up their peanut butter.  This story is clever and the idea of a creating a peanut-free cafe at our house and at his school greatly excited my son!

 

 

 

(Thank you in advance! A portion of the proceeds of affiliate links go toward AllergyStrong.org – an organization aimed at helping at risk families with food allergies.)

 

EoE – A Learning Process May 26, 2015

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My husband, my father-in-law (a doctor) and I have been trying to manage next steps in what appears to a forthcoming EoE diagnosis.  Ironic, considering last week was EoE Awareness Week, eh?!

 

So, what is EoE?

 

According to GIKids.org, Eosinophilic Esophagitis (EoE) is an inflammation of the esophagus.  The wall of the esophagus becomes swollen with white blood cells called eosinophils.  A person with EoE might experience trouble swallowing, pain, heartburn, nausea, regurgitation or vomiting. They may note mild symptoms like heartburn or more severe ones like the feeling that they are choking.  It’s a relatively new diagnosis that doctors are still struggling to learn more about.

 

This emerging health issue for my food allergic son has been brewing for at least the past year, growing steadily worse and more frequent each month.  Originally appearing to be a classic case of acid reflux, my husband and I tried everything suggested to reduce his discomfort.  We raised his head at night, tried to feed him earlier in the evening so that he had time to digest, stayed away from acidic foods as much as possible, and gave him acid reducing medication as directed by his pediatrician.  However, his symptoms seemed resistant to medicine and relatively unphased by our other efforts.  And, other symptoms were muddied with his food allergies and asthma.  My son would complain of burning in the lower part of his throat.  He began wheezing within only a few minutes of laying down at night.  He began complaining of pain (actual pain) in his stomach.  His throat felt “weird” after having dairy (to which he’s no longer allergic, but that symptom is always scary to food allergy parents!).  And, started articulating a sensation that finally rang my alarm bells on EoE:  he felt like he had something stuck in his throat.

 

We immediately went back to the pediatrician who ruled out a number of conditions like celiac disease and quickly thereafter booked an appointment with a pediatric gastroenterologist.  One Upper GI (where they watch barium travel down your esophagus and into the stomach via x-ray) and one Upper Endoscopy later and we’re only a *little* closer to figuring this thing out.  EoE is more common in patients with food allergies and other allergic diseases (like asthma) and far more common in males than females – although the connections aren’t clear.

 

While his doctors rule out causes, his symptoms persist and we have more endoscopies, food challenges and allergy tests (I almost can’t believe it) on the horizon.  I’m certain many of you have already gone through this cycle of testing and I would love to hear your experiences and any advice you have to offer.