Allergy Shmallergy

Simplifying life for families with food allergies.

The Dangers of a Dairy Allergy November 17, 2017

cereal and milk pixabay StockSnap

 

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.

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Updated: A Loaded Gun for Lunch May 9, 2016

Update (5/12/16):

Kellogg’s addresses some of the facts regarding their decision to add peanut flour to formerly nut-free snacks.   The public is still asking why, but this link should clarify some of what’s going on:

http://origin-www.openforbreakfast.com/en_US/content/nutrition/peanutflour.html

Again:  As it is not uncommon for formulations and manufacturing practices to change, this is a great reminder to check every label of every food you purchase every time.

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In early April, Kellogg’s added peanut flour to eight of its previously nut-free products. Several varieties of Kellogg’s Austin and Keebler cracker lines – crackers that have been safe to families and individuals with food allergies for many years – will now contain peanuts. Kellogg’s didn’t issue a press release or alert their customers directly.  Instead, hoping consumers would find and read their advisories, they notified FARE and posted a statement on their website mentioning the change without citing a reason.  But many families and other individuals with – or responsible for feeding those with – peanut allergies remained in the dark.

This change comes at a time when food allergies are on the rise and public health officials fear an “epidemic.” Food allergies have increased 50 percent in the last twenty years, currently affecting roughly 15 million Americans. Peanut allergies are among the most dangerous, causing severe allergic reactions called anaphylaxis – a condition that can cause a sudden drop in blood pressure, difficulty breathing, and death. Approximately 300,000 ambulatory visits per year are attributed to severe allergic reactions.

According to the non-profit Food Allergy Research Education (FARE), “Most allergic reactions to foods occurred to foods that were thought to be safe.” Imagine the impact of Kellogg’s addition. It’s like slipping a loaded gun into a child’s lunchbox.

The fact that Kellogg’s did not alert their consumers appropriately is disappointing to those with food allergies to say the least – maybe even reckless. To make a change that will knowingly impact the health of some of their customers without issuing a press release is inconceivable. Families, schools, daycare centers, aftercare programs and camps that rely on readily available nut-free snacks are likely still unaware of the addition of peanuts to Kellogg’s crackers and could be putting children in a perilous position unknowingly.

Adding insult to injury is the fact that Kellogg’s did not initially alter the packaging of the new formula of crackers so that a consumer would be clearly alerted of the additional ingredient. It is virtually invisible. [Update:  Kellogg’s has now updated the packing with a “Contains” statement located at the bottom of the front of the package in white.]

To date, Kellogg’s has not given the public an explanation for their decision to change the ingredients of these crackers.  Without an answer, speculation abounds.  Perhaps they were trying to add protein to these snacks.  Perhaps the crackers are made in a facility where peanuts are processed and the inclusion of peanut flour in the ingredient list reflects that.  SnackSafely.com, who has been leading the charge in informing food allergic families and individuals about the sudden change and who started a petition asking Kellogg’s to reconsider it, has a theory: could Kellogg’s be adding peanut flour to avoid the cost of complying with new FDA regulations? In an effort to protect the nation’s food supply, the FDA has raised their concern about food allergy cross contamination to the same level as food-borne illnesses. In doing so, it has put stricter manufacturing codes in place. Companies have until September 2016 to implement necessary changes. SnackSafely wonders, could it be cheaper for them to add peanut flour to their products in order to reduce cost in complying with the FDA’s Food Safety Modernization Act?   Until Kellogg’s clarifies, the public is left guessing.

Kellogg’s has responded to complaints and petitions, by vowing to remove peanuts from one of the varieties of crackers affected beginning in September. This hardly constitutes a consolation after confusing and endangering their most vulnerable customers.

Let this situation serve as a reminder to all to check the ingredient lists of all the foods you purchase for yourself and your family every time you buy them.

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After following this issue and reading the above, Fox 5 DC wanted to inform the public of this change:

http://www.fox5dc.com/news/140044884-story

http://up.anv.bz/latest/anvload.html?key=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

 

Food Allergies and Family – Disagreements Not Break-Ups April 12, 2016

I hear stories all the time from food allergy parents that their family members aren’t taking their child’s food allergy seriously.  And, this – of course – can have serious implications.  I’m also saddened to hear when this difference in perspective leads to family disagreements – or worse, families cutting one another off completely.

 

Our parents (our children’s grandparents) didn’t grow up with this alarming rate of food allergy.  In fact, many of them didn’t know a single person with a diagnosed food allergy.  Times have changes and current parenting is more active and vigilant than it was 30 years ago.  I’ve explained to many a grandparent that the rise in food allergies is not a trend of parent over-sensitivity or as a result of over-protectiveness, but -in fact- an actual, black and white medical diagnosis.

 

Grandparents and other family members may not understand the amount of work and preparation it takes to safely raise a child with a severe food allergy: the advanced preparation when eating out; repeated education of others; familiarity with labeling laws (such as the FDA’s FALCPA in the United States), alternative names for allergens and a general sense of where it might pop up and cause problems; the worry about our kids and the exclusion we fear they face.  Let’s face it, none of us were prepared for the intense amount of work prior to our family’s first food allergy diagnosis.

 

If there’s one thing I know for sure though, it’s that a parent’s love for their child is fierce.  It knows no bounds.  As food allergic parents, that fierce love we have for our children and our instinct to protect them may come off a little strong.  And, understandably so when we feel like their lives are in danger.  But in the face of difficult decision-making, our anxiety over their well-being may not offer the patient, gentle voice that our family and friends need in order to truly hear our concerns.

 

It doesn’t help that food allergy parents feel disrespected when their own parents don’t fully abide by or outright disregard their guidance about how to feed (and therefore protect) their children.  Food allergy parents can feel betrayed when others are unwilling to make changes to protect their children.

 

So, what can you do when you’re at odds with your family over your child’s food allergies? 

 

First, have a kind but firm talk about the allergies and severity of the possible reactions.  Do this when your child is not present.  Expect a lot of questions, so come prepared with answers from your allergist or pediatrician.  Bottom line: be informative and remain calm.

 

Reminder: don’t put your parents (…siblings, friends…) on the defensive.  Remember the “I” statements you were taught in school.  Now’s the time to employ them.  In essence, phrase your emotions with “I feel…”  rather than pointedly, “You” statements.  “I’m worried that Charlie will have a dangerous allergic reaction because he’s a toddler who doesn’t know the difference between peanuts and raisins,” rather than “You’re not listening to me: put away the peanuts!”

 

Share your learning curve.  Relate to them by reminding yourself (and them) how overwhelmed you first felt when you first received your child’s diagnosis.  They probably feel this way too right now: they’re trying to take it all in and food allergies have likely seemed very far off and remote to them.

 

If necessary, spell out the seriousness.  It can be hard to truly admit – most especially to yourself – the possibility of a severe food allergic reaction and its real consequences.  I have a lump in my throat just writing about it.  Watch the Discovery Channel’s 2013 documentary “Emerging Epidemic: Food Allergies in America” with your parents and siblings (again without the kids present).  The first 10 minutes of this multifaceted documentary deal with an anaphylactic reaction and is a firsthand example of the dangers of food allergies.

 

Remember that old habits die hard.  Most habits are not malicious, but they can be dangerous.  My own father had a nightly habit of snacking on a bowl of nuts, which he continued to do unconsciously when we visited.  When my son could crawl, I reminded him again that this wasn’t safe.  I was frustrated having to restate this every visit, so to drive the point home, I told him, “These nuts are like arsenic for my child.  Leaving them on the table is the equivalent of leaving a loaded gun for my toddler to figure out.”  It clicked immediately.  My dad apologized profusely and has since been phenomenally careful with my son’s allergies.

 

Invite them to a doctor’s appointment.  Allow them to ask as many questions as they have.  Maybe give your allergist or primary care physician a heads up so they know to allow a little extra time for questions and answers.  Hearing the information from a medical professional often underscores what you’ve been saying all along.  You know how your kids listen to their teachers but not you?  Your parents might be the same way.

 

Remind them that as much of an inconvenience as it is for them to adapt to your allergy-friendly lifestyle, assure them that it is SIGNIFICANTLY more so for you and your family.  Make it easier for them to navigate by suggesting some of the tips in The Host’s Guide to AllergiesThe Host’s Guide: Part II; and the Host’s Guide: Part III.

 

Invite them to participate in your lives by organizing activities that DO NOT revolve around food or meals.  I know that’s hard when we talk of family because food and socializing traditionally go hand-in-hand.  But, there’s no need to sacrifice your relationship with even the most obstinate family member – just take away the point of contention:  food.  I know that tensions can flare in the process of trying to win over someone’s mindset, but – by doing other things and removing the obstacle – perhaps you will both come to an understanding about your different perspectives.

 

Families are important.  They are our best cheerleaders.  They remind us of who we are and where we come from.  And, they teach our children all kinds of lessons we can’t impart alone.  By trying to handle differing opinions over a difficult issue like a child’s food allergies in a calm and collected way, we are also modeling great conflict resolution to our kids who pick up on more than we’d like to believe.

 

Food allergy parents need support too.  Parenting is hard.  Parenting a child with life-threatening allergies to something as common as food makes it exponentially more challenging.  Families should be there to help out and pat us on the back for encouragement, to give us a cup of coffee (or glass of wine) after a particularly rough day.  And they should be available to envelope our kids in love, support and safety so they grow up to be confident, self-assured adults with loving families of their own.

 

 

 

 

Costco’s Getting More Allergy-Friendly September 25, 2012

Need a safe snack to send to school?  Have a class party, soccer team to feed, play group snack to contribute to?  Check out what I found during one recent trip to our local Costco!    Has anyone tried these products?    I can only vouch for the School Safe Banana Chocolate Chip bread snacks which are delicious and perfect for school lunches/snacks.  They are nut-free and freezable (bonus for shelf life!).  My son loved the bread, so naturally I’m curious how the other snacks taste.

 

Note:  The popcorn was gluten-free but made in a facility with nuts.

 

 

Nut-Free Pumpkin Seeds at a Discount! April 23, 2012

Finding nut-free seeds is like finding Willy Wonka’s Golden Ticket.  Bizarrely difficult.

 

Enter Gerbs.

 

I’ve already tried the Toasted Onion and Garlic variety (see Found: Nut-Free Seeds).  And, now we can’t stop eating the Touch of Sea Salt.  Gerbs are addictively delicious!  And, a great way to satisfy those nut cravings in our nut-free household.  Plus, they are safe to send to school, camp, and playdates.  Too bad I have to share them with the rest of the fam!

 

If you want to try them, check their website for local retailers -OR- you can order online and receive a 10% discount on your entire order by using the code “SHMALLERGY”.

Let me know if anyone tries the trail mix!  Mmmm…..

 

Expired EpiPens? EpiPhany! October 21, 2011

After being inspired to clean out some spaces in my house that haven’t received much attention recently, I amazingly stumbled upon a large stash of expired EpiPens.  I was holding on to them with the thought that they might be useful in some way or in need of special disposal, but instead they simply sat in the back of a closet.

 

Suddenly I had an epiphany (an EpiPhany if you will).   Instead of throwing them out, I brought the EpiPens into our school nurse to help train other teachers, assistants, interns and substitutes on the administration of an EpiPen.  More than 15% of food allergic children experience a food allergy reaction while at school.  Given that statistic, emergency training with real EpiPens is only to everyone’s benefit (not least of which is my own son).

 

So, consider donating your expired EpiPens to your local school, preschool, camp or daycare facility and spread the word to any allergic adults you may know.  Our nurse was excited to use our old EpiPens and to store our old trainers for faculty food allergy training and I felt great putting them all to good use.