Allergy Shmallergy

Simplifying life for families with food allergies.

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.

 

NYT Bullying Headline Screen Shot 2018-09-17 at 12.08.15 PM

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.

 

 

 

Correction: Pizza Nut… I Mean Pizza Hut… February 18, 2012

Update:  While it appears that Pizza Hut has updated their allergen information to remove some of their peanut and tree nut designations on their menu, I was still surprised to see what allergens were present in non-obvious menu items.  For example, their sauce still contains egg, dairy, wheat, soy, shellfish and gluten.  The lasagna contains tree nuts.  I stand by my recommendation below to check their allergen list before visiting or ordering from a Pizza Hut if you have food allergies.

Updated Pizza Hut Allergen List

http://www.pizzahut.com/files/pdf/updated%20ph%20allergen%20list%2004.17.09.pdf

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I had heard through the grapevine that Pizza Hut’s sauce is not safe for people with tree nut allergies.   Sure enough, if you check on their website, not only is Pizza Hut’s sauce made on equipment commonly used to manufacture tree nut products, but also egg, milk, wheat, soy and shellfish products.   If you frequent Pizza Hut, it might be worth it to check out their allergen chart as I found many surprise cross-contamination issues.


 

The Host’s Guide: Part II May 25, 2011

Now that you understand your visitor’s food allergy, here are a couple quick things you can do to ensure any mishaps are handled with ease.

 
 
  • If you don’t already have one on hand, now is a good time to ask a friend or neighbor for the name and number of a trusted pediatrician.  Accidents happen (and not always having to do with food allergies).  I cannot tell you the number of times we have seen our surrogate pediatricians in New York and New Jersey while visiting and vacationing.
  • It can’t hurt to keep Children’s Benadryl on-hand.  It’s one of the things I never travel without.  But just in case, I also store one at my parents’ house and in-laws’ beach house for when we visit.  And, yes, we’ve used them.

Most of the time, you won’t need to even think about employing the above.  But you’ll be glad you were ready if you do.

 
 
 

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Next post, we’ll discuss how to prepare your kitchen to make it food allergy friendlier in a snap!

 

The Host’s Guide to Allergies May 23, 2011

I’ve been reflecting recently about some of the excellent ideas and small mishaps by my extended family as they, too, learn to deal with my son’s multiple food allergies.  We see everyone with regularity and I’ve been impressed with how conscientious our family became once they fully understood our situation and how they could help.  Plus, they even gave me ideas for how to handle it.  So, I plan to share some of our suggestions in a short series of posts.

 
 

Whether you visit weekly or yearly, understanding your grandchild, niece, nephew, cousin, best friend’s food allergy will help put everyone at ease!  And, by considering some of our tried and true strategies, it should make your summer visit to grandma’s house all the more enjoyable!

 
 

Understand the Allergy (or Allergies)


Get an Allergy List Going and Post It

As the parent of a food allergic child, some intricacies of their allergy or allergies become second nature as you monitor food allergies on a daily basis.  To catch family members up on your routine, it may be helpful to type up a list outlining your child’s restrictions and some of the unusual places these allergens can be found.   I update my list after each visit to our allergist (when the list has the most potential to change) and email it around to my parents and in-laws.  We all print out our copies and post them on the fridge so that everyone has something to reference.

My list looks something like this:

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Food Allergy Restrictions
May 2011
 
 
My child CANNOT eat:
Peanuts
Tree Nuts
Sesame Seeds
Dairy
Eggs
 
 
Look out for:
Asian Foods (typically contain nuts, sesame seeds, and nut/sesame oils)
Bread Crumbs (most have sesame seeds)
Meatballs and Meatloaf (which are typically binded with egg)
Tahini and hummus (sesame seeds)
 
 
He CAN have:
Coconut and coconut oil
Safflower and Sunflower seed oils
All fruits, vegetables, and juices made without exposure to the above allergens

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Educate the Household:

Make sure each member of the household knows that a food allergic visitor is coming and can help keep him/her safe by keeping them away from allergens and steering them towards safe, healthy options.  Now is a good time to remind each member of the host’s household that they should ask the child’s parents before giving him/her any food or drinks.

 
 

Take Note:

You should note several things that families with a food allergic member do on a daily basis:

 

1.  If you have just eaten an allergen, you cannot kiss the food allergic child for a while.  Discuss this with the parents, but we have certainly noticed times where an allergen has caused hives from touch even without an allergic child ingesting anything.   As excited as you are to see the kids, please consider this carefully before laying on the smooches!

 

2.  If you have handled or prepared food with the child’s allergen, you’ll need to wash your hands before touching him/her.  Again, exposure can lead to hives which are uncomfortable at the least.

 

3.  If you are dealing with a nut allergy, you may wish to ensure that your hand soaps, body soaps, and/or lotions are not made with almond or other nut products.  If they are, now’s a good time to shelve them for the remainder of the stay.

 

4.  If you don’t know, just ask the parent.  It’s not worth taking chances with food allergies.  Reactions can be quite severe.  Most parents would prefer to be asked whether something is safe in advance than worry about potential consequences.  Ask a hundred and one questions.  We really don’t mind!

 

5.  Try to be relaxed about it.  Although food allergies requires vigilance, it’s important to be flexible.  Kids feed off adult energy.  The more relaxed you are, the more relaxed they’ll be – and the more fun will be had by all!

 

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Next post, we’ll discuss a few quick but helpful preparations for a food allergic visitor you’ll be glad you did.

 

Crouching Tiger, Hidden Sesame March 4, 2011

Sesame seed allergies are a little tricky.  Sesame seeds may be  tiny but they are potent and can cause a serious reaction for those who are allergic.  Additionly, federal law does not require sesame to be highlighted on grocery items (although it will still be included in ingredient lists).  So it’s worth familiarizing yourself not only with foods that typically contain sesame seeds but also the names of ingredients that are sesame seed derivatives.

 

As discussed in an earlier post (https://shmallergy.wordpress.com/2011/02/01/bring-on-the-meatballs/), sesame seeds are often included in bread crumbs, making ordering food with breadcrumbs just a little more complicated.  Sesame seeds are often an ingredient in wheat and multigrain breads (sliced bread, baguettes and rolls).  They also make frequent appearances in crackers and cereals (such as muesli), so read your ingredient list carefully.  Cross-contamination with sesame seed bagels are an issue when ordering bagels from a bagel store.  Again, proceed with caution.

 

Sesame oil is unrefined, meaning sesame seed protein can still be found in the oil — the same protein that will likely cause an allergic reaction.  Ordering Chinese food is likely out for anyone with a sesame seed allergy as much of its restaurant fair is cooked in sesame oil and includes the actual seeds in their dishes.  But, if you’re cooking Chinese meals at home, you should also know that Hoisin sauce lists sesame seeds as an ingredient.

 

Remember when you are ordering sushi to do so without sesame seeds.  Not only are rolls often covered in seeds, but seeds can be sprinkled on a variety of hot dishes as well.

 

 

As for Mediterranean fair, be aware that tahini is sesame paste.  This is important to know as tahini is included as an ingredient in hummus, amongst other dishes.  Ask whether or not your dish is cooked or served with tahini when ordering at Mediterranean restaurants.

 

 

 

Hamburger buns are not just sprinkled with sesame seeds.  Many times, sesame seeds are included as an ingredient.  Veggie burgers sometimes include sesame seeds as do various salad dressings and marinades.  Again, read ingredient labels carefully and ask all appropriate questions when dining out.

There are several ingredients that are derived from sesame seeds.  These are:

■ Benne/benne seed/benniseed
■ Gomasio (sesame salt)
■ Halvah
■ Sesame oil is also known as gingelly or til oil
■ Sesamol/sesamolina
■ Sesamum indicum
■ Sim sim
■ Vegetable oil (read ingredients, most are made with soybean oil)

(Source: Food Allergy Initiative)



Also, be aware of contact with sesame seeds via some beauty products, cosmetics and dog food.  Just pay attention!

 

Miyagi: Delightful… for Date Night February 3, 2011

Let me lead off by saying that we are longtime fans of Miyagi in McLean, VA.   In my humble opinion, it ranks among the best sushi in the area and my husband loves their cooked entrees.  However, after the experience with our son the other night, I would have a hard time recommending it to anyone with food allergies.

 

Japanese food is typically a great cuisine for those enjoying a nut-free, dairy-free diet.  We’ve long enjoyed carefully broadening our children’s culinary horizons with a great selection of delicious dishes.  That said, Miyagi disappointed the other night.  We ordered my food allergic son chicken teriyaki – hold the sesame seeds.   We explained that his food cannot come in contact with sesame seeds because he has a severe allergy to them.  We made it clear: he gets sick;  NO sesame seeds.  Our server nodded, wrote something down and headed straight for the kitchen.  Ten minutes later, our waitress returned with his food.  Plain chicken, steamed vegetables as requested with a garnish of marinated sprouts which she pointed to and said, “Don’t let him eat this.  This sit in sesame seeds.”

 

We requested the kitchen make him a new meal on a new plate without the sprouts.  My son, being my son, mostly ate the steamed rice anyway.  But….

 

Well, so much for getting that concept!  I think Miyagi’s food is delicious and it’s ambiance quaint.  It’s a very small space and there are, at most, three servers – the head one of which definitely didn’t understand the concept of a food allergy.  We’ll return here to eat ….alone for date night when allergies aren’t a consideration.

 

Bring on the Meatballs! February 1, 2011

Finding allergy-free breadcrumbs seemed an impossible task.  My mother and I once went on a hunt to find prepackaged breadcrumbs and left our respective breadcrumb aisles empty-handed across three states!  They always either contained dairy or sesame — and, most often, both.  While it’s easy to substitute cornflake or panko crumbs for regular breadcrumbs, neither option tastes exactly right in many classic recipes.

 

Perusing our local market one day, I noticed breadcrumbs in the Kosher section – several aisles away from their more traditional breadcrumb cousins.  By some sort of miracle, Jason’s breadcrumbs contain neither milk nor sesame.   They come plain or seasoned and have made my meatballs all the more scrumptious (if I do say so myself…).

 

Plain

Seasoned