Allergy Shmallergy

Simplifying life for families with food allergies.

Food Allergies at School: Moving Beyond Food Bans December 10, 2021

For years, school administrators and parents alike have struggled with the question of how to keep students with food allergies safe while in their care. And in some cases, both schools and parents have supported school-wide bans on allergens in an effort to protect food allergic children. But for many, food bans just don’t work. So what do studies show? And what should schools be doing to safeguard children with food allergies?

School-Wide Food Bans

Food bans often prohibit all students from bringing in a specific allergen. Most often it is peanuts that are banned, followed closely by tree nuts (almonds, cashews, walnuts, pistachios, etc) or more generically “all nuts” (presumably peanuts and tree nuts). Limits like these can work on the classroom level, but are impractical when elevated to a school-wide policy.

  1. Peanuts and tree nuts are only two of the nine most common allergens and there are over 160 documented foods to be allergic to.
  2. Any allergen can cause a serious reaction. Banning nuts only protects those students and staff who have a peanut or tree nut allergy.
  3. School-wide bans cannot be enforced.
  4. Banning food school-wide often leads to the assumption that everything that comes through the school door is safe. We know that teachers and administrators cannot police every snack, special treat and lunch that each and every student and staff member brings. And the last thing you’d want to teach a food allergic child is to eat something (assuming it’s safe) without checking on the ingredients first.

Studies have also shown that food bans don’t protect students. In fact, a five-year study conducted by McMaster Children’s Hospital in Ontario, Canada notes that bans can actually stigmatize them by making them targets of frustration over food. Students with food allergies often cannot eat with their friends and become victims of bullying – a far too common, far too unmentioned experience of kids with food allergies.

When are Food Bans a Good Idea?

Preschool aged children are at a difficult developmental stage for food allergy management. They may not be able to understand the nuances and dangers of their food allergic classmates’ condition. In their effort to be a good friend, they may try to share food; and food allergic kids may be unable to distinguish safe from unsafe food at that age. And, of course, preschoolers have their hands on everything, setting the stage for cross-contact reactions.

Food bans are also a good idea within a classroom. The classroom is meant to be a safe and inclusive place for ALL students. It should be the protective home base for students with food allergies. Eliminating a student’s allergen from the classroom whenever possible is conducive to learning. If a student is worried that they may have a frightening reaction triggered by something in the classroom, they will be unable to focus on almost anything else as their minds and bodies go into fight or flight mode.

Food bans are also a good idea at group events such as the school dance, special group rewards involving food, team snacks, etc. Focusing on inclusiveness is critical – it’s a lesson in empathy and support for all involved.

What DOES Work? Better Management Ideas for Better Outcomes

Couple classroom and event-based food bans with these strategies for a protective and inclusive experience for students with food allergies:

  1. Food Allergy Education: Kids are told to protect their friends with food allergies but are never taught the basics of the condition. Lessons on food allergy fit nicely into units about nutrition and health. Bonus: lessons about food allergy tend to be very interactive. They result in noticeably stronger sense of community and empathy for this and other invisible conditions in classrooms of all ages.
  2. Food Allergy Training: Teachers, administrators and staff should also receive an education on food allergies. Theirs should include symptoms of an allergic reaction and the language a student might use to describe it, how to manage a reaction and what to do in case of emergency. They should also focus on the social/emotional impact of food allergies and related conditions so they can keep an eye on students who may be struggling.
  3. Cafeteria: There are many ways to make the cafeteria a safer place for students with food allergies. First, make the ingredients transparent for diners by either posting the inclusion of the top 9 allergens on each item without an ingredient label or offering a point person to answer questions (or both). Second, offer allergen-friendly tables or seating. Peanut-free tables do not protect students with nut or other allergies. If there is flexibility, offer a broader allergen-friendly table where kids with food allergies can eat and feel understood. Also, reserve the ends of dining tables for kids with food allergies; this way, they can eat with their friends but not feel bound on either side by potential danger.
  4. Enforce Hand Washing: Encourage or require children to wash their hands after eating and before entering their homeroom. Hand sanitizer (which is good at killing bacteria and viruses) does not remove the food protein that causes an allergic reaction. The only way to remove food protein is to wash with soap and water.
  5. Stock Epinephrine: Finally, in addition to allowing students to keep an extra set of epinephrine auto-injectors at school, schools should take advantage of the Stock Epinephrine Act to keep extra, unassigned epinephrine auto-injectors at school for use by anyone who may experience a reaction. Anyone can develop an allergy to anything at any time in their lives, so having this life-saving medication available in an emergency is critical.

 

Another Pitch for Food Allergy Education October 28, 2020

Following my fascinating time teaching a senior writing seminar at a local high school (see What Does Food Mean to You?), I was struck by two things:

  1. These high school seniors were impressively thoughtful, creative and bravely willing to share their rich and rewarding stories (and souls) with their peers. And,
  2. They wanted to talk about food allergies more than any of that.

It’s FUN to talk about food – who doesn’t love to tell stories about their food adventures, a favorite meal, a holiday celebration, their dream dessert…?! As robust as our conversation was about writing and food, the conversation that followed was absolutely enlightening.

When I mentioned to the class that, in addition to my other writing, I often write about food allergies, hands went up immediately.

“How is a food allergy different than a food intolerance?”
“Can you outgrow a food allergy?”
“Do adults acquire new food allergies?”
“Are there treatments available?”
“What that medication people carry? How does it work?”
“How can I support my friend who has a food allergy?”

We spent 45 minutes – half of their class time – talking about food allergies that day. Forty-five minutes before we needed to cut them off and return to writing.

I spend a lot of time talking to school administrators about the value of food allergy education – especially for young children through early adolescence. This experience not only underscores the importance of food allergy education, but it highlights the continuing need to discuss it.

Two kids in every classroom have at least one food allergy. But as teenagers grow into young adults, they’ll soon find that EVEN MORE adults have food allergies than children. According to a study by Dr. Ruchi Gupta and her colleagues at Northwestern, 1 in 10 adults live with food allergies – 25% of whom acquired a new allergy AS an adult.

Administrators often see the value of a short unit about food allergies to health education, but don’t often add it to their curriculum. Why? Because, they say, these days kids grow up around food allergies. They know all they need to know from being around their peers.

But, based on my time in the classroom, it is clear this theory that students are absorbing food allergy lessons by osmosis doesn’t cover it. Young children don’t understand what a food allergy is and why some people have them. Pre-teens may lack understanding of the frequent obstacles and dangers their peers with food allergies face day-to-day. Teenagers are expected to help keep their friends safe but don’t know what it’s really like to have food allergies and don’t know how to help. And young adults may need to know how to recognize symptoms of food allergies and use an epinephrine auto-injector to save someone’s life.

Students hear the words “food allergy” and only have a vague sense of what it means. Even by age 18, students hadn’t learned what they felt they needed to know about the food allergies that they encounter. They were left with so many questions, I could have filled several sessions answering their questions.

If we expect our children and young adults to be empathetic to their peers who are physically, socially and emotionally affected by food allergies (and other medical conditions), we need to give them a proper introduction and equip them with the age-appropriate skills to become supportive friends and classmates.

At this time, most schools STILL don’t formally teach their students about food allergies despite the fact that there are nut-free classroom, peanut-free tables, and gluten-free options in the cafeteria. A short lesson would go a long way in fostering community, building empathy, empowering helpers and protecting students.


 

Crafting a Comprehensive Food Allergy Policy at School July 23, 2019

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Across the country, schools create and reshape policies to balance the needs of their many students.  Every school should – but so often don’t – have a food allergy policy.  This policy should protect students with life-threatening food allergies – and it should be noted that although peanut allergies tend to provoke some of the most severe reactions, an allergy to ANY food can turn deadly. [Read about other allergic reactions here and here, for example.]

 

A food allergy policy is critical to give parents and their food allergic students guidelines about what to expect while their children are at school.  In addition, policies surrounding food allergies allow parents to prepare their children to safely manage their allergies in their school’s setting and gives parents and teachers time to prepare anything they need to keep their student both safe and included at school.

 

Where should schools begin?  And what should schools consider as they think of updating their current policy?

 

Some factors schools may wish to consider when formulating an inclusive food allergy policy and procedures:

 

  1. Creating a culture of inclusion and empathy:  What kinds of lessons are students receiving as part of their social-emotional learning?  What kinds of messages are students taking away from role models?  Does the behavior they see match the kindness and inclusion the school expects?  Read Including Food Allergic Students at School to review the many simple ways to begin the process.
  2. How and where to store epinephrine: Is the nurse’s office centrally located or would it be wise to also store epinephrine with a trained administrator closer to a lunchroom or classrooms?
  3. Keeping stock or unassigned epinephrine: In many states, schools are allowed to store epinephrine auto-injectors that are not prescribed to a particular student.  These stock epinephrine auto-injectors may be used with anyone who experiences a severe allergic reaction.  In a nationwide study, stock epinephrine is used in 38 percent of reactions that happen at school. That means approximately 30% of reactions happen to students and staff without a known allergy.
  4. Nursing schedules and availability: Who is trained to recognize the signs of a food allergy reaction? Do they know what to do in an emergency?  If the nurse is unavailable, who is responsible for handling this kind of crisis? Severe allergic reactions (called Anaphylaxis) are extremely serious and require IMMEDIATE attention.
  5. Hand washing:  Hand sanitizer does not remove food protein.  So actual hand washing is required when handling a student’s allergen to prevent cross-contamination. When and where should teachers enforce this habit?
  6. Communication with parents: Families of food allergic students need advance notice to make alternative arrangements for their children.  Schools benefit from this type of forethought as well.  For example, an upcoming in-school event which appeared to a teacher to be a problem for my food allergic son, turned out to be easy to manage with a few easy tweaks to the plan after we discussed the details involved.
  7. Availability of food storage space (for food allergy-friendly snacks and treats): whether the school supplies allergy-friendly snacks or families send them in, deciding where to store them for convenience and how to label them so that they are easy to identify is helpful.
  8. Field trip protocol: How will epinephrine accompany a student when he/she is off school grounds?  Who is trained to recognize symptoms of an allergic reaction and know what to do in such an emergency?
  9. The bus ride:  Are the students allowed to eat on the bus?  Do they anyway?  Is the bus driver prepared or trained to administer epinephrine if needed? Are students allowed to carry their own medication on the bus?  Is this feasible for your students based on age, maturity, income level, etc (epinephrine auto-injectors are costly in some cases)?
  10. Classroom events:  birthdays, celebrations, holidays, and special events.  Specific guidelines for what is and is not allowed must be set as well as strict adherence to the policy established. Food allergies are NOT a preference. They can result in hospitalization in a matter of minutes.
  11. Nut bans: Worthy of a separate article and discussion, schools need to weigh the burden/reward of banning nuts entirely.  And they need to discuss the extent of the restrictions (will it extend to cross-contamination warnings like, “made in a factory with…”) and how to enforce them.

 

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Faculty and staff should be educated and re-educated about food allergies each year.  They must learn to recognize the signs of severe allergic reactions (called anaphylaxis) and what those symptoms might sound like in the words of a young child. They need to learn how to react to an allergic reaction.  Understanding the basics of cross-contamination and ingredient label reading, among other lessons, will help protect food allergic students in their classrooms.

 

Clear policies that are consistently enforced, as well as appropriate and reasonable accommodations,  will help teachers, administrators and students alike have a safe and fun school year.

 

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 Allergy Policies at School – Considerations and Perspective August 14, 2018

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As the school year beings for some and approaches for others, now is an excellent time to reflect on the food allergy policies and procedures at your school. As research and information about best practices emerge, schools should know that small changes can have a big impact.  Camps may also wish to track these same kind of policy shifts to keep campers safe while in their care next summer.

 

Why do schools need a food allergy policy?

 

Schools must create a safe environment for students with life threatening food allergies. Administrators should begin by creating a comprehensive food allergy policy for the entire school or school district.  Policies may vary from school to school depending on their experiences and limitations.  In fact, allergists are hesitant to suggest blanket recommendations for that reason.  Whatever each school decides, the policy and procedures set regarding food allergies need to be

1.  widely communicated;

2.  easily accessible; and

3.  consistently applied and protected.

These policies serve as a baseline for food allergic families to make decisions about additional measures they may need to take in order to keep their child safe.

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Where do schools begin and what factors should they consider in regards to their food allergy policies and procedures?  

When formulating food allergy policies and procedures, schools should consider some of the following factors:

  1.  Age of students and their cognitive and physical development:  Schools may have different policies for students of different ages.  For example, elementary schools may forbid a child from carrying his/her own epinephrine auto-injector while a middle and high school may allow that.
  2. Common risks facing the age group of their students:  Are the students allowed to share food without permission?  What are the school’s thoughts on classroom parties and celebrations? Do your students commonly face peer pressure or bullying? Are they allowed to snack/eat independently (away from a cafeteria or not during a traditional lunch time)?
  3. Stock/unassigned epinephrine: In many states, schools are either required or allowed to keep unassigned (or stock) epinephrine on-hand in case of an anaphylactic reaction.  That means that if a student, staff, or faculty member has a reaction and does not already have epinephrine prescribed to them and stored at school, the unassigned epinephrine may be used.  Consider whether your school should carry this useful medication and who should be in charge of administering it.
  4. Nursing schedule and availability:  Does your school have a full-time nurse?  How many students is he or she responsible for looking after?
  5. How and where to store epinephrine: Is the nurse’s office centrally located or would it be wise to store epinephrine with a trained administrator closer to a lunchroom or classrooms?
  6. Hand washing: Hand sanitizer does not remove the proteins that can cause a food allergic reaction.  Only a scrub with soap and water can do that. Are the students required to wash hands at any point in the day?
  7. Communication with parents:  This piece may not make it into policy, but it should be discussed.  Advanced communication with parents regarding upcoming class parties, school celebrations involving food, field trips, and other food-related events allows parents and teachers to make appropriate accommodations to keep their food allergic student safe.
  8. The classroom versus the lunchroom: How will food allergy policies differ by location within the school?  Rules in the classroom regarding food may be very different from rules in the cafeteria.  Who will be responsible in which location?
  9. Field trips: Each school should consider who is responsible for carrying and administering epinephrine when students are away from school.  Go over a plan should someone have a severe allergic reaction.  Be reminded that epinephrine must be kept at room temperature, so if you are spending time outside in hot or cold weather, epinephrine will need to be temperature controlled.  Communicate this plan to teachers and parents so that everyone is on the same page.
  10. Faculty and staff education:  Faculty and staff should be educated and RE-educated about food allergies each year.  They must learn to recognize the signs of severe allergic reactions (called anaphylaxis) and what those symptoms might sound like in the words of a young child.  [See The Language of Food Allergies for the symptoms and language students may use to describe an allergic reaction.]  They need to learn how to respond to an allergic reaction.  Understanding the basics of cross-contamination and ingredient label reading, among other lessons, will help protect food allergic students in their classrooms.

 

Food allergies are often misunderstood.  Not only can they cause severe allergic reactions that can be fatal, but they cause a great amount of time, preparation, and anxiety for students and parents alike.  This anxiety can hamper a student’s ability to learn. Therefore, it is imperative that schools make every effort to provide a safe environment for learning both academically and socially.  With two students in every classroom suffering from food allergies, it is critically important that schools consider how they can best prepare families and teachers to protect these students.

 

Important Story: FDA Warning to Mylan, Maker of the EpiPen, on Device Defects and Review November 6, 2017

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Earlier this fall, the FDA issued a warning to Mylan, the makers of EpiPens.  In a scathing letter, the FDA highlighted manufacturing defects as well as Mylan’s failure to conduct adequate internal reviews after receiving many complaints about the life-saving device, EpiPen’s malfunctions.  To date, there have been 7 deaths, 35 hospitalizations and 228 complaints about EpiPen and EpiPen Jr. devices this year.  [See F.D.A Accuses EpiPen Maker of Failing to Investigate Malfunctions, New York Times, Sept. 7, 2017]

 

Following an FDA inspection of the manufacturing plant, FDA’s letter to Mylan describes EpiPens that were leaking epinephrine and others that malfunctioned.  In March of this year, Mylan issued a recall of a small batch of EpiPen and EpiPen Jr devices.

 

While it is difficult to connect these defects to the deaths reported, as anaphylaxis itself can be deadly even with properly receiving epinephrine, these reports are not encouraging.

 

In February of this year, we had a frightening experience. [Please read the full story,  The Fire Drill- 5 Key Lessons from an Intensely Scary Night.]  Not long after eating at a restaurant, my 12 year old, food allergic son was rushed home, wheezing severely and coughing.  He was so weak and nauseous that he could barely stumble to the bathroom.  As I asked him questions, trying to evaluate the situation, it was becoming increasingly impossible for him to speak at all.  I wheeled around to grab my EpiPens just steps from where my son sat.  When I turned back around, he was blue.

 

This is every parent’s worst nightmare.  It was certainly mine.  Amidst the chaos of an increasingly critical and deteriorating situation, my only saving grace was that I held in my hand an EpiPen that would contain the correct amount of the life-saving drug, epinephrine and deliver it safely.

 

I can’t imagine being in that same moment now, knowing that the EpiPen in my hand may or may not save my son’s life.  That it may or may not have the right dose of medicine.  That the needle may or may not misfire.  Would the knowledge of EpiPen defects cause you to hesitate?  Would you instead call an ambulance that would take even more time to arrive?  When minutes matter, these short hesitations in action, improper delivery of medication, and any other complications that arise during anaphylaxis could be costly…. even deadly.

 

Bear in mind, Mylan has also increased the cost of EpiPen from $50 in 2008 to over $600 currently.  And, while the high cost of EpiPens are prohibitive, parents are still buying them, and they’re paying for one thing:  reassurance.  They pay for the firm knowledge that this product administers the correct amount of medicine properly every time.  If that can’t be demonstrated, there are plenty of other auto-injectors on the market with a proven track record of reliability to consider.

 

Despite these less-than-comforting reports, please continue to carry and use your EpiPens and other auto-injectors.  According to the FDA in a recent Bloomberg article, “We are not aware of defective EpiPens currently on the market and recommend that consumers use their prescribed epinephrine auto injector. We have seen circumstances in which adverse events reports increase once a safety issue is publicized, like a recall. We continue to monitor and investigate the adverse event reports we receive.”

 

I plan to keep you all informed as we continue to follow this story.

 

To read more on this story, please see EpiPen Failures Cited in Seven Deaths This Year, FDA Files Show posted on Bloomberg, Nov. 2, 2017.

 

The Language of a Food Allergic Reaction September 11, 2017

A food allergic reaction can vary from mild to severe and typically takes place shortly after eating or exposure.  All reactions require immediate attention.  But with severe allergic reactions, called anaphylaxis, minutes matter.

 

As kids head back to school and begin new activities, it’s important for EVERYONE to become familiar with the symptoms of anaphylaxis and what it language a young child might use to describe it.

 

Symptoms of Severe reaction

Some of the symptoms of a severe reaction are obvious: hives, vomiting, coughing.  But for others, we need to rely on verbal clues.  Young children may describe an allergic reaction a little differently than adults would.

 

Language of Food Allergic Reaction

 

Should you suspect that your child, or one in your care, is experiencing anaphylaxis, act immediately:

  1. Administer epinephrine, holding pen for 5-10 seconds in meaty part of outer thigh.
  2. Call 911.
  3. Contact parents.

 

Minutes matter when it comes to treating anaphylaxis.  Knowing the symptoms and the different ways it might be described will help you save a life.

 

 

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.

 

 

 

 

Food Allergy Education: Allergy and Asthma Today Spring 2016 March 8, 2016

 

As you all know, I strongly support the need for food allergy education in school.  The non-profit Allergy and Asthma Network (AANMA) recently picked up one of my articles on the subject for their publication, “Asthma and Allergy Today.”

asthma allergy today spring 2016

Here’s a link to my article in their Spring 2016 issue:  Thank You For Being a Friend.

 

Or, read it below. And in the meantime, I’d love to hear from you!  Comment below, on our Facebook page, or email me: erin@allergystrong.com:

  • I’d love to hear your thoughts on:
  • What your school is doing right;
  • Any issues you or your child has faced as a result of insufficient food allergy information/education;
  • Suggestions you have for schools/teachers to create a safer, more inclusive school environment;
  • General comments.

Thank you as always for your support!

 

Thank You For Being a Friend
published in Allergy & Asthma Today – Spring 2016
By Erin Malawer

 

Walking through the halls of an elementary school, you might see inspirational bulletin boards, posters promoting “School Spirit Week,” perhaps a donation box for clothes or backpacks.

 

You would not expect to see a whole walnut rolling around on the floor. That’s what some students at my son’s elementary school found recently. At first they didn’t even know what it was.

 

One of the students bent down to inspect it. “Hey,” he yelled to my 10-year- old son, who is allergic to tree nuts. “Come over here. Is this a walnut?”

Feeling a little nervous, my son backed away, explaining that he, of all people, is not qualified to be a nut inspector. A classmate, a girl also diagnosed with food allergies, stepped in to remind everyone about my son’s allergies. Soon after, the kids began to file into their classroom. Somehow the nut followed them.

 

My son’s deskmate grabbed the walnut and teased him with it, waving the walnut close to his face saying, “Oooooh … A walnut.”

 

My son began to speak up – we had practiced for these types of situations at home. The same girl quickly interjected, “Are you crazy? He’s ALLERGIC to nuts! He could go to the hospital!”

 

My son wasn’t harmed. But he WAS upset when I picked him up from the bus.

 

“Mom,” he said, “I know I seem really tough – like my feelings are as thick as a wall. But inside, they can be as thin as paper.”

 

We discussed what he was feeling, things he would have liked to have said, how thankful he was to have a friend like the girl who stood up for him. He felt sure his classmates acted out of misunderstanding or lack of education, rather than malice.

 

This incident was innocent enough. The first boy was curious; the second boy truly didn’t understand the potential consequences of his actions. He thought my son would join in on the joke because they are friends.

 

I asked the school if I could come into the classroom to teach the kids about food allergies – and they agreed. The students were attentive and engaged, and had intelligent questions. They were very sympathetic to how difficult it is to manage food allergies.

 

Both boys apologized to my son, explaining they had no idea about the severity of allergic reactions.

 

In the end, the incident brought my son and his classmates closer together. Looking back, it’s very easy to imagine a different outcome. But as my husband rightly points out, “Kids WANT to do the right thing and be supportive. Sometimes they don’t have enough facts to know how.”

 

Statistically, there are two students in every classroom with food allergies.  But that number is growing.  We need to teach our kids the facts about this condition, so they can act appropriately. And we need to teach them to be supportive of each other.  A lesson in food allergies is a lesson in empathy – and it just might save a life.

 

If your school doesn’t include food allergy education in their health curriculum, I encourage you to volunteer your time to do it yourself.

 

 

Three Sweet Ways to Say “I Love You” Dairy, Egg, Peanut and Tree Nut-Free February 11, 2016

Since we have the weekend to prep for Valentine’s Day, I thought I’d suggest three simple and sweet ways to brighten your Valentine’s day.  All three are easy to prepare, GREAT for classrooms and parties, and all are dairy, peanut, tree nut and egg free.  Happy Valentine’s Day, everyone!

 

 

Cupid’s Arrows

Grab some fruit and a cookie cutter and you have yourself one adorable (and healthy – shhhh…) fruit kabob!

Cupids Arrows AS

 

 

Sweetheart Sorbet Pie

Trickiest thing is remembering to prep this a few hours in advance.  And, then not eating it before presenting it to your sweetheart.

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Rice Krispie Hearts

Subbing out the dairy, makes these hearts safe and scrumptious.  If you have letter cookie cutters, you could also spell out the words, “LOVE” or “HUGS” or “XOXO”.  Infinite possibilities!

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Back to School Again! August 29, 2012

It’s that time again!  Some of you have already gone back to school while the rest of us are still preparing.  Now’s a great time to renew prescriptions for EpiPens and inhalers you may need to leave with the school nurse.  I’m republishing my post from last year which outlines my back-to-school process; including storing medications, ensuring safe snacks for my son, and preparing for special in-class celebrations.

 

Good luck to everyone on their first week!

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Starting a new school can be so exciting.  But it can also be daunting if you have a child with food allergies.  For some parents, this is the first time your child will be given food without your supervision.  And for others, it’s a point of transition to a new system for handling food allergies.  In both cases, it can be stressful.  But there’s a way to ease those nerves. Here’s how I would recommend handling everything to start your child’s year off right.

 
 

Understand Protocol:  First of all, talk to the school about your child’s food allergies and how they handle food allergies in general. It’s important to understand the standard procedures they have in place.

 

Store Emergency Medications:  Next, get a refill on your child’s EpiPens and keep them in their original packaging (most schools require this).  Keep two EpiPens at school (I kept ours in the classroom or at the nurse’s office) along with Children’s Benadryl.  Make a list of your child’s triggers and made a note of any symptoms he may have experienced to inform the teacher about his reactions.  In some cases, I didn’t know what my son’s reaction might be (thank goodness) so I deferred to my son’s pediatrician and allergist to give me a list of general reactions to look out for.

 

Ensure Safe Snack and Lunchtime:  Arrange a time to speak to your child’s teacher about snack and lunch.  Understand the process and how to work within it.  In my son’s case, the school provided snacks.  This originally horrified me.  I was uncomfortable about having the school give him snacks that I didn’t choose, but didn’t want him to feel left out if everyone was eating graham crackers and he was having rice cakes.  Thankfully, the school had a set snack list.  And, my son’s teacher took me through their snack closet and let me read the ingredients of every snack they provided.  Turns out he could safely eat eight of the ten snacks they regularly provided.  The teacher made a note of the two unsafe snacks and we agreed to substitute with a safe alternative on those days.

-OR- Leave a bag of safe snacks in the classroom for your child to choose from each day if that’s easier. Your child would probably be just as happy with that if you load up the safe snack bin with his/her favorites. Ask the teacher to let you know when you need to refill.

 

Prepare for Special Occassions:  Ask the teacher to alert you when in-class birthdays will be celebrated as well as any food-related holidays (think Halloween, Valentine’s Day, etc).  I send in a SAFE alternative on those days or keep one in class depending on the class/teacher (and it doesn’t have to be cupcakes!  For example, my son loves Golden Oreos and considers them a special treat).  But the teacher NEEDS to keep you posted on that stuff or it can result in a lot of disappointment.  **I would also make yourself available to parents who are planning these parties if they need safe snack suggestions.**

 

Inform and Practice Social Situations for Food Safety:  Now’s a great time to talk to your child/refresh her knowledge about her food allergy in some basic terms.  It’s a good time to check out the books recommended here: Food Allergy Books For Young Children and here:  Helping Toddlers Understand Their Nut Allergies.  Arm him/her with some words to politely decline sharing offers and remind him to ask his teacher if he’s not sure of the safety of something.  Have your child practice with you so they feel more comfortable using these techniques at school.

 

Educate Peers:  Offer to inform the other students in your child’s class about food allergies.  Educating your child’s peers will empower them to keep him/her safe as well.  Many kids have no experience with food allergies at all.  Bring in a book about food allergies along with a safe snack for everyone to share.  Let them ask questions and let your child help answer some of those questions.  My son’s classmates were so supportive once they understood he couldn’t always share the snacks provided.  In several instances, his close friends offered to eat some of his safe snacks in solidarity with him during class parties.  And, by the way, nearly all of his pals now love Golden Oreos as a result.  And some classmates, will ask their parents NOT to pack peanut butter/nuts so they can safely sit next to my son at lunch.  How wonderful!

 

I hope my on-the-ground experience helps alleviate a little of those back-to-school jitters and gives you some ideas of how to proceed at your school.  I was nervous at first when my son began school, but it’s been great — allergies and all!

 

React? Act! April 25, 2012

Like a lot of people these days, my kids are sneezing up a storm from spring airborne allergies.  And, for my older son:  this often means an increase in his asthma.  As if the sniffling wasn’t bad enough!

 

After his first spring asthmatic reaction in school (a doozy – the kind that he hasn’t had in a long time!), we had a chat.  Knowing my son and his proclivity for following classroom rules,  I assumed correctly that my son was trying to wait until his lesson was over to let his teacher know he was wheezing.  That won’t do!  Not only is wheezing the first symptom of asthma, but can also be a symptom for a food allergy reaction.  We had to re-emphasize the importance of reporting to adults even if it means interrupting them or demanding their attention.

 

My husband and I told him that one of the FEW exceptions to following the school and classroom rules is when you don’t feel well. “If you are wheezing, you need to tell the teacher right away – even if she’s talking or teaching the class.  If you are at recess, find an adult in charge and tell THEM right away.”  We very calmly expanded the lesson to include food allergy symptoms, “If your belly feels sick, if you have hives or an itchy throat, you must also tell an adult right away.  Even if those feelings aren’t really bothering you yet. It’s important to let the nurse see what’s going on so you can get back to playing!”

 

Thankfully, my son digested this lesson very well.  Since this chat, he’s been speaking up and heading to the nurse to get a puff of his inhaler as needed.  Not only does it empower him, but it helps keep his wheezing from escalating to a full-blown asthma attack.

 

Our hope is that calmly and gently teaching kids to recognize signs of asthma and allergic reactions will make them feel in control and ultimately help protect them.

 

 
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