Dealing with Food Allergies Around the Holidays

The holiday season is a festive time, but can present unique challenges for children with food allergies and their parents. We spoke to Vanessa Chrisman, a clinical pediatric dietitian at CHOC Children’s, who has advice for parents on navigating a season often filled with parties and treats while managing their child’s dietary restrictions.

What are some of the most common food allergies/dietary restrictions that children face?

The most common food allergies that children face include: wheat, dairy, egg, soy, peanuts, tree nuts, shellfish and fish. They are known as the top eight, as these foods account for 90 percent of all allergic reactions to food. The severity of an allergic reaction really varies from one child to the next. An example of a mild reaction would be a small rash on one hand that goes away in a couple hours. A more severe reaction could involve swelling of the face, vomiting and diarrhea, and/or coughing or wheezing. Severe reactions can be life-threatening.

How does suffering from food allergies complicate festive occasions such as holiday celebrations?

Children with food allergies often are restricted from eating the foods that are offered at holiday parties. As a result, these children may feel like they are missing out or being punished for having food allergies. To help ease this problem, parents need to be proactive and plan ahead when it comes to approaching holiday parties and meals. Bringing allergen-safe food along to parties or preparing special baked good for the child with food allergies are two examples of how to deal with this.

What can parents do in their own home to accommodate dietary restrictions that one child faces, when there are other children in the home without that allergy or restriction?

Depending on the food allergen, parents can decide whether or not they will keep food allergens out of the home or not. Labeling areas as safe zones (allergen-free) both in the pantry and the refrigerator is helpful. Keeping unsafe foods tucked away and stored in air-tight containers is also advised. Everyone in the family should learn how to read food labels and ingredient lists. To prevent the transfer of food allergens, all family members should wash their hands before and after eating. Practicing safe food preparation is important for avoiding cross-contamination. Counters and tables should be scrubbed down before and after meals. When eating or serving food use separate utensils that have not come into contact with allergens. Parents can educate their children on food allergies, as well as the importance of keeping food allergens away from the child who is allergic.

How can parents accommodate their child’s allergies when partaking in festive events outside the home?

Parents should talk to their child’s teacher and school nurse at the beginning of each school year so they can be prepared for any celebrations at school where food is involved. When their child is going to a birthday party or to a friend’s house, parents need to talk with the parents who will be watching over their child. Explain your child’s food allergy, what foods to avoid, what symptoms to look for, what specific foods are safe to give and how to practice safe food handling. Parents can also send their child with special “safe foods” to be consumed when outside the home. For those with a prescription for an epinephrine injection for anaphylaxis, ensure your child has it with them at all times and that other care providers know how to administer it.

Related posts:

  • Kids and Living with Food Allergies
    A food allergy usually occurs in the first two years of life, says Dr. Ellis, a CHOC Allergy and Immunology Specialist. “It’s important to know that allergic reactions to food ...
  • Tips for Keeping the Home Safe for Kids with Food Allergies
    Raising a child with a food allergy can be challenging enough, but what should families do when they have children with and without food issues? That’s a question CHOC Radio ...
  • Food Allergy Resources for Families
    Having a child with a food allergy can be challenging at times, but with care and menu planning, these kids can lead happy and healthy lives free of allergic reactions. “These ...

 

Kids and Living with Food Allergies

Girl WatermelonSIGNS AND SYMPTOMS

A food allergy usually occurs in the first two years of life, says Dr. Ellis, a CHOC Allergy and Immunology Specialist. “It’s important to know that allergic reactions to food typically occur immediately or within two hours of eating the food,” Dr. Ellis explains. “The child might have skin issues like hives (itchy red spots) or develop itchy skin, or the child might throw up. All the organ systems can be involved. The child might wheeze or become short of breath. In severe cases, the cardiovascular  system can be involved and the child could have a drop in blood pressure, feel light headed and faint.”

MANAGING FOOD ALLERGIES
There is no cure for food allergies and the best way to avoid getting sick is avoiding the food. “You have to find out what the child is allergic to. This comes from the family history and then we take a blood test or a skin test to confirm what the family has told the doctor,” says Dr. Ellis. With a serious reaction, an adult should inject the child with epinephrine (adrenaline that reverses the symptoms) and call 9-1-1. “Always have an epinephrine auto-injector. Learn how to read food labels and be careful at high-risk eating areas such as buffets, ice cream parlors and Asian restaurants.”

FOOD FOR THOUGHT
Any food can cause an allergy but a small number of foods are most commonly associated with food allergies. In fact, eight foods/food types account for 90 percent of all allergic reactions. They are: milk, eggs, peanuts, tree nuts (such as walnuts and almonds), soy, wheat, fish and shellfish. Even trace amounts of a food allergen can cause a reaction, including a severe or life-threatening reaction. Peanuts, tree nuts and fish are the most common causes of severe reactions, says Dr. Ellis.

FAST FACTS

  • Estimated number of American children and adults with food allergies: 15 million
  • Annual cost to the U.S. economy related to children’s food allergies: Almost $25 Billion
  • Percentage of children under the age of six with food allergies: 6 – 8

View the full feature on Kids and Living with Food Allergies

Dr. Mark Ellis
Dr. Mark Ellis
CHOC Allergy and Immunology Specialist

PHYSICIAN FOCUS: DR. MARK ELLIS

Dr. Ellis completed his residency at the University of Arizona Health Sciences Center in Tucson and a fellowship in Allergy-Immunology at the University of California, Irvine, Medical Center. Dr. Ellis is chief of the CHOC Children’s Specialists Allergy & Immunology Division and is the Director of the Allergy, Asthma & Immunology program at CHOC. Dr. Ellis specializes in the treatment and management of allergies and asthma. He is a principal investigator for many clinical research studies for adults and children concerning new treatments for asthma and allergies.

Dr. Ellis’ philosophy of care: “I like to identify the problem and educate the family on ways to prevent disease.”

EDUCATION:
Tulane University School of Medicine in New Orleans

BOARD CERTIFICATIONS:
Pediatrics
Allergy and Immunology

More about Dr. Mark Ellis

This article was featured in the Orange County Register on April 7, 2014, and was written by Amy Bentley.

Tips for Keeping the Home Safe for Kids with Food Allergies

Raising a child with a food allergy can be challenging enough, but what should families do when they have children with and without food issues? That’s a question CHOC Radio host Bryan Mundia recently asked Shonda Brown, a CHOC Children’s clinical dietitian who works in the hospital’s Eosinophilic Esophagitis Clinic.

There are many things a family should consider before deciding to rid the house of one child’s food allergens, thereby restricting the diet of the entire family. The ease of removing particular items from the home and the severity of the allergy are just two things to keep in mind, says Shonda.

In this podcast, Shonda offers tips for keeping the home safe for kids with allergies, without preventing other members of the family from enjoying foods they enjoy.

Food Allergy Resources for Families

Having a child with a food allergy can be challenging at times, but with care and menu planning, these kids can lead happy and healthy lives free of allergic reactions.food_allergy_families

“These kids can live a normal life and with proper education, this problem is very manageable,” says Dr. Mark. Ellis, director of the allergy, asthma and immunology program at CHOC Children’s.

Dr. Ellis says that food allergies are becoming more common, but while many hypotheses about the increase exist, none are supported by the medical research.

CHOC offers families many educational resources to help handle food allergies, including nutritional support and dietary advice.  A CHOC dietitian can ensure the child’s diet is nutritionally sound, Dr. Ellis says. Patients can also visit Food Allergy Research & Education (FARE), a nonprofit organization that offers food allergy information.

Even parents of children without known food allergies should know the symptoms of an allergic attack. The American Academy of Pediatrics offers this list of the most common symptoms:

  • Skin problems
  • Hives (red spots that look like mosquito bites)
  • Itchy skin rashes (eczema, also called atopic dermatitis)
  • Swelling
  • Breathing problems
  • Sneezing or wheezing
  • Throat tightness
  • Stomach symptoms
  • Nausea
  • Vomiting
  • Diarrhea
  • Circulation symptoms
  • Pale skin
  • Light-headedness
  • Loss of consciousness

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Coping with Food Allergies

Food allergies can be rough on children and their families. Children, especially if they are older, may feel depressed or angry about having foods taken away from them. Younger children may feel frustrated about not being able to eat the things their friends are eating, and may not fully understand why they have been put on special diets.

Parents and family members of children with food allergies deal with a full range of emotions, as well. They often feel worried about how their child will feel and be accepted by others. Some feel sad or guilty about taking foods, especially those the child enjoys, away. Others experience varying degrees of stress or anxiety. If you have a child with a food allergy, consider these tips to help your child and other family members cope with some of the challenges:

• Education is the key. Sit down with family members, teachers, friends, coaches and other people important in your child’s life. Explain the allergy and why it is so important that your child stay away from his or her suspected allergens.

• Be an advocate for your child at school, church, sports or any activity they may be involved in.

• Join a support group, online forum or talk with someone going through the same situation.

• Seek out reliable resources such as apfed.org, foodallergy.org and kidswithfoodallergies.org.

• If your child is on a “formula only” diet, make the formula as cold as possible to minimize its strong odor and taste. Consider making it a smoothie with ice in the blender.

• Change family outings to things that are not food- related. Consider arts and crafts, hiking, swimming, music and games.

• When preparing meals for the rest of your family, try to stay away from making your child’s favorite dishes that contain his or her allergens.

• Remove, from the house, treats and snacks that contain your child’s allergens so that they are not reminded of them. Encourage siblings and family members not to eat foods containing the allergens as well – at least not in front of your child.

• Children with extreme allergies may have all foods removed from their diets and may struggle with the idea of celebrating their birthdays without cake. Make the child a “cake” out of something that isn’t edible. This way they can still blow out the candles. Encourage your child’s siblings to select birthday party themes and the like that do not center around food.

The most important thing a family can do to help a child with food allergies is to stay united and supportive. By being careful about what is eaten in front of the child and changing the way the entire family relates to food—as nutrition, instead of a means of celebration or emotional support—life with allergies will be a little easier for both your child and the family.

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