How do I deal with my child's food allergies?
June 6, 2012 9:43 AM   Subscribe

My 15-month old son is allergic to egg whites and peanuts. How can I keep him safe?

We're taking him to an allergist soon, and we just got a prescription for an EpiPen that we will keep at home and at daycare. Right now we mostly control what foods he is exposed to, but I'm worried about what may happen when we visit other places and homes, not to mention what will happen as he gets older and becomes more independent. So far his reaction is not anaphylactic-shock severe, and he seems to be okay when there are peanuts nearby, but I know that with repeated exposure his reaction may get worse.

For anyone else out there who has food allergies or children with food allergies, do you have any advice or resources you'd recommend? Are there any traps for the unwary that you've run into? (For instance, I found an AskMe thread from someone with severe peanut allergies who was nervous about flying since planes often serve peanuts.) How do you make sure everyone knows about the allergies? Does your child wear a Medicalert bracelet? Do we need to remove all peanut products from our home? What about eggs?
posted by chickenmagazine to Health & Fitness (19 answers total) 5 users marked this as a favorite
Sloane Miller's Allergic Girl Resources (and her book Allergic Girl) are very helpful.

The allergist will also help you create a plan.
posted by Sidhedevil at 9:46 AM on June 6, 2012

My nephew has a severe peanut allergy. At home, my sis and her husband control all their food. At this point they have pretty much identified all brands that are safe.

Travel: When they travel internationally, they used to request that the airlines not serve peanuts on that particular flight and up until recently most airlines (especially Singapore airlines) honored such requests. But now they just ask that you choose another airline. British Airways is peanut free.

School: My nephew attends a private school which is peanut-free (so no one gets to bring pb&js to school). All the food in the cafeteria is safe for him.

Eating out: Over time, my sis has identified every restaurant near them that does not use peanut products. Italian is generally safe. If they are going somewhere new, calling ahead and asking is the best way.
posted by special-k at 10:16 AM on June 6, 2012

As a teacher, I can tell you that schools are getting better and better about watching for these issues. It's still a worry because there are a lot of people involved and not all of them will always be attentive, but if you tell them "My son is severely allergic and this is how bad it could get," they'll take it very seriously. Mileage varies depending on locale, of course, but be proactive about informing your son's teachers and it should be fine.

FWIW, I'm a substitute, and I get around to a lot of schools. Most of the time one of the things I find in a teacher's "substitute file" of instructions is a list of students with allergies and what those allergies are. This has gotten better year by year. That said--I'm in Seattle, so I can't speak for all schools everywhere.
posted by scaryblackdeath at 10:17 AM on June 6, 2012

Do we need to remove all peanut products from our home?

Not necessarily. As long as you keep those separate and are careful when preparing food for the kid, you should be ok. But with my sis, they just got rid of everything.
posted by special-k at 10:18 AM on June 6, 2012 [1 favorite]

Does your child wear a Medicalert bracelet?

Yeah, my nephew does.
posted by special-k at 10:20 AM on June 6, 2012 [1 favorite]

Best answer: I'm the father of a ten year old with a peanut/tree nut allergy. I think we found out about it when he was three, after a couple seriously bad vomiting incidents after eating peanuts.

Any advice below is based on my experience with a nut allergy only so you'll need to consider the additional egg allergy before you take any of my advice.

First off, if you just recently found out about this you're probably in this phase where you're going to resent the world for a while as it seems like there is no safe place for your child. This will get better.

Go see the allergist and take his/her advice. There are allergy networks and resources for parents out there but they can often be filled with scary stories that will make you even more afraid. They are valuable resources and you should look into them but try not to let them panic you.

EpiPen: Take it everywhere. If you have a house that he spends a lot of time at, such as a close friend or relative, keep an extra one there. We have one at my mom's house. Make sure they know how to use it, and when.

Seriously, no not leave home without the EpiPen. Twice we have gone places where we thought "we have no food with us and there will be no food there or otherwise anything that could harm him" and both times we ended up finding peanuts or peanut shells on the ground. Not just one or two, but tons. Once was on a beach in South Carolina, where I guess they love to eat boiled peanuts and litter the beaches with the shells. The other time was on a remote island in a lake in Canada. No people, just peanuts on the rocks. WTF? Bring the pen. Never assume.

There will be times that will be frustrating. When all the kids are grabbing cookies and you have to tell your son that, no, he may not have a cookie because you don't know what's in them, it can be tough. We generally carry extra treats with us (tootsie rolls and Starburst work for my son, YMMV) so that when all the other kids are getting a treat we have something to give my son. He's grown up with this so he's usually pretty understanding about it.

Friends houses: As your child gets older he will most likely be spending time at friends houses without you around. You need to talk to the parents before this happens. Ask that they make sure there are not going to be nuts present and that they just avoid them altogether when your child is there. Show them how to use the EpiPen and leave it with them. We have a kit in a fanny pack with some Benadryl and the EpiPen that we leave with him wherever he goes.

Most parents are very understanding. You'll have no trouble. Occasionally you'll find a clueless parent ("Oh, don't worry, there's only a LITTLE BIT of peanut butter in these cookies") and you'll have to maybe decide you can't leave your kid with them. This is pretty rare though.

Babysitters: Make sure they are familiar with EpiPens and they know where yours are.

A weird thing about food allergies is there's a small percentage of people who have no personal experience with them who assume they are somehow all in your head, or your kid is just a picky eater or your're an overprotective parent or whatever. These are the same type of folks who think the cure for depression is just to smile more. Don't bother arguing with these folks. Don't let them upset you. Just stay the hell away from them and don't leave your kids with them.

Baked goods: You'll get to know the local nut/egg free bakeries. We generally avoid baked goods if we don't know they're nut free. When he goes to birthday parties we just have him bring his own cupcake. He's cool with that. We bought his last birthday cake at Blackers in Newton.

Halloween: A lot of candy, even though it has no nuts, has been processed in plants where there are nuts. What we do is buy candy ahead of time from Vermont Nut Free Chocolate and then just trade him after he's done trick or treating. We sort his loot into "No nuts, good to eat", "Nuts: DO NOT EAT" and "We're not sure." We trade him for the "do not eat" stuff and then research the "not sure" or just trade him for it.

The most valuable piece of advice I can offer is this: Perspective. On the big list of Things That Can Be Wrong With Your Child, this one is manageable. Right now it is SCARY, and it will occasionally be Scary. There are a lot of unknowns. But pretty soon you'll be so used to it and your son will understand it more and more as he grows up. It will just be something you have to do so often it'll be no big deal.

The good news is America, and I assume the world at large, is getting more and more understanding about food allergies. They are a real thing. Nut/Dairy/Egg/Gluten free products, restaurants and bakeries are getting more and more popular. My son's school is nut free. Lots of them are.

I see by your profile you're in MA. MA seems to be one of the leaders with acceptance of allergies, as I'm sure you can see by the sign inside every restaurant. I was recently out in Arizona and Nevada and when we'd tell them in a restaurant that our son had an allergy they'd just sort of shrug. It was frustrating.

Talk to other local parents of kids with allergies. They'll tell you about restaurants that are safe or understanding. "Oh yeah, the owner of this Chinese place has a kid with a nut allergy, he's really good about it..."

Good luck. What seems unmanageable now will be easier as time passes.
posted by bondcliff at 10:25 AM on June 6, 2012 [19 favorites]

My 5-year-old has a treenut allergy. Bondcliff has given you so much good advice! I can only add this:

--EpiPens and Benadryl need to stay at room temperature. Do not leave them in a car, as they might not work when you need them to.

--Things can get better! My daughter was diagnosed with allergies to peanut, treenut, milk protein, and egg at 2; at her last allergist appointment she had outgrown everything but the treenut. My husband outgrew his anaphylactic egg allergy at 35 (!).

--Keep checking labels every time you buy. Formulations change frequently.

--Watch out for vegan items. You can count on them being eggless, but they will frequently contain nuts/nut butter/nut oil.

--This is an awesome allergy-safe cake (contains gluten). Appropriate for birthdays, cupcakes, whatever.
posted by apparently at 11:05 AM on June 6, 2012 [2 favorites]

Best answer: I was going to type a long post as the father of two daughters, one with a peanut allergy and one with an egg allergy, but bondcliff beat me to it. Lots of good advice in there.

Going to the grocery store will take longer for a while, because you will have to read everything.

Many "Italian" restaurants, especially quality ones, make their own pasta, which almost always include eggs. Old Spaghetti Factory -- generally child friendly--does not have egg-free pasta.

What I have found is that people are much more aware of peanut allergies; and not so with eggs. People will equate eggs with dairy, which is not always accurate. And, in restaurants and other people's homes, you must remain vigilant ("CONSTANT VIGILANCE!!" in the words of Mad-Eye Moody) and recognize what typically has eggs, because eggs are used in lots of things.

Ranch dressing and mayonnaise contain eggs. Breads with a glaze frequently do. Some ice creams (but not others). Diners can be an issue if eggs are cooked on the same griddle.

But bondcliff is right, that it will get easier as time passes. MeMail me if you have specific questions.
posted by China Grover at 11:06 AM on June 6, 2012

OH! Forgot about backpacks. Our children have backpacks (they are animals, so they have personality) that contain a hard pencil-type case, with identifying information, epi-pens, benadryl, and other stuff. They are not "friends," they don't get played with, they are tools. We remind the kids to constantly have the backpacks on them.
posted by China Grover at 11:10 AM on June 6, 2012

What is the current status of building up immunities to food allergies by consuming tiny amounts (graduating to larger amounts) under medical observation?

Perhaps see if there are any studies available in your area.
posted by 2manyusernames at 11:26 AM on June 6, 2012

As someone who is also allergic to eggs, one tricksy thing to watch out for are alternate names on ingredient lists. You might see Egg, Egg White, Egg Yolk, but sometimes you see Albumin. In my googling, this site says that Globulin and Lecithin can also be used (which I didn't know!).

My daughter has the egg allergy, too, and I have worked hard to teach her generally what kinds of foods to avoid. Just don't eat cakes or ice cream unless you can ask about the ingredients.
posted by frecklefaerie at 11:46 AM on June 6, 2012 [1 favorite]

Best answer: Also, once your son gets older, teach him to be assertive about refusing things he thinks might not be safe to eat (even if they just smell wrong). Because while adults will in general do their best to keep him safe, chances are that sooner or later there will be another kid (possibly an older kid) who finds out about his allergies and tries to make him eat a peanut just to see what will happen. Besides which there are a lot of social pressures to eat what you're given if you're someone's guest, and it's helpful to have a polite script he memorizes so he knows what to say if such a situation arises (e.g. some friend's parent remembers the nut thing but accidentally gives him something with eggs in it). As he gets older, you will also find yourself asking waiters a lot of questions about ingredients at restaurants (you never know which pasta salad or new sauce secretly has peanuts in it!) - encourage him to participate in this process so he will feel more comfortable doing it when he's not with you.

In terms of removing things from the house - the problem is not them being in the house as much as them being used in the house. I can't speak to eggs as I don't have that allergy, but if there's peanut butter being used, then it's on a knife, on a plate, possibly on the counter (or even in other food containers if someone careless is making a PB&J), and it's easy for that to spread around. So if you do keep these things in the house, be good about avoiding cross-contamination and cleaning up immediately rather than leaving dirty dishes in the sink. Also peanuts are pretty aromatic, and your son may find the smell quite unpleasant even if it doesn't make him ill.

Be on the alert for other allergies - other than vomiting, symptoms may include swollen lips, sore throat, upset stomach, or rash. As a kid I didn't reliably know what these meant. I seriously just thought everyone's throat got scratchy when they ate apples, for years, and never mentioned it.

FWIW, it is possible to have a safe childhood with allergies - I had the vomiting-level ones from when I was very little, but didn't have to use an EpiPen for the first time until I was in college. But do remember to replace the EpiPens when they expire - maybe make a note on your calendar in advance, as it's kind of easy to forget.

And for me, "processed in a facility that also processes peanuts" level contamination has never yet been dangerous - so figure out what level of vigilance is right for your son, and realize that not all allergies follow the same course. For some people, the slightest peanut exposure can be deadly and must be treated as such. But for many others (myself included) there is a wide range of exposures and reactions, from life-threatening down through many shades of "somewhat unpleasant," and some of those are well worth the trade-off for having a mostly normal life. This is just one more kind of risk to be assessed and navigated - yes, there is an extent to which I am risking my life every time I eat at a restaurant - but there's also that risk every time I ride in a car, so I wear a seatbelt, carry an EpiPen everywhere, and try to be smart about evaluating each situation as it occurs.
posted by unsub at 12:09 PM on June 6, 2012

2manyusernames, Oral Immunotherapy is being studied at sites across the country, but a 15 month old is really much too young to be enrolled- study participants have to be old enough to reliably consume the entire dose, even when it causes some nausea, as sometimes happens. It's definitely something to keep an eye on four or five years down the road, though.
posted by ambrosia at 12:21 PM on June 6, 2012 [1 favorite]

My son has a non life threatening egg allergy. We keep eggs and food with eggs in the house. He is 11 and has known for years what foods contain eggs. He knows to stay away from most baked goods and he doesn't miss them. Thankfully most breads and ice cream does not contain eggs. Avoid ice cream that is labeled "homestyle" since it almost always contains eggs. As does French Vanilla and custards (though these are made with egg yolk so your child might be fine) of course. Other than that he can have most Bryers ice cream , Dairy Queen, McDonalds ice cream, etc. because it doesn't contain eggs.

We have learned what kinds of foods contain eggs. Foods you wouldn't think of, like salt water taffy and a lot of candy for that matter. It's almost a blessing to have an egg allergy. His pediatrician said there was a good chance that he would outgrow his egg allergy. It hasn't happened yet. We don't know if he is allergic to the entire egg or egg white (most allergenic as you are probably aware) since we never had him tested for allergies. We just know he has an egg allergy and it causes severe abdominal pain, upset, and nausea. He used to vomit as a baby/toddler/preschooler but nowadays if he ingests something that contains eggs he only experiences pain and nausea. Sometimes (very rarelyP he will test himself and eat something that is labeled: contains less than 1% egg white (like salt water taffy). He still gets sick.

He can also touch his tongue to a piece of food that contains egg and know pretty much immediately if it contains egg or not.
posted by Fairchild at 12:35 PM on June 6, 2012 [1 favorite]

Sounds like you are getting good advice for the immediate future... but long term...

Speaking as a person who has grown up with allergies (to citrus and until my early 20s to eggs), it is not really a big deal if you, the parents, model this as important but not life altering. In fact, my standard response to "Wow, you can't eat citrus... what a bummer..." is "You know, I have never been able to eat citrus, so I think it tastes weird and I can eat lots of other things." And then I change the subject because most people, even children, want to talk about something more interesting.

As a child the only differences I remember included trading in my candy, not eating certain holiday foods, bringing my own cake or sweet to people's parties (and school birthdays), and my mom being really worried that I did not get enough vitamin C so I had to take non-citrus vitamins (hard to find in children's form). Your older kid will get very good at asking and very good at knowing if something is off (in the food or afterwords).

Sure, I still have to ask at everyone's house, potluck, restaurant, and read every ingredient list in the store (every time) but that is my "normal." And occasionally you have a laugh, I went to a bakery and got an egg free, citrus free, nut free (because the friend we were visiting was highly allergic to nuts) cake and I forgot to ask if it contained alcohol (friend's wife was pregnant) - and then after tasting it we all had a laugh and made pregnant friend a different dessert.
posted by mutt.cyberspace at 12:43 PM on June 6, 2012

Best answer: As your kid gets older, a little medicalert bracelet can help him get respect (from adults anyway) when he says he has allergies. You just point at it while you ask about the offending food and people snap to attention.

I have been allergic to peanuts all my conscious life, but I still don't have a reaction to people eating peanuts near me. For what it's worth.

Also, it's important to have the epipen, but I have been to the ER three times and all they ever administered was Benadryl. Further, in my experience, taking Benadryl immediately often stops most of the reaction from happening in the first place. So have some Benadryl with you for sure (if babies can take Benadryl).

Peanut oil is not technically allergenic unless it was cold pressed. That's because the allergen in peanuts is a protein and peanut oil is refined at such high heat that it eradicates the protein. Not that you should feed your kid peanut oil, I still avoid peanut oil myself, but this part is worth knowing and discussing with the allergist.

The bit about being on a plane while everyone simultaneously opens a pack of peanuts always makes me feel uncomfortable but does not make me sick. I have a friend who can't ride a lot of planes because it does make them sick -- your kid's mileage will vary, ask the allergist for advice.

Also, many allergies disappear over time but peanut is cumulative, meaning for most people it gets worse each time. So what for me as a kid was just scratchy feelings and nausea is now an episode where my whole torso turns bright red and my extremities swell.

Feel free to memail me if you have any other questions...
posted by feets at 2:00 PM on June 6, 2012

Response by poster: Thanks, all. This is very helpful information (and if anyone else has advice, please keep it coming!) Nobody else in the family has food allergies, so this is all new to us. My biggest worry is that I'll just forget about it and not be vigilant, since I'm not used to having to think about this. But I'm sure that will get better with time.
posted by chickenmagazine at 2:16 PM on June 6, 2012

Our daughter is (was) allergic to egg and peanut as an infant. She has grown out of the sensitivity to peanut and it looks like the same for egg.

We occasionally forgot and few her something before checking. Sometimes it sucked, sometimes we dodged a bullet. More irritating were the instances where relatives would attempt to feed her things like raw egg icing, EGG ON TOAST and mayo. Things we had said again and again not to have as meals around her because she's a toddler and couldn't verbalise or understand that tasting the icing will cause hours of discomfort. But we still just dealt with it and we're hoping the next egg challenge is victorious.

We didn't go gung ho though. I ate a lot of peanut while breastfeeding, and egg, so I kept doing that. Until we had reactions to egg in baked goods she still had those. We generally ignored the "made in a factory with" adn only paid attention to it as an ingredient.

Also, lots of preprepared custards and mayos do no desereve the name because they don't have egg. Weird.
posted by geek anachronism at 3:47 PM on June 6, 2012

Best answer: My toddler is allergic to eggs and peanuts.

I am a big fan of the pre-filled "spoons" of Benadryl and keep them everywhere. (Although the 1 tsp. dosage seems high, our pediatrician recommended it for emergency use when she was under a year.)

I prep her a lot for events where she will not be able to eat the food. She can eat Oreos and I stash mini-packs in the car and in my purse for unexpected times.

We're also in MA. The wait times for allergist appointments have been slower than expected. At her appointment in March she qualified for a baked egg challenge. The first available appointment was in 2013. You may also have to visit the allergist for flu shots.

For daycare, the staff bring a backpack with them to the playground, etc. that includes her epi-pen and Benadryl.

Both Fenway Park and McCoy Stadium occasionally have peanut-free sections or games.
posted by poodelina at 11:52 AM on June 9, 2012

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