If you went through the process of introducing the top 9 allergens to your child and found that they have a food allergy (or multiple allergies), you may be wondering what to do. Of course the simple answer is avoid the allergen, but real life is often way more complicated.
Like with many of the food allergy articles I write, I will be focusing on IgE-mediated allergies. Some of the principles will apply to non-IgE mediated allergies, like FPIES, but certain aspects, like reactions may vary.
You are not alone. It can feel incredibly isolating dealing with a child with a food allergy. While family and friends may be empathetic, it’s hard to truly understand what you’re going through unless you deal with it as well. Luckily, there are many ways to meet other parents of kids with food allergies so that you can find your people.
There are about 1 in 13 kids in the US with a food allergy. This means that in an average classroom, there are 2 kids with an allergy. This number has been on the rise with a 377% increase between 2007 and 2016 (1).
If you can’t find anyone local, there are online forums and support groups that can help you connect with people globally.
Educate Yourself and Your Child
While your child is young, you will be handling the responsibility of managing their allergy, but they will eventually need to take over. Talking about their allergy with them while they are still young so that it becomes a normal part of their life can help make it easier.
Read up on your child’s specific allergen. Learn what foods it can be in and where it can be hidden. Sometimes foods can be found where you wouldn’t expect them, like peanuts can be found in gardening mulch. You can search through my site for information of each of the top 9 allergens.
Teach your child not to accept food from other people. They should understand that certain foods can make them sick. Teach them how to describe a reaction and ask for help. Often kids will use language like “it feels like spiders are crawling on me” to indicate hives. Other adults may not know what that means. Teach your child to state clearly that they are having an allergic reaction and need help.
There is an episode of Daniel Tiger regarding an allergy to peanuts which can help younger children understand food allergies. This can be helpful for siblings of children with food allergies as well.
Avoid the Allergen
As I mentioned previously, this is easier said than done. You will need to carefully read food labels, avoid cross contact, and make sure that everyone preparing food for your child does the same.
The Food Allergy Labeling and Consumer Protection Act passed into law in 2004 and required manufacturers to clearly label the top 8 allergens. The FASTER Act went into effect in 2023 and required sesame to also be labeled. For tree nuts and shellfish, the type of nut or shellfish must also be labeled.
The food must be clearly listed in the ingredients list, in plain language, or be under the ingredients in a “contains” statement. They are not required to include labels such as “may contain” or “processed in a facility with.”
These labels are required for packaged foods, supplements, conventional foods, infant formulas, infant foods, and medical foods. They are not required for fresh foods, carry out foods, highly refined oils, medication, personal care items, alcohol, or pet foods. If your child’s allergen is not one of the top 9 allergens, it is not required to be on labels.
Companies aren’t required to specify “natural flavorings” or proprietary blends, so if your child is allergic to a different food, you will need to contact the manufacturer to see if it contains that allergen.
Tips for Remembering to Read Labels
- Use color dot stickers to note that an adult has checked the food
- Leave sticky note reminders on the fridge and cupboards
- Check labels at the store, when you put food away, and when you serve foods. This way if you forget once, you still have 2 other times you should’ve checked.
Cross contact is when foods and their proteins touch. It is very similar to cross contamination, but it refers to the proteins, not germs. You may not be able to see that there has been any cross contact, however trace amounts of the protein can be on foods where you don’t expect it and that can cause a reaction.
Tips for Avoiding Cross Contact
- Always wash utensils, cutting boards, and pans with soap and water.
- Cook allergy-safe foods first. Then keep them covered and away from other foods.
- Don’t share food, drinks, or utensils.
- Clean counters and table with soap and water after making meals.
- Use different utensils/cutting boards for different foods.
- Use soap and water, not hand sanitizer. These are proteins, not germs. They need to be washed away.
Know What a Reaction Looks Like
Every time your child comes into contact with their allergen, the reaction could look different. It’s important to know what a reaction looks like so that you can appropriately treat it. Reactions usually happen within 2 hours of exposure to a food.
There can also be a biphasic reaction. This is when there are 2 waves of symptoms. The first wave will subside and then the second wave will appear 1-4 hours later.
|Skin||mild rash, some hives||widespread rash, hives all over the body|
|Face||itchy mouth, runny nose, sneezing||lip swelling, tongue swelling|
|Airway||none||coughing, wheezing, trouble breathing|
Make a Plan
Unfortunately, there will most likely come a time when your child has an allergic reaction. It’s important to know how to handle that day when it arises. Food Allergy Research and Education has a great emergency plan guide that you can download and fill out.
Your child’s doctor may give recommendations for medications that can be given for more mild reactions. You can make a note of the medication and dosage on your plan. They should also provide you with epinephrine to use for severe reactions. You should feel comfortable administering it prior to ever needing to.
It is important to keep epinephrine with your child at all times. You never know when you will come into contact with an allergen. Epinephrine is the only medication for severe reactions.
Be an Advocate
Whether this is at school, restaurants, or birthday parties, you will need to speak up for your child. Let everyone know that they need to take your child’s food allergy seriously.
You will likely need to ask for accommodations at school (this post has tons of tips for back to school). This can feel uncomfortable, but remember that there are probably other parents who have done this too. See if you can find another parents so you don’t need to reinvent the wheel.
It can be really helpful to have backup snacks and treats available. This way when there’s an unexpected birthday at school, your child isn’t left out. You can ask your child’s teacher if it’s ok to leave some shelf-stable treats in the classroom.
Bring some backup foods to restaurants so that if you get a weird feeling about the food, you have an alternative to offer.
You can also offer to bring alternative desserts or foods to birthday parties so that your child can feel more included. Many hosts will appreciate this, so that they don’t have to worry about accidentally triggering a reaction. Just make sure that the food isn’t served buffet style, as there is a high likelihood of cross contact.
Remember: You’re Doing a Great Job
Having a child with a food allergy can feel incredibly overwhelming. It can feel like a full time job. Remember that you’re doing a great job. It’s a lot to learn and figure out.
Krystyn Parks is a Registered Dietitian and Lactation Consultant who specializes in feeding children. She has a Master’s Degree in Nutritional Science from California State University Long Beach. She is an International Board Certified Lactation Consultant and has been registered with the Commission on Dietetic Registration since 2013.