Q&A: Proactive doctors can ensure safe Halloween for families with food allergies

Ghosts and goblins may be make-believe, but families with food allergies face real dangers at Halloween. Doctors can be proactive in educating families and the community about allergen exposure risks, ensuring all kids can safely have fun.

Healio spoke with allergist Neeta Ogden, MD, director of the Allergy, Asthma and Sinus Center in Edison, N.J., to find out more. Ogden also is a member of the Medical-Scientific Council of the Allergy and Asthma Foundation of America, as well as a spokesperson for the American College of Allergy, Asthma and Immunology.

Healio: What are the top treats that families with allergies need to avoid or minimize?

Neeta Ogden

Ogden: Families should focus, of course, on what their child is allergic to. Looking at the top food allergens among children, parents may want to especially avoid treats with nuts, peanut, milk, soy and sesame. Parents should also be aware of the hidden sources of their child’s culprit food allergens and other names they may have in ingredient lists.

Healio: What dangers do these treats present?

Ogden: Treats are dangerous for food-allergic children because they can lead to allergic reactions that can range from mild to more severe, including deadly anaphylaxis.

Healio: How can doctors best communicate these dangers to the families they treat?

Ogden: Every doctor treating a child with a food allergy should go over a food allergy action plan about how to treat every phase and manifestation of a food allergy. Similarly, as mentioned above, it is important to share that not all allergens are always spelled out, so make sure parents look for ingredient warnings. They should be aware of what products may have hidden allergens or allergens that are not always spelled out clearly.

Healio: Are there any resources you can recommend that doctors can use to help in these educational efforts?

Ogden: Yes. I think foodallergy.org is a useful website, as well as snacksafely.com. ACAAI.org is another great place that can provide education and materials.

Healio: Even if families practice caution, exposures are still possible. How can doctors help families prepare for potential exposures?

Ogden: Parents of kids with existing food allergy are well-prepared and educated about what to avoid and how to treat mild reactions. Again, doctors can help families by always going over a food allergy action plan to help prepare for exposure and always checking that they know how to use the medications in the food allergy action plan, including reviewing technique and use of an EpiPen and making sure they indeed have more than one EpiPen and that it is not expired. It is also important as early as possible to educate children to speak up about their allergies and how to get help if they are not feeling well and may be having an allergic reaction, especially if they are not with their parents.

Healio: Do allergists see increases in cases during this time of year? If so, how can practices prepare for them?

Ogden: They might, but as I said above, parents of food-allergic kids tend to be more vigilant around this time of year. Practices can help by reviewing the food allergy action plan as often as possible, well before this season so that reactions are less common. Additionally, making extra time for families before the school year is a great way to review things including the food allergy action plan and the asthma action plan because change of season and cold weather also can bring on asthma.

Healio: Halloween is just the start of the holiday season. Is there anything different that families should do to prepare for other upcoming celebrations?

Ogden: The holiday season introduces a lot of variables that aren’t part of our usual routines, including food and travel, as well as staying in different places. For food-related celebrations, if there is a food allergy, let your host know beforehand. Make sure you always travel with more than one EpiPen and other allergy medications. Make sure EpiPens are not expired and are stored properly, not in temperature extremes. If you’re very concerned about food exposure, you might even bring or make your own foods. If you’re allergic to allergens that might exist in another home, always have allergy medication such as antihistamines and your asthma inhaler at hand.

Healio: Is there anything different that doctors should do to prepare for these celebrations?

Ogden: Doctors can check in with their patients and remind them that holidays in particular are a time to be more vigilant than ever, especially about food allergy.

Healio: Awareness is key not just among the families that doctors treat, but in the community as a whole. What can doctors do to promote allergy awareness in their communities?

Ogden: Keeping the discussion alive and going is essential. Consider speaking to local schools and media to keep the community educated. For example, FARE’s Teal Pumpkin Project is a great way to bring attention to food allergy in the community around Halloween with allergy-safe homes displaying a teal pumpkin on their doorsteps.

Healio: Do you have anything else you’d like to add about how families and communities can ensure a safe and fun Halloween season?

Ogden: Never be complacent. Allergies, asthma and eczema are very serious conditions that can instantly be triggered by culprit foods, allergens and other environmental stimuli. Constant education and discussion to maintain awareness is really such a huge part of treating allergy and allergy prevention.

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Neeta Ogden, MD, can be reached on Twitter @DrNeetaOgdenMD.