Plan ahead for child’s food allergies to enjoy safe, happy holidays

Editor’s Note: In Healio Allergy/Asthma’s new column, “Food Allergy: Fact vs. Fiction,” Douglas H. Jones, MD, breaks down what’s true and what’s myth for a variety of topics related to food allergies. If you have a question you would like answered in this column, email Jones at rmaaimd@gmail.com or Sasha Todak at stodak@healio.com.

A few years ago, I read a tragic article about a teenage girl who was out for a pre-Christmas meal with her family when she accidentally ate a peanut-based sauce and suffered a severe allergic reaction.

When the teenager’s mother rushed to a nearby pharmacy to get help, she was refused a life-saving adrenaline injection because she didn’t have a prescription. The distraught mother was told to bring her daughter to a hospital, but the two had only made it a few yards away when the teenager collapsed.

Douglas H. Jones

The mother was quoted as saying, “My daughter died on a street corner with a crowd around her. How could a peanut kill my child?”

Unfortunately, as food allergy continues to grow, these types of stories are becoming all too common. Even one story is too many. Parents who have children with food allergies are constantly anxious about what their children will be exposed to and when they may be in danger. This is especially true around the holidays because family parties and gatherings are often centered around food. Sometimes, the fear overshadows the benefit of the event and families may choose not to attend and isolate instead.

I have said for years that it is better to be prepared than scared when it comes to food allergies. How can families with food allergy be better prepared during the holidays? Here are some suggestions:

• Make sure epinephrine auto-injector prescriptions and devices are up to date.
• Ensure it is understood how and when to use the epinephrine auto-injector.
• Consider alerting those attending the gathering about the child’s allergy beforehand, or providing food so the foods to which a child is allergic can be more easily avoided.
• Don’t assume that everyone listens to these allergy concerns and suggestions.
• At the event or gathering, check the foods and inquire once again about ingredients from those who brought or prepared the foods.
• Read the labels of the foods when they are available.
• When in doubt, do not consume a food.
• Children can consider bringing their own food and avoid the other foods.
• Create an emergency anaphylaxis plan if there is an accidental ingestion that does not include diphenhydramine. Epinephrine is the drug of choice in allergic reactions from foods, not diphenhydramine.
• Refer to an allergist who has experience with food allergy, as they may consider doing actual treatment called oral immunotherapy. OIT can decrease the risk of severe life-threatening reactions to foods.

Fortunately, there is a lot a family can do to prevent and treat food allergies. No matter the case, though, the better prepared, the less scared. I also tell my families to act like the military and prepare for worst-case scenarios, not the most likely scenario. Let’s have our patients create happy holiday memories.

For more information:

Douglas H. Jones, MD, FAAAAI, FACAAI, is cofounder of Global Food Therapy, Food Allergy Support Team and OITConnect, the director at Rocky Mountain Allergy at Tanner Clinic, and a Healio Allergy/Asthma Peer Perspective Board Member. He can be reached at rmaaimd@gmail.com.