Holiday celebrations with friends and family almost always center around food. While these visits are simply good times to many, for families of food allergy sufferers, an invite can mean preparing for a stressful event.
People with food allergies experience reactions when they touch or eat a food they are allergic to. Food allergy reactions occur within minutes, are reproducible with every exposure, and can become very serious, even life-threatening, within a matter of minutes. Common symptoms include itchy hives and swelling, but can progress to include difficulty breathing, difficulty swallowing, vomiting, loss of consciousness, and unfortunately, even death. People with food allergies need to strictly avoid exposure to their allergen and there is no safe amount they can eat – even trace amounts can cause symptoms in some people.
Even though food allergies are becoming more common (approximately 8% of all children), many people are unaware or in disbelief of how sick they can become. Interacting with someone who is well intentioned but has poor understanding regarding food allergies can create a very uncomfortable situation. Holiday gatherings involving food increases not only the risk of exposure, but the chance of encountering someone with a poor understanding of food allergies as well.
Here are some tips on how to safely navigate the holidays:
Always be prepared: Absolutely make sure that self-injectable epinephrine (ideally, two injectors) is immediately available at all times and everywhere you travel in case of a severe reaction occurring after accidental ingestion.
Communicate and plan ahead: Ask the organizer of the party or call ahead to the restaurant to find out what the menu will include, whether safe options are available, or offer to bring your own. Discuss concerns and risks with the organizer ahead of time to increase awareness and allow for open discussion well in advance of the busy day of the gathering.
Prepare your discussion: Inevitably, you will encounter someone who is not familiar with food allergies. Try your best to remain polite and avoid emotional interactions, as they are most likely well intentioned. Some may not find it necessary to say anything at all and politely decline a food offering. Whereas others may wish to have a few basic points to discuss such as what happens when your child eats a particular food and how there is no safe amount.
Remain vigilant: Food can fall on the floor, be wiped on furniture, or fall into the hands of young children, who can do who knows what with it. Make sure your child is always with someone who can recognize an allergic reaction, in case of inadvertent exposure away from the dinner or snack table.
Educate caregivers: Many people will leave their children under the care of grandparents, aunts, uncles or others who may be unaware of how to monitor foods or may be overwhelmed with the task of recognizing or treating a reaction. Discuss well ahead of time and share educational material, your child’s food allergy action plan, and review use of self-injectable epinephrine with them. Allow them to ask questions and remember the steep learning curve you experienced when your child was first diagnosed.
Talk to your child: Remind them that it is not safe to accept food from anyone without checking with you first. This can be challenging with relatives especially, but they may not be aware of cross contamination or may misidentify a safe food. Asking all adults not to offer your child food can be helpful as well.While this is by no means a comprehensive list of things to consider, I hope it provides a framework for communication and preparation. Lastly, enjoy yourself! The holidays are meant to be joyful and fun for all.For more information about food allergies, join Dr. Mike Patrick in the PediaCast studio!
David Stukus, MD, is an associate professor of pediatrics in the Section of Allergy and Immunology at Nationwide Children’s Hospital. Dr. Dave, as his patients call him, is passionate about increasing awareness for allergies and asthma.
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