Handling Other Children's Food Allergies
Follow these six steps to be better prepared for preventing and treating allergies.
Even if your child doesn't have food allergies, chances are he has a friend who does. A recent study in Pediatrics found that 8 percent of all children under age 18 are allergic to at least one food. "Overall, eight foods account for 90 percent of all food-allergic reactions: milk, eggs, peanuts, tree nuts, fish, shellfish, wheat, and soy," says Todd Mahr, M.D., an allergist at Gundersen Lutheran Health System in Wisconsin and the chair of the American Academy of Pediatrics' section on allergy and immunology. Learning about different allergies might seem overwhelming and a little scary, but by finding out which foods are off limits and what to do in case of a reaction, you'll keep your child's pals safe. Here's how you can be prepared the next time your little one's buddies come over for a playdate or party.
Know the Difference Between a Food Allergy and a Food Intolerance
Trying to distinguish between a food intolerance and a food allergy can be confusing, especially because they exhibit some of the same symptoms. A food allergy occurs when the immune system mistakenly attacks a food protein and causes an allergic reaction; a food intolerance does not involve the immune system. "People with food intolerances are not able to digest certain foods because their bodies lack the specific enzyme needed to break down that food," says Ruchi Gupta, M.D., associate professor of pediatrics at Northwestern University Feinberg School of Medicine in Chicago. "For example, if you're lactose intolerant, you're missing the enzyme lactase, which breaks down lactose, a sugar found in milk and other dairy products. Food intolerances can cause great discomfort, but they are not life-threatening the way a food allergy can be." Talk to the child's parents about any food intolerances or allergies, but keep in mind the difference between the two.
Learn the Signs of an Allergic Reaction
It's important to keep in mind that any food can induce an anaphylactic reaction, which can be fatal. Symptoms typically appear within seconds to a few hours after the person has eaten, touched, and/or inhaled an allergic food, Dr. Gupta explains. Common symptoms may include one or more of the following: a tingling sensation in the mouth; swelling of the eyes, lips, face, tongue, throat, or other parts of the body; difficulty breathing; rash or hives; redness and itchiness; vomiting; abdominal cramps; diarrhea; decreased blood pressure; and loss of consciousness.
Keep Tabs on What Food Is Off Limits
Always talk to a child's parents to learn more about the child's food allergy and find out exactly what's off limits. Even if a particular product does not contain peanuts, it might be made in a factory that processes products that do contain peanuts. Ask the child's parents for a quick run-through about what is safe, and write notes if it helps you remember. Parents of children who are allergic to common foods such as wheat or eggs might want to provide safe snacks just to be safe. But if there's any question about whether a food is acceptable, find out the ingredients and, if necessary, call the child's parents to get permission for him to consume it. If you can't reach them, stick with another snack or meal that doesn't contain the allergen. Or plan your menu and snack selections before the playdate so that the child's parents can review it. This way, no one has to worry about anything.
Treat Symptoms with the Correct Medication
Make sure that you know the first step in treatment of allergic reactions: epinephrine. Epinephrine, also called adrenaline, is the medication of choice for controlling a severe reaction. It is available by prescription as a self-injectable device (EpiPen® or Twinject®). Children's medication that includes diphenhydramine (such as Children's Benadryl®) is also used to treat mild skin symptoms such as a rash or hives. Ask the child's parents how to use the epinephrine device and how to administer the correct dosage of medication. If you're going to watch a child with food allergy, remind the parents to pack what she needs in case of an allergic reaction and bring everything with you wherever you go.
Always Have a "Food Allergy Action Plan"
Ask the child's parents to share what Dr. Mahr calls a "food allergy action plan" with you. Have them explain and guide you on what to do if their child accidentally consumes a food he's not supposed to eat. If there are signs of an allergic reaction, it's important to react right away. If the symptoms are just a few hives around the face or a rash, start by giving the child medication with diphenhydramine. Call his parents and watch him very carefully until they arrive. If the symptoms progress and/or if the child's throat is itchy and closing, or if he is having trouble breathing, administer epinephrine immediately and call 911 before you call the child's parents. "If you're unsure about the severity of a child's allergic reaction, it can't hurt to use epinephrine," Dr. Gupta says. "You might save his life." It's always better to be safe than sorry. "Delayed use of epinephrine during an anaphylactic reaction has been associated with deaths," Dr. Mahr adds. "It can take just minutes for a reaction to change from simple to severe, so having a plan and putting it into action immediately is extremely important."
Improve Children's Allergy Awareness
Help the child feel more at ease by showing an active interest in keeping her safe. For instance, if your daughter's friend is old enough, ask her to explain the allergy in her own words. This can help her feel empowered. Consider role-playing with your own child so that she knows the signs of an allergic reaction and can get help in case you're not present if one occurs. Teach her not to share certain foods with friends who are allergic. Check out The Food Allergy & Anaphylaxis Network at foodallergy.org for more information on how to handle allergic reactions.
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