By Katherine Cook
Having a child that has food allergies changes everything.
Not only does the child have to learn how to cope with lifestyle changes, but your entire household does. Little mistakes in the kitchen could mean a trip to the doctor or hospital, going out to eat becomes nearly impossible, and you get to know the school nurse well. You become that person reading every single ingredient label super closely in the supermarket, being rewarded with eye-rolls and mockery from your fellow shoppers. In short, the adjustment can be rough.
After my son, Stanley, was diagnosed with multiple food allergies the first thing I did was research. I wanted to know everything there is to know about food allergies, mainly how to protect him. I knew that we needed to make our home a safe place for him. I couldn’t control what the rest of the world was doing, but I could control his home.
Making the Home an Allergy Safe Zone
The foods that cause allergic reactions are called “allergens.” Even the smallest amount of an allergen coming in contact with an allergic person can cause a reaction. Reactions most commonly occur when the food is eaten, however with more serious allergies all it can take is a touch.
Some families choose to eliminate the offending foods from their homes all together. This is easiest when the child has only one or allergens that need to be eliminated. When you get into multiple food allergies, like Stanley has, keeping everything out of the home becomes more difficult. We have other children in the house who may gain some nutritional benefits from the foods he is allergic to as well. We decided complete elimination wasn’t an option for us, we would have to adjust by safe food handling and education for Stanley on what not to touch.
By choosing to allow allergens to remain in our house there was the risk that those foods could “contaminate” our safe foods and home, this is known as cross-contact. Cross-contact happens when a food allergen comes into contact with food or items not intended to contain that allergen. There were measures that we needed to take to make sure that did not happen.
- Learn how to read food labels properly and look for hidden allergens. FARE has some good guidelines on how to educate yourself on how to do this. The U.S. Food and Drug Administration’s Food Allergen and Labeling Consumer Protection Act and recent Gluten-Free Food Labeling Rule have made shopping much easier, but care and caution are still important.
- Label foods as either safe or unsafe. This will help your child to know what they can have as well as other visitors (grandparents, babysitters, etc.) when they are over. It is also more convenient for you when you are still learning what is safe or not. All you need to do is read what you wrote on it instead of having to re-read labels. We used a black permanent marker and wrote the words on them, and with Stanley being older (seven) at diagnosis this worked well because he could read it.
For younger children who may not be able to read kidswithfoodallergies.org recommends using red and green stickers. Red for unsafe foods and green for safe. (Red means “stop,” green means “go.”)
- Dedicate at least one shelf in the pantry, refrigerator and freezer to allergen free foods. To avoid cross-contact it is best not to place open foods next to each other. It can also be confusing for items that look similar to be on the same shelf. Even if they are labeled that can be overlooked when you are in a hurry.
For example we buy both peanut butter (for our allergy free child) and sun butter (it’s like peanut butter but made out of sunflower seeds in a peanut free factory.). The packaging looks very similar and having them next to each other could be a risk.
- Assign “safe” kitchen utensils and appliances. For example we have separate cutting boards. One for all the foods Stanley can eat and one for the foods he cannot. It is also good to assign a cabinet for the pots, pans, cutting boards, etc. that are only used for allergen free cooking. For wheat/gluten allergies it is recommended to use a separate toaster as well.
- Avoid food supply contamination. Make sure everyone is washing their hands before touching any safe foods. Do not allow utensils with allergens on them to touch your safe foods. For example, if you spread butter on wheat toast then dip your knife back into the butter the butter is now contaminated with wheat and is unsafe. Make sure everyone is cleaning all surfaces after preparing food. Food made on an unclean countertop could result in cross-contact.
- Avoid spreading allergens throughout the house. When someone eats or touches an allergen they should wash their hands with soap and water immediately after. Confine food consumption to the dining room and kitchen to help prevent spreading. If you don’t you run the risk of crumbs and allergen traces getting into your carpet, furniture, and other surfaces. Clean any utensils and surfaces that may have come in contact with the allergen right away.
It is important to note that hand sanitizer does NOT remove food proteins. Hands must be washed with soap and water.
- Take special precautions when cooking. If you are making a meal with both safe and unsafe foods you should prepare the safe food first. Make sure you cover the food well when cooking the unsafe food. Do not use the same utensils to prepare un-allergenic and allergenic foods. After use immediately place all plates, cutting boards, and utensils into the sink and/or dishwasher. Teach your food allergic child that things in the sink and dishwasher are not safe until they have been washed properly. When using a grill you need to fully clean it before cooking for an allergic child. Using foil or a clean grill pan to prepare their food is even better.
- Wash dishes immediately and carefully. All dishes need to be washed in hot, sudsy water before using them to prepare safe foods. Rinse off all dirty dishes before loading them into the dishwasher to prevent bits of dried allergens from sticking to clean dishes.
*Keep medications in a safe and easily accessible place, just in case.
Making Your Child Safe Outside of the Home
As a parent sending your child out into the world is a scary thought. When your child suffers from food allergies it becomes even scarier. It is very important to take the proper measures in your home to ensure their safety, but more than that, you need to teach them how and why. You won’t always be around to protect them so it is vital to educate them. Everything you know, they should know so they can make the right choices when you aren’t around.
- Going to birthday parties and friends’ homes. With careful planning you can make sure your child has safe food to eat. Whenever Stanley is invited to a friend’s home or to a birthday party I always call the parents and discuss his allergies with them. Often you will hear a slight hesitation or annoyance in their voice when you talk to them. They already have a lot going on planning a party or get together, they don’t want to worry about more. I don’t want him to ever feel excluded because of his allergies. I cannot stop him from feeling different, but I can keep him from being isolated. So I am quick to assure the parents that if they are unable to work around them that I will send Stanley with his own food. All they have to do is keep it separate from unsafe food. This is typically what ends up happening. I will also print out an allergy action plan for them just in case and send him with medications he may need.
- Going to school. By working as a team with the school personnel, other parents, and your physician, you can ensure that your child has a safe and rewarding experience. Food Allergy Research and Education (FARE) has created a guidance document to help you help your child attend school safely every day. I found it very useful in talking to Stanley’s school about his safety. You will probably attend countless meetings with teachers, principals, and nurses at the beginning of every new school year. And eventually you will be able to spell the words epinephrine and anaphylaxis without batting an eye as you fill out endless health forms, allergy action plans, and 504 plans. We send Stanley to school with packed lunches to help him stay safe. On top of all of this keeping your child educated on what they can and cannot come in contact with is vital.
- Dining Out. Eating out as little as possible is probably best, and avoid fast food all together. Dine-in restaurants may be equipped to handle food allergies safely, but in my experience fast food joints don’t really have the resources.
FARE offers these tips, and we use them on the occasions we go out to eat: Talk to the restaurant manager and wait staff. Tell the manager or the head waiter about your child’s allergies before you are seated. Present your chef card and ask that it be shown to the chef. Ask what is in your child’s dish and how it’s prepared. Make sure your server understands what they are allergic to, and explain that cross-contact must be avoided. You should never be embarrassed if you feel you’re not communicating effectively. Sometimes, the safest choice is to avoid eating at that restaurant.
If you do decide to eat at the restaurant, keep your child’s meal selections simple. Stanley will usually have broiled chicken, steamed vegetables, and/or a baked potato, which is what FARE recommends as it is one of the easier meals to prepare without contamination. Avoid fried foods and desserts as allergens can hide in these.
*Always have medication where you or your child can access it easily just in case.
It feels like a lot to handle doesn’t it? Two posts in and I still feel like there is so much that we can talk about. It may seem overwhelming, but I promise you it is manageable. There may be times that you cry and that is okay. Just make sure you have that brave smile on your face when you are with your child. Because they are afraid too, and they need you to be strong. Apart from educating yourself, your child, your friends, and your family, finding support is the best thing you can do. I like these sites.
- Food Allergy Research and Education (FARE), http://www.foodallergy.org/
- Kids with Food Allergies, a Division of the Asthma and Allergy Foundation of America, http://www.kidswithfoodallergies.org/page/welcome.aspx
- Food Allergy Education Network, http://foodallergyednetwork.org/
- Arizona Food Allergy Alliance, http://www.arizonafoodallergy.org/
- Mothers of Children Having Allergies, http://mochallergies.org/
- Phoenix Allergy Network, http://www.phoenixallergynetwork.com/
There are also online support groups that can be found on Facebook.
Remember, you are not alone, and this gets easier over time. It becomes just another daily habit, a part of life. I wish you and your child(ren) well.
Read Part One
- My Child Has Food Allergies: Part 1 (fillyourplate.org)