Parents of kids with food allergies know that it's tough to protect kids from reactions sometimes, even with full knowledge of the allergy. Mistakes happen: labels are mismarked or misread, previously "safe" foods change manufacturing practices, foods unknown to be allergenic are fed to kids. A recent study in the journal Pediatrics shows that this type of accidental ingestion accounts for 87% of allergic reactions. This is reason enough to reinforce a responsible, cautious approach to life-threatening food allergies. But wait, there's more.
This recent study shows another disturbing trend: some caregivers may be giving known food allergens to kids intentionally.
"Non-accidental exposures resulted in 13% of reactions. It's not clear why caregivers would purposely give a child a known allergen, maybe "to see if (the child) has outgrown an allergy, or how allergic he is," says lead author David Fleischer, a pediatric allergist at National Jewish Health in Denver. " -- USA Today
Because an allergic reaction is unpredictable and can lead rapidly to a life-threatening situation, this type of "do it yourself" allergy testing can land you in the ER -- or worse. This is why it's so important to keep in communication with your doctors about new tests or any questions you might have. Please don't try this at home.
I remember hearing a pediatric allergist speak at a recent FAAN conference about "trying out" his son's egg allergy at home -- something he strongly discouraged conference-goers from doing. He fed his allergic son some egg and soon found himself in a life-threatening emergency that he greatly regretted. The moral of this story: it doesn't matter who you are. If you give allergen to an allergic individual, you are risking that person's life and health.
Regarding accidental ingestion, the original Pediatrics study found that, most of the time, it was not parents causing accidental ingestion, but other caregivers.
Why are caregivers making these types of mistakes (besides being human, of course)? I can only guess, but I have a few theories. For one thing, the general public doesn't fully understand the dangers of food allergies. You have to be clear, vocal and willing to advocate for your child.
Please, whatever you do, don't fall into the "I don't want to be that mom (or dad)" trap because it's only going to leave your child more vulnerable in the long run. Repeat after me: "It's OK to tell people how severe my child's allergies are, that they have to be careful and that I have to show them how to do this." Repeat to yourself daily, hourly, whatever you need to do. Telling people about your child's severe medical condition isn't overbearing, it's necessary. Of course, your approach matters. Be calm, matter-of-fact and kind to the person you need to help you and most of the time, you will be effective. Nothing working for you despite your best efforts? Then you have to re-evaluate this person as a caregiver.
Another possible reason why caregivers are exposing kids to allergens? It can be inconvenient to find safe food alternatives or activities and everybody is crunched for time these days. My approach has always been to help educate others and to make it easy for them to help you create the safe environment you need for kids. Partnership is my mantra and it works. In fact, much of my e-book is devoted to coaching you on how to educate and work with others with regard to your child's nut allergy. It is one of the most important things we will do to manage food allergies.
If you ever feel that someone is not taking you seriously, don't leave your child with that person. This is one of the first things that my doctor told me and I still think it's some of the best advice I've ever received. Do what you can to educate your circle, but follow your parental gut instincts. You have them for a reason, right?
Rather than being disheartened by this study, I've found new reasons to believe that a cautious and communicative approach to food allergies works. One new resource for helping others stay on top of allergies/emergency procedures is a new downloadable document created by the doctors at AllergyHome in conjunction with the Kids with Food Allergies Foundation. Here is the link. Thanks to both of these organizations for this resource!
What kinds of problems have you experienced as you try to help others learn about good food allergy management? What solutions have you found?
4 comments:
Thank you for your great Blog, Nut-Free Mom! I am a pediatrician with a daughter with a severe peanut allergy. Our city had a tragic accident in a school this year where a known allergic girl died after peanut ingestion. Since our town is now much more aware and much more interested in listening to me and other allergy moms, I thought maybe my pediatrics background could be used to help. I have recently taken on the interesting task of helping my church have a nut-free vacation Bible school, and after all the work I have done (including talk I gave to the 50 volunteers) I am quite dismayed to say there is still a lack of understanding! After I spoke of avoidance of allergens (there are 12 allergic kids of 150, of whom 6 are Epi-pen needing nut allergies), I found out a "craft" for this week involved M and Ms. Though the plan was for them to be plain, M and Ms are certainly quite known for having fairly high risk of peanut contamination (says so right on the label). How can I find the strength to keep repeating the severity of food allergies and the unnecessary risk of 3-yr-olds and up "playing" with M and Ms but expected to not eat them? I find myself worn-out with this uphill battle of education. Maybe it is because I am used to people listening to me and following my instructions "in the office" and was not prepared for the huge lack of correct information out there. Any ideas on how to get through and continue to educate and advocate without pulling out all of my hair?
6Thank you for your great Blog, Nut-Free Mom! I am a pediatrician with a daughter with a severe peanut allergy. Our city had a tragic accident in a school this year where a known allergic girl died after peanut ingestion. Since our town is now much more aware and much more interested in listening to me and other allergy moms, I thought maybe my pediatrics background could be used to help. I have recently taken on the interesting task of helping my church have a nut-free vacation Bible school, and after all the work I have done (including talk I gave to the 50 volunteers) I am quite dismayed to say there is still a lack of understanding! After I spoke of avoidance of allergens (there are 12 allergic kids of 150, of whom 6 are Epi-pen needing nut allergies), I found out a "craft" for this week involved M and Ms. Though the plan was for them to be plain, M and Ms are certainly quite known for having fairly high risk of peanut contamination (says so right on the label). How can I find the strength to keep repeating the severity of food allergies and the unnecessary risk of 3-yr-olds and up "playing" with M and Ms but expected to not eat them? I find myself worn-out with this uphill battle of education. Maybe it is because I am used to people listening to me and following my instructions "in the office" and was not prepared for the huge lack of correct information out there. Any ideas on how to get through and continue to educate and advocate without pulling out all of my hair?
Hi, thanks for your kind words. Your story is a common one. I'm sure as a pediatrician you did an excellent job of explaining things. Unfortunately, it takes time for people to fully absorb what food allergies mean. They are only thinking "peanut" or "tree nut" and not what may or may not contain these allergens. I would keep checking in with them and asking if they can lessen use of things like M&Ms for those types of activities. It just makes life so much easier and then accidental ingestions won’t happen. I have eaten an M&M or two that was “plain” but that DID contain a peanut fragment. M&Ms also now have an almond allergy warning on them.
I wrote an article in which I suggested non-edible items for school activities. I wonder if this would be helpful to your camp:
http://www.chicagoparent.com/magazines/chicago-parent/2011-october/features/parties-with-allergies
Thanks so much for writing! I’m so happy to hear that my blog has been useful to you. Thanks for reading and for your comment!
I agree, cross contamination is the hardest thing to explain. It also has been sometimes difficult to explain tree-nut allergies. Every time I say nut allergy, people assume it's only peanuts.
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