Food Allergies and Allergic Teens: Taking the Next Big Step

Happy Birthday, dear Alex.

Today my daughter is a teenager! And while turning 13 is exciting and fun on many levels for her and for us, it also represents for me, at least, a new phase for our family. Food allergy management is no longer just the domain of parents or other adults; kids now step into a leadership role.

Our daughter was diagnosed with life-threatening nut allergies 9 years ago; it's hard to believe it's been that long. We've all learned a lot and grown a lot. No matter how old she gets, of course I will always be there for my daughter if she needs me. I'm always willing to advocate for her if she needs the help, which she will need, for awhile. However, more and more I'm seeing that it's time for me to begin to trust her, offer her the opportunity to self-advocate and make good decisions. This is what she will need to do the rest of her life and frankly, I've always had an eye on this fact. All through her childhood we've encouraged her to self-advocate and learn to self-manage. Now the real test begins, because she will need to do this for herself more and more frequently.

For parents of younger kids who are not yet in my shoes, let me tell you that it does give me a lot of hope and a feeling of security to know that I have taught her as well as I can. Whatever you are doing now to support and teach your child, it will give you more peace of mind when they get older and manage things on their own. I trust my daughter; she's given me no reason not to. But let's face it--kids are kids. They make mistakes. Teens are famous for pushing the envelope; in a way, it's their job to do that.

My daughter's pink "Groovy Girl" b-day cake when she was in kindergarten.
Yep, that seems like yesterday.

The goal is an independent, self-sufficient teen and young adult who can confidently manage their food allergies. But life isn't perfect and neither are we. How do we go forward and help kids get through the teen phase, safely, and healthy in both body and spirit with regard to life-threatening food allergies?

For me, a lot of unknowns still exist. We have a long way to go. But I feel confident (most of the time!) that my daughter can manage her allergies in just about any situation because we have done a lot of work together to get to that point.

A few things I can suggest that have helped me in this effort:

Try to stay positive about handling food allergies. Yes, food allergies rocked our daughter's world and occasionally prevented her from certain activities (ice cream shops, bakery birthday cakes, school treats) but we always focused on the positive as much as possible. Everyone has a challenge in life or multiple challenges; that's life. This is just one of them. If you approach food allergies with an attitude of  "you can handle this" I do believe it helps kids get through some potentially difficult situations.

Offer unconditional, calm support. Suppose your child makes a mistake about what to eat or is struggling with managing the allergy at school. Even if you are so upset (at the school, your child, another child) try not to freak out on this subject, at least in front of your child. They need to feel like they can share with you and so, be calm and offer solutions. If you need to vent, talk to your spouse or a friend. Some kids might feel like they don't want to burden you, so if you get really upset, they won't tell you what's up. And you don't want that. It's good to remember the motto: "Keep Calm and Carry On."

Give kids ownership of the allergy right from the beginning. Starting when they are young, have them be the one to remember to pack the epinephrine (of course, you'll double-check, but let them initiate), speak up in a restaurant or to a friend. We have always encouraged our daughter to do this and it's second nature to her now. I remember my daughter's kindergarten teacher telling me that my daughter always asked about foods, would say "no" to certain things and generally advocate for herself. Start young and it will pay off later. It also helps kids to feel more empowered and less shy when they can do this.

Be honest. This is life or death stuff, so you have to be honest about concerns and food allergy management requirements. In turn, kids should be able to feel comfortable sharing their feelings, good or bad, about food allergy management.

Remember that you are not your kid. If you don't have any food allergies yourself, you may not understand everything that your child is going through. Listen to them and sympathize and acknowledge that they may be experiencing things unknown to you. They will respect you and trust you for admitting that.

I'm not going to tell you I'm never scared about sending my daughter out there with allergies or that I don't have anxiety about certain things.  All I can do is trust that I have done what I can do and that I will continue to be a resource for her.

For more information on teens and food allergies, click the link for a great article on management and coping.

And visit Anaphylaxis Canada and the FARE web site for specific teen info. Allergic Living magazine has a lot of good information, too.

Teaching Kids To Manage Peanut and Tree Nut Allergies

Make sure your kids know what to avoid by
 showing them what allergens look like.

With school in full swing and food-centric holidays and events a constant reality, now is an excellent time to think about how well your child is able to advocate for himself with regard to food allergies. Obviously, very young children need lots of help, protection and direction. But as kids get older, you can begin incorporating some of the responsibility for managing allergies into their routine.

Each child’s own maturity will dictate much of your approach, but it’s never too early to start teaching kids how to protect themselves. It’s not often talked about and sometimes it’s uncomfortable to think about, but your child can be the first line of defense in any attempt at preventing a severe allergic reaction. It's important to have your child's school and caregivers on board, but don't forget the most important person: your child.

Teach them to be their own best advocates.

Your approach will vary according to age and maturity. For younger kids you can start by showing them what the allergens look like and what they need to avoid.  Does your child know what a peanut or a tree nut looks like? Make sure they know and understand, by showing them pictures of these items and discussing them, and be ready for some funny questions.

A friend of mine showed her 3-year-old nut-allergic son some pictures of peanuts and told him to avoid them if he saw them. Later that night, she was pulling a pan of baked potatoes out of the oven and he said “Why are you and Dad eating those big giant peanuts?” As much as we chuckled about his question, her son had  a point — baked potatoes DO kind of look like peanuts, especially if you are a little kid trying to do the right thing. So be sure to review the foods that are safe and how to tell the difference.

My daughter was served a pizza while on vacation a few years ago and despite the fact that we spoke extensively with the restaurant before ordering it, when it arrived she told me it didn't look right. She said "Mom, I think there are pine nuts on the pizza." Sure enough--there they were. (Pine nuts are considered a tree nut and those with tree nut allergies should avoid them according to most allergists). At first the pine nuts looked like slivers of garlic, so she had a sharp eye! Her ability to know a pine nut's appearance prevented her from eating the pizza and we were able to avoid a potential reaction. 

Kids are offered food constantly

It seems like no matter where you go, kids are being offered food — at the supermarket deli, bakery, dentist, your place of worship, even the pediatrician. Use these instances to teach your child to say “No” to any unknown foods, politely but firmly. When my daughter was younger, I liked to carry a few safe treats around in my bag for those times she had to refuse an unsafe food. It is nice reinforcement that, no, you might not be able to have that cookie, but here is a cookie you can have. 

School, daycare and friends’ homes are other places where there will be a high probability that food will be offered. Allowing your kids to see that food allergy management is just a part of your daily life and normal experience will show kids that it’s OK to refuse foods if they aren’t sure about them. To help kids deal with having to say no to foods, it's always a good idea to carry safe snacks and/or to provide the play date treats. Another that helps: directing kids' interaction away from food and more towards playtime. In the end, teaching kids that fun with friends doesn't always have to focus on food can only be good for their general health. Silver lining, yes!

Adults need a boost, too.

It's not always easy to be the gatekeeper and instructor in the very important role of teaching a child to manage life-threatening peanut and/or tree nut allergies. Check out the following resources:

Beyond a Peanut educational flashcards -- great for all ages, caregivers, kids, parents, relatives and friends.

The New Nut-Free Mom: A Crash Course in Caring for Your Nut-Allergic Child -- my e-book is a guide for parents facing nut allergies and it's filled with support, practical advice and encouragement.

Supermarket finds-- one of my recent blog posts features nut-free foods found on the store shelves(always read the labels; things can change.)