Food Allergies: Don’t Panic. Make a Plan.
I’m an allergy mom — my daughter is allergic to peanuts and tree nuts — so I tend to read everything that comes my way about food allergies, including stories about what it’s like when your kid suffers an allergic reaction.
So often these stories are plagued by panic and confusion — like this post about pink peppercorns. The point was to let folks know about a potentially hidden nut allergen but what about the fact that her daughter suffered an allergic reaction and no one knew what to do? Or this post by from a few years ago in which the writer seems consumed by her feelings of guilt and helplessness.
My daughter has suffered quite a few allergic reactions, including several that resulted in a trip to the emergency room, so I do understand the panic. Allergic reactions are scary and unpredictable. You need to act quickly but what should you do? Are you overreacting? Are you underreacting? When your kid has an allergic reaction, you or your child’s caregiver may be too panicked to think straight.
What’s essential — and often missing from these pieces — is an emergency care plan. The plan should make clear — with words and images — exactly what steps to take when your child suffers an allergic reaction. We use this one from F.A.R.E. An emergency care plan is a great tool to help caregivers cut through their panic and act quickly and decisively.
Unfortunately, another hallmark of these stories is misinformation — either in the piece itself or in the comments. Here are some important facts that always seem to get lost in the shuffle:
1. Benadryl does NOT treat anaphylaxis. It should only be used to treat mild symptoms such as hives. Many people think that Benadryl is an appropriate medication to give someone who has ingested an allergen but in some cases it can actually mask symptoms of a severe reaction and delay a life-saving shot of epinephrine. For that reason, our allergy treatment plan leans toward administering the epinephrine shot under most circumstances. There is virtually no risk to it and it can be a lifesaver.
2. Do NOT assume anything from a history of mild reactions. People often ask me — how allergic is your daughter? Well, that’s a tough question. An allergy sufferer can experience anaphylaxis without any past history of severe reactions. My daughter has never gone into anaphylactic shock but that doesn’t mean she won’t in the future. Also, skin prick and blood test results (unlike molecular tests for peanut allergies) aren’t a very precise tool for measuring severity of the allergy.
3. There is no diet or homeopathic treatment than can cure food allergies. This is probably obvious to you but I keep seeing recommendations for this diet all over the place, including in the comments of the aforementioned pink peppercorn blog post.
4. Don’t rely on your pediatrician. Seek treatment from a good allergist. Pediatricians aren’t always up on the latest food allergy research. For example, our pediatrician advised that we delay the introduction of other allergenic foods when our daughter presented with an egg allergy but there’s no evidence to support that strategy. The reverse may actually be true. What I like about our allergist is that she always refers to the research and isn’t afraid to say Right now, we don’t know the answer to that.
6. Immunotherapy treatment for peanut allergies looks promising but it’s still in clinical trials. Also, even if the treatment is successful, it means your child will survive eating cross-contaminated food, not that he will be able to enjoy peanut butter.
7. Keep calm and remember the statistics. I know that seems counterintuitive given all of the warnings I just rattled off but the statistics do seem to keep me calm. Remember that, at least according to the CDC, the number of peanut allergy-related fatalities between 1996 and 2006 was just 13.
One encouraging postscript: The mother who wrote the pink peppercorn blog post has since made an appointment for her daughter with an allergist, and she does intend to discuss a treatment plan.