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The Thriving ChildParenting Successfully through Allergies, Asthma and Other Common Challenges
By Reid, Erica
Center StreetCopyright © 2012 Reid, Erica
All right reserved.
A THRIVING CHILD IN A WORLD OF ALLERGENS
Children Living with Food Allergies and Asthma
For any parent, I think you must first be well-informed before you speak to your child about his or her food allergies. I think the key, as it is in any other life lesson, is to be truthful, calm, and clear about the subject. Don’t sugarcoat it, but at the same time teach your child that their food allergy is manageable, that they can successfully take the responsibility to be mindful and cautious, and that they don’t have to live their life in fear. Knowledge is always power. There is no reason for a child with food allergies to feel left out or odd. They need to know what will hurt them and that they can live a full, normal life.
—Lori Stokes, mother of two
I will never forget the day my son was lying sick on the bathroom floor. Usually filled with boundless energy, twenty-two-month-old Addison was wrapped in a towel, his body limp and lethargic. His normally sparkling eyes, full of life, looked weak, and his typically glowing complexion was dull and pale. He was wiped out. I knew something was wrong. Really wrong. This wasn’t a little cold or the latest bug going around. Addison’s immune system was trying to fight something. My child’s sick. Really sick, I thought as adrenaline raced through my body. Just moments earlier he’d been coughing, a deep, persistent cough that sounded like it was being caused by phlegm in his chest. I had turned on the shower and sat with him in the bathroom encouraging him to inhale the steam that surrounded us. I thought this would help break up the phlegm. But five minutes later, his cough was as deep as ever. Actually, it was worse, so I felt I’d made a mistake with the steam. I knew it was time to call our pediatrician.
“Bring him in,” she said before I’d finished describing his symptoms.
I strapped Addison into his stroller and dashed the seven blocks to the doctor’s office. (We live in New York City, where we walk and cab it everywhere.) I’d never moved down the street that fast in my life.
“He may have pneumonia,” the pediatrician said after listening to Addison’s chest. “Let’s get a chest X-ray.”
“An X-ray?” I asked.
“There’s no other way to find out,” she said. I hesitantly agreed. Then I strapped Addison in the stroller once again, left the pediatrician’s office, and ran another seven blocks to the radiologist’s office for the X-ray.
Before allowing Addison to sit on my lap, the X-ray technician diligently covered me with a heavy padded smock that went from my shoulders to the tops of my thighs. But nothing was used to protect my little boy. This made me feel uneasy. If they’re protecting me so carefully and I’m an adult, isn’t all that radiation dangerous for his body? I thought. But I had no choice and, like always, coached myself through it. This is happening for a reason. I don’t know why, but one day I will. (Maybe it was to share my journey by writing this book.)
The X-ray confirmed my pediatrician’s suspicion: Addison had pneumonia. “I’ll call the drugstore with a prescription for an antibiotic,” she said. I was amazed. My son wasn’t even two years old and he was going from radiation exposure to getting his first antibiotic—a medication you’re always told to use as infrequently as possible. Little did I know that this was the first of many antibiotics he’d be prescribed, and upper respiratory problems he’d have, and that I’d just taken my first step on an unexpected journey—because although Addison did get better, the condition was never healed; the antibiotics were only a temporary fix, and the root cause of the problem was never addressed.
For the next year, Addison and I were in and out of different doctors’ offices. He was having recurrent upper respiratory infections, and I was always told that it was bronchitis and that he had to have an antibiotic. This was not only frustrating, but upsetting and nerve-racking; I didn’t like having to give him antibiotics so frequently and at such a young age. Aside from the fact that all these doctors’ appointments were time-consuming, it was frustrating to have to share Addison’s health history over and over again each time we saw a new doctor. One visit to a pulmonologist really stands out for me.
“He definitely has asthma,” the doctor said after taking a family history. “Take this prescription and fill it immediately.”
“What is it?” I asked.
“A nebulizer with a steroid,” she said nonchalantly. It didn’t feel as if her diagnosis and remedy were specifically for my child, but more robotic, automatic. She was doing exactly what she’d done with the patients who came in before my son, and would do the same with those who came after. Yes, I was prepared to hear that medication was the answer, but steroids? For a child who was under the age of two? I glanced over at my son, who was on the floor coloring. The thought of strapping a mask on his head and letting him inhale steroids into his tiny body was heartbreaking. Was this really the only way to help him? There was no other option here? This was a child who needed to build up his immune system, not fill it with chemicals.
“Come back in four weeks,” the doctor said briskly, as if trying to wrap things up and move on to the next patient as fast as possible. No way, I thought. Something firm inside me was saying to her, Your words are going in one ear and out the other. And nothing you suggest is going into my son’s body! I felt stubborn (more so than my usual stubborn self).
After this, a friend recommended that we see a well-known allergist at one of New York City’s most prestigious hospitals. He was so busy that at that particular time there was a three-month wait to get an appointment with him. I was looking forward to meeting him, thinking this man with such a huge reputation would be able to help me find some answers.
When we finally got around to seeing him, he did some routine tests, including a skin test for some of the most common allergies such as peanuts, eggs, chocolate, and dairy. His conclusion? “For now, your son won’t be able to do anything physical outside without two puffs of an albuterol inhaler every day,” he said.
Albuterol is a medication that warns of asthma-related death on its label, so I wasn’t particularly thrilled at this suggestion. I was also nervous because I recalled that the sister of supermodel Niki Taylor had lost her life after using an inhaler for her asthma. I didn’t know the details of the story or if the inhaler was the official cause of death, but that tragic story stood out in my mind and raised a red flag for me.
Next, the doctor handed me a stack of prescriptions: one for the inhaler, one for a nebulizer, a third for steroids, and the last for an EpiPen, an injectable device that contains the drug epinephrine, which he said Addison couldn’t leave home without.
“Why an EpiPen?” I asked.
“Your son is highly allergic to eggs.”
“But he eats eggs and he’s fine,” I protested. Addison had never had an allergic reaction to eggs, and certainly not the hives, shortness of breath, or swollen lips that would have warranted the use of an EpiPen.
“He’s highly allergic,” the doctor repeated, an air of frustration in his voice. “His tests revealed that he’s allergic to egg.”
I continued trying to convince him otherwise, but he didn’t seem to hear a word I was saying. Instead he dismissed me. I wasn’t surprised. During the appointment he had been racing back and forth between my son and the patient in the room next door. He was on autopilot. Not once did he look me in the eye or show any compassion or patience. Though he said very little, his whole manner spoke loud and clear. It told me, You’re the patient. I’m the doctor. Just sit there, be quiet, and accept my help. Not once did I feel that I was being heard or did he slow down long enough for me to say, “What do you mean?” And this was the famous doctor who had a three-month-long waiting list! Just like the immunologist we’d seen before, he was stuck in a routine and made me feel like Addison was just a number.
That appointment revved up my engine. From the moment I stepped out of that doctor’s office, I was on a mission. I can’t and I will not just take someone else’s word, I thought. There must be something else I can do to help my son deal with these health issues. What are the options? Keep him medicated? Shots? Something natural? Get a second opinion? And that was the start of my trying to find alternative remedies for the medications these doctors wanted to prescribe for my child. A child who had yet to celebrate his second birthday!
Knowing there was something else out there for Addison besides steroids, but unclear what that “something” was, I started to do research. I went directly from that doctor’s office to a health food store. After all, if I was being urged to take a chance with prescription medications, it couldn’t hurt to take a chance first with something with no side effects. At the health food store, I perused the aisle of books, pulled one off the shelf, and put it on the counter.
“That book’s okay,” said the store owner. “But this one is great.” He pointed to The Allergy and Asthma Cure: A Complete 8-Step Nutritional Program by Dr. Fred Pescatore. I was intrigued. It sounded like what I was looking for.
“Thank you,” I said, grateful that someone was actually trying to help me. I was so taken aback by the title of Pescatore’s book that to this day I don’t remember the name of the first book I’d selected. All I remember is that I put it back on the shelf, grabbed Dr. Pescatore’s book, paid for it, and headed home.
Later, my kids and I went through our usual nightly routine of dinner, baths, and bedtime stories. Though I usually savored our bedtime ritual, that night I was eager to curl up with my new book and hopefully find something—even just one piece of insightful information. And I did. I read the book from cover to cover, so absorbed, highlighting so much information, that the next thing I knew it was 1:00 a.m. I knew I needed to sleep, because soon enough I’d have to wake up and start the day with two young children. But I was too wide-eyed and excited. Everything this man was saying made sense. He was talking to me. He was talking about my son! I flipped the book over to see where the author was located and was amazed to find that he had an office right in New York City. I wanted to make sure he was still in practice, so I called information for his number and then called his office. (Yes, I knew no one was going to answer at one in the morning, but I wanted confirmation that this was the right place.) When I heard, “You’ve reached the office of Dr. Fred Pescatore,” I was elated. The next morning, the first thing I did was call again and make an appointment. I brought Addison in days later (and my daughter after that), and we’ve been seeing Dr. Pescatore ever since. I can honestly say that this man has helped change our lives.
At that first appointment, Dr. Pescatore did a blood test for food allergies. (The last doctor had done only skin tests, which aren’t believed to be as accurate.) Even before that appointment with Pescatore, I knew Addison was allergic to milk and soy, something I’d discovered when he was an infant. I had nursed both of my children, but Addison ate a lot, so I never had enough breast milk to pump and store in the freezer for him. This was a problem if I had to go out and someone else had to feed him. I had needed a backup plan. Our pediatrician had suggested a milk-based formula, but my son broke out with a little reddish-colored rash on his cheeks immediately after I gave it to him. Obviously, he was reacting to something. When I gave him soy milk, the same thing happened.
Dr. Pescatore’s more thorough testing revealed that Addison was allergic to more than a dozen foods! The list the doctor handed me, along with a color-coded chart, included black pepper, vanilla, cinnamon, and wheat. This was surprising at first. I’d never heard of anyone being allergic to some of those things (black pepper?). I was even more surprised when Dr. Pescatore told me to omit these foods completely from my son’s diet. “Just try it for three months,” he said.
He tried to reassure me, but honestly, I wanted to cry. All I was thinking was, How is it really possible to avoid all those foods? I’m no chef. I hesitated, because this was a lot to do. But once I set those feelings aside, I agreed, even though I really wasn’t sure that I had it in me to do this. This task felt beyond overwhelming. But I thought about my son and his health instead of thinking about what I wanted to do.
At that point I did know a little bit about food allergies. All my life I’d been allergic (like my mother before me) to tree nuts (the only “nuts” I can eat are peanuts, which aren’t technically nuts, but legumes), fish, and seafood. As a result, I grew up very aware that I had to be careful. My daughter is also allergic to nuts, which I discovered when she was a baby. Still, dealing with nut and fish allergies is very different from dealing with a son with a long list of foods—common foods that are everywhere—to avoid.
I’ll be honest. I’ve been doing this for five years now, and at times it is still overwhelming to have to monitor my children’s food intake and be on guard for a reaction. At times it’s challenging. But so are many other things in life—such as marriage and work—and I believe that it’s all in how you choose to go in there and tackle it. If you’re trying to move up the job ladder at work, you have to roll up your sleeves and put in some hard work. You have to educate yourself, to learn. I don’t see this as any different. I had to make myself aware and knowledgeable. I can’t focus on the fact that I have to study every food label or fill my purse with special food and medication every time we leave the house. Am I going to get upset and angry? No, because that won’t take away my children’s, or my, food allergies. They are a part of who we are, but they don’t define us. I try to focus on the positive: my son may have a lot of allergies, but they are manageable. He doesn’t have to live in a bubble, and it could be a lot worse.
Allergies are more prevalent today than ever before, so you can find foods made without eggs, gluten, or dairy, and many labels tell you if a product was made in a facility with nuts or other allergy-causing ingredients. Plus, more people are aware of food allergies today than ever before. For example, my son certainly has it better than I did when I was his age. When I was growing up, I was the only kid in class with food allergies. Today, I know so many people whose children have allergies and asthma. Some cases are mild; some are severe. In short, those of us with food allergies are not alone.
Researchers from the University of Pittsburgh discovered that allergic reactions caused by food led to more than 7 million emergency room visits during the period 2001–2005. That’s an average of 203,000 each year! Ninety thousand of those were for the potentially life-threatening allergic reaction called anaphylaxis.
This is why I want to share whatever knowledge I’ve discovered on my journey, because I know that every little bit helps. What follows are the things that have made living with my children’s allergies and my own safer and easier for all of us.
Take Your Time Introducing New Foods
When Arianna was six months old, her pediatrician, Dr. Barbara Landreth, told me she was ready to try eating solid foods. Dr. Landreth gave me a feeding chart and told me to give my daughter just one food for two to three days, because that’s a good way to check for food allergies. This was long before I knew Arianna had any allergies and two years before Addison was born.
I’d heard other pediatricians suggest offering your child different foods all at once, but I liked Dr. Landreth’s more conservative and careful approach. This was also the approach I took with Addison, because by the time he was starting to eat solid foods, I knew he was allergic to dairy and maybe sensitive to soy. So I took my time, introduced one food for two to three days, and watched for a reaction. The reasoning behind this is that if you give a child a few foods at a time and he has a reaction, you won’t know which food was the problem. I strongly suggest you try this. It is very helpful.
Look for Subtle Signs
With allergies, we all look for the well-known reactions, the ones that are obvious, such as hives, swelling of the face, or the inability to breathe. But there are subtler signs of allergies or asthma. For example, my son ate eggs without a problem until he was around four to five years old. Then one day I gave him a fried egg. Instantly, he started snorting, and his nose was running—something that wasn’t normal on an eighty-degree summer day. This, it turned out, was a subtle sign of an allergy. Other subtle signs of an allergy include sneezing, coughing, throat itching, a headache, a skin rash, and an eczema breakout, among others. After that, I took him off all foods with eggs in them. No cake, no cookies. At that point his diet was already wheat-free, dairy-free, and gluten-free. Now it was egg-free.
When Addison had that reaction to the fried egg, I thought back to the doctor who’d told me Addison was allergic to eggs, even though he seemed fine eating them. It turns out, as I have since learned, that you can become allergic to a food you’ve already been eating for a while. (More on this in the “Answers from Erica’s Expert” section of this chapter.) Since then I have found out that Addison is allergic not to the entire egg but only to the white part. No doctor had told me that it is possible to be allergic to the yolk of the egg and not the egg white or vice versa. Normally when you think “egg,” you don’t think to separate the yolk from the white.
Read Food Labels
I read labels carefully and have tried to learn the alternate names for foods and ingredients that my kids and I are allergic to. For example, you can’t have palm oil if you’re allergic to certain seeds. And a food label that may not explicitly say the food has milk in it may in fact contain milk, as there are other words that mean milk, like dairy, or milk protein, like casein. I discovered this when I gave Addison rice cheese, thinking it was dairy-free, and he had a reaction. I researched the product further and learned that rice cheese contains a milk protein called casein.
If I have any doubts at all about a food, we don’t eat it. I like to be on this side of caution. If I’m not clear about what an ingredient means, and I can’t Google it or ask someone who knows, then I don’t let my kids eat it. Period. It’s just not worth the potentially fatal risk.
Talk to Your Children About Their Allergies
This is important for a few reasons: First, I don’t want my children to feel that there’s something wrong with them or that their allergies were caused by something they did. Nothing is wrong with them and they did not do anything to cause their problem. Their allergies are just part of them, not something they asked for. I talk to my kids about their allergies. I do not make a big deal about it, but I want to inform them. Second, they need to know about their allergies because that information just might save their lives. For example, my son knows not to eat or drink anything at a playdate, party, or at school, and he knows to ask if a food is okay for him if he’s never eaten it before or if he is unaware or unsure he’s had it before.
Don’t Leave Home Without Supplies
I never want to be caught unprepared. We live in New York City, where many stores are open 24-7 and where there are drugstores every few blocks, but I still keep important medications and other items on me at all times. It’s too risky to assume that I can race to the store in the event of an emergency, so I never leave home without the following:
An EpiPen. I keep one in my purse, one in the car, and one in a kitchen cabinet. If my husband, kids, and I are attending an event and I am carrying a smaller purse (the kind that has just enough room to fit a cell phone, driver’s license, lip gloss, and cash), I carry with me a few pre-measured, packaged spoons of Benadryl (they are called Children’s Benadryl Allergy Perfect Measure pre-filled spoons) and an EpiPen. Get the dual EpiPen package, which contains two EpiPens and a practice EpiPen in one box. That way, if you mess up with one EpiPen, you’ll have a backup. I also regularly check the expiration dates of any medications, such as our EpiPens and Benadryl. When they’ve expired, I make sure to replace them.
EpiPen instructions. You and your child may know how to work your EpiPen—and if you don’t, practice, maybe on an orange, before an emergency occurs—but in the case of an allergic attack, you may not be the ones using it. A friend, teacher, or babysitter may be the person on hand to use it on your child, so keeping the instructions with the EpiPen is critical. (Note: Once you’ve used an EpiPen on your child, take him to the emergency room right afterward, because of the effect the medication can have on the heart and to make sure your child has received enough of the medication. The dose from the EpiPen may not carry him through, so he’ll need to be monitored to stop flare-ups. Though I carried an EpiPen for years, I didn’t know this until I was an adult.)
Benadryl. The use of medication is not my first choice, but if my kids’ mouths are itching, it may be an allergic reaction. For this, I give them Benadryl. I’m not going to play around. For me, Benadryl is like a credit card: I never leave home without it. This wasn’t always the case. It wasn’t until I had children with allergies that I thought to carry an EpiPen and Benadryl at all times for my own allergies. I have a few purses I use regularly, so I buy a box of Benadryl and put at least three pills in each purse, so if I switch bags at the last minute, I’m still covered. (And who knows? Someone else may need one, too.) The company that makes Benadryl also makes liquid Benadryl, with pre-measured spoons that are individually wrapped, so you don’t have to carry a big bottle with you. Because liquid is absorbed into the bloodstream faster than pills, this is my first choice, so I carry both pills and liquid.
Albuterol inhaler. I rarely ever use this for my son, but you never know what’s around the corner. Situations can arise, and I have to be smart, realistic, and prepared. I always take the inhaler on vacations, just in case (and have had to use it on Addison while traveling).
Medical bracelets. My kids wear medical bracelets that list what they’re allergic to and give my cell phone number. It’s a precaution I take, because you can never know what will happen. For example, if I drop them at a kids’ club on vacation, I may tell one caregiver there that the kids have allergies, but another caregiver may come in later and not be given this information. The bracelets are just another precaution, another way to make everyone aware. And nowadays they come in many cute styles, so kids don’t mind wearing them.
Your own food. I can’t take a chance that a store, birthday party, airport, or plane will have something that my kids can eat, so my purse is always stocked with acceptable snacks. When we’re traveling, I bring more than I think we’ll need, so I’m ready in case of a flight delay or unexpected traffic. (More on that in chapter 7.) I carry these snacks in my purse because I live in New York City and don’t drive a car. But if you’re in your car a lot, keep it stocked with snacks. When we travel by plane, I always bring extra food, and this often includes applesauce and soy yogurt. Because these foods have a bit of a liquid consistency, they’re not normally allowed through airport security. So I carry a signed and dated letter from Addison’s doctor explaining Addison’s life-threatening food allergies and that he needs to carry food with him on the plane. This has been a huge help on several occasions.
Make Living with Allergies/Asthma Easier for Your Kids
Obviously having so many food allergies makes it difficult for my children to eat in certain circumstances. As a result, I make sure that our home is the one place that’s safe for us all. My daughter wants to have what she calls “real food,” such as ice cream or regular (not spelt) bagels, but in my opinion our home needs to be the one safe haven for all of us to eat freely and comfortably. As a result, I purchase only what we can all eat and not all that we want to eat. I want to be able to leave my house and not worry that someone who doesn’t know any better is pouring cow’s milk for Addison rather than rice milk or giving him the wrong cheese. The minute Addison leaves our home, we have to be concerned, so I don’t want him to have to feel that when he is in the comfort of his own home. Yes, it’s a sacrifice that we don’t have nuts, cow’s milk, or cheese in our kitchen, and it may not be what others in my home want, but we have to set those feelings aside so our home is safe for all of us.
IN THE SCHOOL CAFETERIA
My son’s school offers only one option for lunch: their cafeteria food. You can’t bring your own lunch from home. School rule. (Crazy, I know, especially in today’s world of food allergies.) But because the school can’t accommodate Addison’s food allergies with the foods they offer, he is allowed to bring his own lunch to school, but only with a doctor’s note saying he has to do so. I don’t want him to feel singled out or different, so each month I get the school’s lunch menu and each morning I pack him a healthier version of what the rest of the kids will be eating that day. For example, if the meal for the day is turkey tacos and oatmeal-raisin cookies, I make him a turkey taco with organic turkey meat and organic corn taco shells and bake him oatmeal-raisin cookies that contain no dairy, no eggs, no nuts, no gluten, no wheat, and no sugar. (They’re simply sweetened with agave or maple syrup and lots of mother’s love. See the recipe on page 229.) If the school is serving pizza, I defrost a frozen gluten-free, dairy-free pizza the night before and bake it the next morning. If they’re having ravioli, I pack ravioli made with tofu, which I get at the health food store. No, I don’t always match the school’s lunch exactly, and yes, this is time-consuming. It’s also not the easiest thing to do when I’m rushing to get two kids up and out the door. But it’s better than letting my son starve or feel ostracized.
I also make sure that his teacher has a stash of sweets that he can eat so if someone unexpectedly brings in a treat for the class, the teacher can pull out his treats and he won’t feel left out. If I know in advance that it’s a classmate’s birthday and that child is bringing in cupcakes, I pack a gluten-free, dairy-free, egg-free cupcake for Addison, which I bake or purchase from a specific bakery here in New York City that makes treats he can eat.
If my son goes to a birthday party, he brings his own food. Before the party, I call the parents to find out what they’re serving for the main meal—which is usually chicken nuggets and pizza. (See “Alternative Birthday Party Menu” on page 238.) I also ask if they’re having cake or cupcakes for dessert. Armed with this information, I then provide versions of these foods that Addison can eat. There are times when I forget to call the parents or don’t have time to make his food. In that case, he knows not to eat anything served at the party, and I give him one of the snacks that is always stashed in my purse.
When we travel, I often try to find a local health food store and buy food that Addison can eat, such as rice milk, frozen waffles, and his favorite ice-cream sandwiches. Then I’ll ask the hotel kitchen to keep these items and deliver them when we order room service. This way when we order breakfast or dessert, Addison can feel included in the room service delivery and I can be certain that what he’s eating is safe for him.
Inform Everyone of Your Child’s Allergies
AT SCHOOL OR ON A PLAYDATE
Wherever my kids go, be it school or a playdate, I call the adult who will be watching them to let her know which foods each of my children is allergic to. Because of Addison’s extensive list of allergies, I tell that parent not to give him anything—no food, no drinks, no gum or candy. Not even water. I want that parent to know how serious the situation is. Unless a caregiver has a child with that specific allergy, or is allergic to that food herself, I can’t assume she’ll know this. I also can’t assume she will be able to figure out what foods not to give my child. So I make it easier for her and for Addison by simply saying, “Don’t give him anything.” Then I pack him a snack and a drink.
I also make sure that anyone who supervises my children knows how to use an EpiPen. I can’t just assume they’ll be able to figure it out.
IN A RESTAURANT OR AT A PARTY
When we’re at a restaurant, dinner party, or anywhere I’m not preparing the food for myself or my children, I always make a point of notifying the people preparing and serving our food that we have severe food allergies, and I inquire if the things we are allergic to are included in the items they’re serving. At restaurants, I make sure that the person taking our order fully understands that we have serious, life-threatening allergies. When I order, I even ask the waiter to repeat the order, because I can never be sure what he’s actually writing down. For example, once on a trip to Florida I made sure the woman answering our call for hotel room service wrote down that our meals had to be made without nuts, fish, cream, dairy, or butter. I also had her write down that we were allergic to these foods. If she hadn’t, it might have looked as if we’re just being picky and those preparing the food might not have been as careful in eliminating those ingredients from our meals.
If a waiter, party hostess, or event planner isn’t completely certain about the ingredients in our meal, I have them ask the person preparing the food. (You can even carry cards with you that say what kind of allergy you have and ask your waiter to give one to the person preparing your food. You can make your own laminated card from index cards. And be sure to put your photo on them so they know which person at the table has the food allergy. Or you can get allergy cards off the Internet that list what you’re allergic to. You can add your photo to these, too.)
Sometimes I even inform the manager or maître d’ of a restaurant of our food allergies. You have to stay on top of this to help prevent mistakes.
I also take note of everything on the plate when the food is served, because an allergen may not be in our food, but could be used as a garnish. This happened to us on a vacation when we ordered room service. Our dessert came with what looked like brown sugar sprinkled around the edge of the plate. Even though the waiter assured us it was brown sugar, my gut told me to ask someone else. And I’m glad I did, because after a lot of back-and-forth with the kitchen, we learned that the garnish was in fact nuts. What saved us was my listening to my intuition.
I’ve also learned to make sure that anyone bringing food to our table in a restaurant knows about our allergies. For example, I may tell the waiter about our situation, but that doesn’t mean the person who brings the bread basket to the table is aware of it. This happened to me when we were on vacation. I told the waiter I was allergic to nuts, but not the person who brought the bread basket. So there I was enjoying a nice piece of bread when I realized, too late, that it had nuts in it. I immediately had a reaction, which included an itchy mouth, itchy lips, and a racing heart (because I was so nervous). In the end, we had to rush out of the restaurant without anyone finishing their meal and call around to find a local doctor who would make a house call. It may sound like a lot of effort to have to inform the employees of a restaurant about your child’s allergies, but it can be a matter of life and death.
IN A FOREIGN COUNTRY
If you’re traveling to a place where you don’t speak the language, it’s a good idea to learn how to say your allergies in that particular language. Or have someone write the words for your allergies down on a piece of paper in that language so that you can show this to waiters, chefs, and anyone else handling your food.
Educate Your Child’s School
Each school has a different policy when it comes to food allergies, so you have to research what foods your child’s school does and does not allow to enter the school building, and how strict they are about enforcing this. If your school is lax about enforcing an anti-allergen policy—and even if they are not—here are some things you should do to protect your child:
On the first day of school, communicate to the teachers about your child’s allergies. So what if they look at you like you are a crazy, overreactive parent. Food allergies are serious, and if you don’t treat them that way, the school won’t either. After all, it’s your duty to speak up for your child.
Make sure the school nurse and your child’s teachers know what to do in case of an allergy attack, such as how to use an EpiPen or how much Benadryl to dispense. Don’t assume they know about allergies or asthma, because unless they or loved ones have allergies, they may not know what to do.
Have your child’s teacher tell other parents in the class about your child’s allergies, so that they can try not to bring foods with those ingredients for in-class birthdays or celebrations.
Find out whom your child sits next to at lunch. For example, if that child tends to bring peanut butter and jelly for lunch and your child is allergic to peanuts, you may have to get that seat reassigned. This is especially important if your child customarily has a reaction to a food even if that food is simply in the same room or if their skin comes in contact with it.
There is a link between being bullied and having food allergies. A recent study in the Annals of Allergy, Asthma and Immunology found that an estimated 24 percent of kids who have food allergies have been bullied, teased, or harassed as a result. They’re teased about what they eat or about what they can’t eat. And the teasing is not only verbal; it can be physical, with the bully sometimes throwing or waving the allergenic food, or touching the allergic child with it. Make this information known to your school’s principal and other officials.
Listen to Your Intuition
I have learned to do this most of the time, but I have my moments when I do not listen hard enough. This happened on a recent vacation. We were at the beach, and Addison ran into a friend he had met the previous year. After they had played together for a while, the boy’s mother told me they were going into town to get ice cream and she asked if Addison could join them. I said okay, but told her that he was allergic to dairy, so he could have only sorbet, not ice cream. Then I told Addison that our babysitter needed to go with him. This wasn’t because I didn’t trust the parents or needed the babysitter to watch Addison play with his friend. It was because our babysitter knows what he’s allergic to, what to watch for, and what to do in case of a reaction. I also wanted her there because I knew that if he did have a reaction, he would be more comfortable going to her than to his friend’s mom, whom he barely knew.
But once I said that the babysitter had to go along, Addison got really frustrated. “Why does someone always have to go with me on a playdate?” he protested. “How come I can’t go with a friend and no adult from our family?”
I understood his frustration, and it was hard to see him so upset. But, as always, I explained to him that I wasn’t going to send him out for ice cream without an adult who was familiar with his food allergies. I explained that his friend’s parents didn’t have a child with food allergies (I had asked) and that I didn’t want to give them the responsibility, in the event of an allergy attack, to know what to look for and what to do. “People from our home know, but that’s not the case for many people,” I told him.
Addison and I argued back and forth. I was so torn. He was so frustrated. I felt for him. I knew he just wanted time with his friend without a babysitter. He persisted and persisted. Finally, I agreed. But first I looked him straight in the eye, pointed my index finger directly at him, and said firmly, “You can go this time, and this time only. But do not ask again. This is the one time and this is it.” He was thrilled. I was nervous. I reiterated to the parents that he could have only sorbet. Then I sent them on their way with our Benadryl and my child.
One reason I let Addison go was that my husband and I were heading to the same place anyway, even though Addison and his friend’s family were going to arrive before us. But shortly after they left, I got a strange feeling. Something wasn’t right. I was already uncomfortable with the decision I had made, and now I had this strong sense that my son needed me. At this point, we were stuck in slow-moving traffic. The slower the cars moved, the faster my heart beat. Finally, I turned to my husband and said, “I’m getting out of the car and walking.” Actually, I started running (we were in a small Caribbean town, so it’s not as if I were running on a freeway or for blocks). When I walked into the ice-cream place, it took a second for me to find Addison. Then I saw him: sitting at a table with his friend and the friend’s parents. He was spitting into a napkin. When he saw me, he jumped up and walked up to meet me. “Mommy, my tongue is itching,” he said. “My tongue is itching.” I ran over to the table and looked at the cup he had been eating from. One look at the creamy texture and I could immediately tell it wasn’t sorbet; it was ice cream.
I dumped my whole purse onto the nearest table, not caring that everything from pens to tampons came spilling out. I was looking for the Benadryl and hoping this moment would require only Benadryl, not an EpiPen or a visit to the emergency room at an unfamiliar local hospital on a little Caribbean island. When I found the Benadryl, I gave it to Addison, and then took him to the bathroom. As I stood there washing out his mouth and wiping his lips, I was crying, saying to him (and to myself), “I knew better. I knew better. I knew not to let you go alone. This is why I wanted the babysitter to go with you.”
His friend’s parents apologized profusely, but I knew it wasn’t their fault. It was mine. We’d been going to that place since Addison was a baby, and nothing like this had ever happened. But I had let my guard down. I hadn’t listened to that little voice inside me saying, Send the babysitter. It was a difficult moment, but I believe every situation offers a lesson. That day the lesson was to continue to follow my instincts whenever that inner voice spoke to me. Addison learned a lesson, too. We learned it the hard way, at the same time and together.
Even with a food allergy, your children can eat their favorite foods. You just have to learn how to make them without the ingredients that cause a reaction in them. For example, I’ve had to learn to make dairy-free, egg-free, sugar-free cookies, because I do not want my son to feel deprived and I want him to eat better-quality food. (I know these treats don’t sound very delicious, but they are. See the recipes in “Really Easy Recipes Your Kids Will Love.”) After all these years of having children with allergies, and dealing with my own, I now try to take a recipe and tweak it so it works for us. It takes a few tries to get it right, but when it’s right, oh my gosh, it’s so yummy. I’m not someone who enjoys cooking, but I enjoy knowing that my kids are eating healthy foods that they can benefit from. As a result, I have surprised them and myself with some of my edible discoveries.
ANSWERS FROM ERICA’S EXPERT
Fred Pescatore, MD, is a traditionally trained physician who practices nutritional medicine and is the author of several well-known books on the subject, such as The Allergy and Asthma Cure, Feed Your Kids Well, Boost Your Health with Bacteria, and the New York Times bestseller The Hamptons Diet. Pescatore is president of the International and American Associations of Clinical Nutritionists and the head of Medicine 369, an integrative medical facility in New York City.
What is an allergy?
Allergies are now the most common chronic disease in North America and are more prevalent than heart disease or diabetes. A broad definition is an abnormal, adverse physical reaction of the body to certain substances known as allergens. Allergy sufferers usually react to quantities of allergens that leave most people unharmed. Some allergies are defined by what causes them, such as a food allergy or insect allergy, while others are defined by their symptoms, such as hay fever, hives, or eczema.
What are the most common food allergies?
Ninety percent of all food allergies are to milk; peanuts; soy; eggs; nuts, such as cashews, almonds, or walnuts (peanuts are actually legumes); shellfish; fish; or wheat. Peanuts, fish, shellfish, and nuts usually cause the most severe reactions.
What’s the difference between a skin prick test and a blood test for allergies?
Skin prick testing is what most people are familiar with and remains the primary diagnostic procedure to determine the cause of allergies in this country. Here, an allergen is injected into the surface of the skin, usually on the back of the forearm, upper arm, or upper back. The allergen interacts with specific antibodies on the surface of your skin mast cells. If you’re allergic to the substance, this will trigger the release of histamines and redness and/or swelling about fifteen minutes after you were injected. Skin prick tests are limited because they measure only an immediate hypersensitivity to antibodies called IgE. If this isn’t the kind of allergy you have, the test will be negative, but you still may be allergic to the allergen tested. The results of this test are also dependent on the person performing it. Factors such as the amount of allergen used; the depth, angle, and force of the needle; and the stability of the allergen extracts can cloud results.
Blood tests attempt to isolate your food sensitivities and allergies using your blood. There are several different types of blood tests. In the one I use most frequently, your blood is incubated with the individual allergens in separate little containers—each for a different food. The reactions that this test measures are multifaceted. Different components of the immune system that may all lead to inflammation, and hence to allergies and asthma, are measured. This is the main reason I think this test is important.
What’s the difference between a food allergy and food sensitivity?
A food sensitivity is only going to make you uncomfortable and cause symptoms you may not even realize are related to the food, such as a headache, runny nose, stomachache, brain fog, and, for kids, not being able to sit still. The tricky part is that it can take up to seventy-two hours before you actually experience these symptoms, so oftentimes you can’t identify the culprit. Also, there are around three hundred symptoms that can be related to food sensitivities. They are not life threatening, but they can be troublesome and, in my opinion, are an underlying cause of asthma, allergic rhinitis (hay fever), eczema, hives, and even acne.
A food allergy is much more dramatic. If you have a food allergy, the reaction to that food will be very immediate, and can also be quite deadly. For example, your throat will close up, you can get hives, or your lips can swell. Other reactions include sneezing and coughing.
If you find out that you have a food sensitivity, do you have to give that food up forever?
No. You should avoid the foods for which you test positive for three to six months. You don’t have to eliminate those foods forever—just until your body has had time to heal and for the inflammation to be reduced. Three to six months may seem like a long time, but the inflammatory process in your body took a long time to develop and needs some time to heal. Be patient.
How does someone develop an allergy to something that just years before they weren’t allergic to?
Excerpted from The Thriving Child by Reid, Erica Copyright © 2012 by Reid, Erica. Excerpted by permission.
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