I have one general rule when it comes to handing out candy. I always give out things that I will want to eat if there's any left over. As I've gotten older, my sweet tooth has gotten larger, and this means not only stocking full-size candy bars but also suckers and gum balls. Having worked at AchooAllergy for several years, I've gotten into the habit of keeping things on hand that lack the nuts or dairy ingredients that can cause many food allergic kids problems. Some years I've also taken a handful of two dollar bills (the novelty never wears off on me) and put one each in a plastic Easter egg. On the big night, I bundle three suckers or six gum balls together, since in my mind, those are about equal to one candy bar. I keep each of these different types of things in different bowls and make up a little sign for each, i.e. "Diary-Free," "Dairy & Nut Free," and "Cavities Ahoy!"
This doesn't cover everything, but it does touch on some of the major food allergens. For me, it's not only important to have food allergic alternatives, but also for any kid who shows up at my doorstep not to feel slighted simply because they have a food allergy. Halloween is supposed to be fun, not disappointing!
Not everyone is going to take the time or effort to be so accommodating, and for many people food allergies are not something with which they have experience. So despite efforts that people do or do not take, here are a list of helpful tips that any parent of a food allergic child can keep in mind.
- Wait to Eat - As the most basic tip, try to avoid letting your child eat the candy while trick or treating. Wait until you get back home to not only tally the evening's sweet plunder but also sort out any potentially dangerous candy or sweets.
- Keep Your Own Stash - I like this tip! This is like your currency that you can use when the evening is over. As you sort and pick out any potentially dangerous treats, trade your child for a safe one from your stash. It's a win-win!
- Always Read the Label - Even treats that have been safe in the past can change, so always, always check the label. Avoid candy that is unlabeled, and if unsure, use the trade-in technique from above.
- Have Fun - Halloween is particularly loved by candy makers, but it isn't all about the sweets. Being in costume, visiting neighbors, and just spending time together can make the evening more fun and sweeter than any candy. If candy, and the possible problems from this, just seem like too much, go to party or host your own! There are always fun alternatives if you're willing to put in a little effort.
- Keep an Auto-Injector Handy - It always bears repeating, but keep epinephrine on hand when out and about.
My name is Lisa Rutter, and I am the founder of a group called No Nuts Moms Group. This is a group dedicated to raising food allergy awareness. We offer many resources on our site including a Support Group and Forum on Facebook for all food allergic families from all over the world as well as over 40 local groups throughout the United States, with one in Canada and one in Australia. Our groups are private, free to join, and are a wonderful way to stay connected with others in your area that are also dealing with life threatening food allergies. Within the local groups, we discuss things like, local events, schools, and safe restaurants. This is also a great place to lean on each other or let off some steam and not feel judged for your feelings. Food allergies can be very hard on families and it is nice to have a place to go where everyone understands these challenges. We also encourage outings and play dates within our local groups. This past Easter, our No Nuts Moms Group of Michigan hosted our second annual food free Easter Egg Hunt, with the Easter Bunny making a special appearance. Our Michigan group is also having a food free Halloween event coming up in October.
When I originally started this group in 2011, I was searching for local support and other playmates for my peanut and tree nut allergic child. I felt alone and overwhelmed, and I really wanted to find other moms and kids that both my son and I could relate to. The group has turned out to be so much more to my family and me. I have met so many amazing people and have had so many great things happen to me on this journey. I am now the Co-Leader of FACES of Michigan, which is a local support group for food allergic families. Food Allergy Research & Education (FARE) recently recognized No Nuts Moms Group as an official support group. This was a great accomplishment and a very proud moment for me. Within the past two years, I have also been invited to educational and informative summits by some of the top food allergy organizations out there, and our group is currently helping to get a bill passed that would allow schools to stock the life saving medication, epinephrine. This is something new for me, and I am very proud to help out in this effort.
I am very passionate about food allergies, and it is extremely rewarding to be able to help so many families. I often say that I have the best non-paying job out there! This community and my family fuel me to keep going, and I couldn’t do it without all of them. At the end of the day, I can honestly say that I am doing everything I can to make my son’s future brighter. We, as a family, have hope and will never let go of that.
If you have life-threatening food allergies or have a child with life-threatening food allergies, please visit our main website, No Nuts Moms Group to learn more about our support groups.
About the Author: Founder of No Nuts Moms Group and Co-Leader of FACES Michigan, Lisa Rutter is a 36 year-old mother of two. She, her husband and children all deal with environmental allergies, and one child has severe peanut and tree nut allergies.
What could an allergist could do to help me other than confirm what I already know? Specifically, is there any way to desensitize my body's responses to dairy so that I can enjoy products like cheese and ice cream again. - submitted by Milk Allergic
Cow's milk allergy is one of the more difficult allergies to deal with. If you see a board-certified Allergist, they would be able to help define what level of reactivity you have to these food products, and if you may have allergic sensitivity to other foods. In addition, there are many different ways the immune system can react to food protein that produces a rash, and an allergist could help determine whether it is an IgE mediated process or not. Also, an allergist could help define the exact molecule in milk protein that you are reacting to, i.e. alpha-lactalbumin, etc. which could point towards cross-sensitivity to beef, chicken, etc.
We know have several methods of food desensitization, but only for IgE reactions. Cow's milk is one of the foods for which there are established protocols. Not every allergist does food desensitization as it is a very new technique. Some allergists do desensitizations to hen's egg and peanut as well.
- Dr. Frank
Inhalants, such as, perfume, smoke, and chemicals, cause my asthma to get much worse. Are there any treatments that work? Simple avoidance makes me feel like a captive. - submitted by Jan & Larry
There are quite a few people out there that suffer from those types of triggers called "oxidants" and "volatile organic compounds" (VOCs). Oxidants are released when things burn, or by electrical equipment - or when stuff burns, and VOCs are petroleum based molecules which can directly or indirectly activate your body's nerves or allergy receptors. Many people with asthma can identify these things are triggers, and it usually means that their asthma is not well controlled and they have a lot of active inflammation in the lungs. the key to reducing the asthma triggers is to get the active inflammation under control as best you can.
Many products on this website can help you clean the air in your home, I would recommend a system that reduces VOCs as well as the standard smoke and dust.
- Dr. Frank
My nose runs when I am in the parrot room. Is there a test to see if I am allergic to my Umbrella Cockatoo? - submitted by Cockatoo Blues
True bird-feather allergy is quite rare, and most allergists do not have that in their testing equipment. We commonly see people who think they are allergic to feather pillows, and 75% of the time it is actually just dust mite matter that has built up in the pillow. People with true feather allergy tend to be reactive to a cross-reactive allergen (gal d 5) which is chicken serum albumin and report symptoms with ingestion of egg yolk and chicken meat. Even in exotic bird fanciers, the majority of fanciers that report symptoms are actually allergic to feather mites, Diplaegidia columbae, a cousin of the common dust mite.
The cockatoo is of the order Psittaciformes(Parrots) and there is a blood test called a Parrot Feather specific IgE, which can determine if you are allergic to it or not. However if you already know you develop symptoms when you walk into the room, you should think about wearing an N95 mask to protect your nose, mouth, and lungs. Depending on the diet, some bird droppings will release ammonia as a by product of nitrogen metabolism, and this can be seriously irritating to the nose and throat.
- Dr. Frank
Author: Kevin Gilmore
As we welcome in August, teachers across the U.S. are headed back to prep for the coming school year. That signals kickoff of back to school shopping but also fresh worries for parents about food allergies. Over the last few years, schools have become more responsive to the increasing numbers of children with food allergies, but it remains important for parents to meet with teachers and administrators ahead of time to prepare. Here are few simple points to go over before the new school year begins.
- Recognize Triggers - Recognizing the situation and diagnosing the problem is the first step. What is the child allergic to? What are the symptoms? What are some common sources of this allergen?
- Lunch Time - Will the school lunch be acceptable? If not, what about trading stuff from a sack lunch? Since as of right now there are no overarching laws or guidelines to govern food allergies in schools, much is left to the local district and even the individual school administrators. So inquire as to what steps they have taken. In some local Atlanta school districts administrators have designated peanut-free tables at lunch.
- Notifying Staff - Typically, you would want the teachers, administrators, lunch room personnel, and school nurse to be aware of the allergy and the situation. At different points throughout the school day it would be important for these staff members to be aware.
- Worst Case Scenario - Set a Plan of Action. Time is critical, particularly when it involves anaphylaxis, so it is crucial to have a plan of action already in place in case of emergencies. What is the problem? What action should be taken? Who should or is trained to administer medication? Who needs to be notified?
- Auto-Injectors and Emergency Numbers - Does the school provide emergency epinephrine? Who can administer epinephrine? Who should be called? What other types of drugs can or should be administered (like antihistamines, bronchodilators, etc.)? Again, as of now, many of these things are handled by the individual school, so as far as administering the drug, ask if the teacher/nurse/emergency care provider will be trained and if the school stocks additional auto injectors (as over 1/3 of all cases that require epinephrine often require a second dose). Though Congress is acting to provide more support for food allergies in schools, many schools do not currently stock epinephrine for cases when a second dose is required or where the allergic response is the first of its kind for the student.
All of these questions should be addressed and answered prior to the start of the school year. In the most severe cases of food allergies, minutes can literally determine the fate of a child, and having a plan of action in place can make difference between immediate action and a slow, uncertain response to an emergency.
For additional tips on managing allergies at home or ways to reduce particle allergies and eczema at home.
Author: Kevin Gilmore
Back into the swing of things - Tuesday the U.S. House of Representatives passed H.R. 2094 (School Access to Emergency Epinephrine Act), a bill that would incentivize states to come up with policies to stock and administer drugs used to treat anaphylactic shock. Anaphylaxis is the most extreme reaction that can occur from a severe allergic attack and within minutes, can be fatal. Most commonly, people associate anaphylaxis with food allergies, but this type of shock can be the result of other allergens as well.
On the state level, recent years have shown a willingness to integrate this type of program into public schools, but this is the first significant piece of legislation that would tie federal grant money to developing programs to deal with anaphylaxis. The proposed bill would not only give the green light for all schools to be able to stock epinephrine, the life saving drug used in auto-injectors (EpiPens), but also permit trained administrators to administer the drug in emergency situations. Lastly, it would make it so that in the event of an emergency, trained school officials administering epinephrine would be legally protected by state liability laws.
From peanuts to bee stings, epinephrine has been effective drug in controlling anaphylaxis which can lead to severe swelling, the inability to breathe, and in the most severe instances, death. Allergies effect millions of school age children, and many food allergies can first crop up while at school. This bill hopes to provide the umbrella under which all schools can develop a plan of action and provide the emergency resources necessary under what can often be a life or death circumstance.
With bipartisan support, the bill now moves to the Senate for consideration.
To read the full version of H.R. 2094.
Author: K. Gilmore
Summertime is the most popular time for weddings. According to the National Center for Health Statistics, June through August tend to see highest percentages of weddings of all months in the year. For most, this makes perfect sense. It's sunny, warm, you can hold the event outdoors, and add a touch of nature to the event. While spring allergy season has been mostly laid to rest, this doesn't always apply (particularly when you hold the wedding in a location other than what you're used to). And for all the planning that can go into this joyous occasion, asthma or allergies, of any kind, can wreak havoc on the event.
The article posted on Fox News outlined nine things that can affect a wedding, and while the list isn't comprehensive, it at least broaches a topic that many people can easily let slip their minds. A few of the tips/things to look out for include,
- Keep an eye on the pollen count - in general plan to avoid times in locations where pollens you are allergic to are peaking.
- Pack your meds - Premedicating can be helpful, and if you have severe allergies, don't forget your emergency kit (auto-injector).
- Avoid certain types of flowers and opt for scent-free candles.
- Do a trial run with the make up artist. If it's not someone you regularly use, you might be wary of new makeups and allergic reactions.
Weddings are generally some of the most memorable occasions of our lives, and while there can be enormous amounts of planning that go into weddings, people should never forget about their health. Anxiety, nervousness and stress all build, but keeping up with certain routines, whether allergy-related or simply daily exercise, can not only help keep you centered, they can also remove one worry from your list.
To read the full article.
Author: K. Gilmore
Cooking oils used by most restaurants, especially the big commercial franchises that use peanut oil, use a highly processed, refined peanut oil. Why is this important? The refining process involves high heat, deodorization, bleaching, purification, and other methods of processing to strip away the peanut proteins that are responsible for the allergic reaction to peanuts and leaves a purified, refined oil.
The peanut oils to avoid are often the gourmet peanut oils. These types of oils may have things like "cold-pressed," "natural," "unrefined," "gourmet" or "aromatic" on the labeling of the bottle. Found in the cooking oil aisles at supermarkets or specialty stores, these oils often forego the refining process and retain allergic proteins.
There are research studies that back up these findings, and the FDA makes specific note of oils in Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA) [Paragraph 1-201.10(B)]. So, if you are craving those fries cooked in the peanut oil, chances are you can probably feel safe eating them. Now, the only reasons to avoid Five Guys might be the actual peanuts in their restaurants or your expanding waistline.
Always inquire about the oil before ordering, and discuss with your allergist if you have any questions or reservations.
For more information on FDA guidelines concerning food allergens or for a convenient way to let restaurant staff know about your food allergies, try our convenient food allergy cards.
Fortunately for us boys, the Easter Bunny knew just what we liked. So he would go easy on the jelly beans and heavy on the Cadbury eggs for me while doing the exact opposite for one of my younger siblings. Sweets and candy weren't the only things that came with our Easter baskets. In every basket was a stuffed animal. Mostly rabbits, but often ducks or turtles, from small to large, there was always one in each basket. Another favorite was a pail with a small plastic shovel and rake (which is great for filling with rocks, making sandcastles or mudpies with later). Other times there might be a pack of toy cars, plastic army men or even oversized chalk (that my dad LOVED to see us use on the sidewalk in front of the house!). There was also, always, an outfit - usually a pair of shorts and a shirt. These types of things can serve two purposes. First, they certainly last much longer than a chocolate bunny, but for children affected by food allergies, they can keep the baskets fun without the focus on candy.
As we grew up and began families of our own we also started having an annual Easter Egg hunt. While there always were at least a dozen or two colored eggs, most of what was hidden were plastic eggs, and though no one in the family has food allergies, some of the things my mother did were a bit forward thinking in that regard.
Starting from just a couple dozen and expanding to nearly three hundred, mom would purchase hollow plastic eggs in a variety of sizes and colors. Some would hold candy, like a small packet of jelly beans, individually wrapped chocolates or packets of sweet tarts (a favorite of mine). She would also fill many with a variety of other things, that while not the intention, were very food allergy friendly.
Running around a massive three acre yard we would find colorful plastic eggs with stickers, rubber bouncy balls, or money. The ones with money were what we called the "jackpot eggs". Filled with anywhere from fifty cents to a whopping two bucks, the older we got, the more these eggs became priceless to us. Another fun idea is to put tickets in the eggs. Number the tickets to match with a corresponding, larger, prize that will prolong the anticipation. They could be redeemable or things like a larger stuffed animal, an inexpensive pair of earrings, an iTunes gift card or even events like a couple hours of bowling or roller skating.
Though we didn't do this, before the event, you can have the children help you decorate the eggs. In reality you can get as extravagant as you want, from using simple stickers to going as far as hot gluing beads or other decorations on each egg. Ribbon or paints can also be used. For real eggs, you can fall back on the trusty Paas coloring kit or even use packets of Kool-Aid to dye the eggs. (Oh, and PLEASE make sure you boil them first! You or your child will only make this mistake, once.) Again though, for children with food allergies, the plastic, or even a purely decorative wooden egg, is likely your best bet to avoid and potential problems.
If you put on your own Easter egg hunt, here's a few tips, coming from years of experience. There are easy hiding spots as well as more difficult ones, so cater to your age ranges. By placing as much or more emphasis on things OTHER than food and candy, you can subtly make the event more inclusive for all kids. Lastly, don't let things get too big. Even with six to twelve kids searching, three hundred eggs is... a bit much. If you don't keep track of exactly how many you had to start with, you might have another annual experience that we had, finding them with the lawn mower a few weeks later.
There is nothing quite like hearing the audible change in the sound of the mower as you buzz through a plastic egg, or watch the contents spew out of the mower into a thousand little slivers (particularly when it is a George Washington that was obliterated). Nearly as bad, if not worse, when you hit one of the real, boiled eggs, after it had been sitting in the yard for three weeks.
For many people, Easter is much like other holidays in that a big part of it is gathering with family or friends. While things like food allergies shouldn't be completely ignored, they do not have to dampen the fun. There are a variety of easy ways to be more inclusive and to ensure all the children and adults involved have an enjoyable time!
Author: Kevin Gilmore
Yesterday I came across a very in-depth article in the NYT about a large food allergy study/experiment on children who were highly allergic to multiple foods. Through oral immunotherapy a doctor was able to raise the tolerance of children to multiple food allergens to the point where they could again safely interact and grow up more like normal children. Some of the cases were extremely severe, to the point where even crumbs or traces of food allergens would send some of these children into anaphylactic shock - a nightmare scenario for any parent. Foods like wheat, dairy, nuts, and the usual suspects were actors in this play, but what struck me was the unspoken reality that accompanies the rise in food allergies - no one knows exactly why. So with such a big question mark, I wondered how does this relate to the "golden rice"?
There are many theories about the causes of allergies, and while the most popular, the "hygiene theory" does seem to hold some water when it comes to respiratory allergies like rhinitis, hay fever, and sinusitis, it meets a serious challenge when you try to apply it to food allergies. Studies have shown that children raised on farms or environments that are a little more germ-friendly than the typical suburban American household do show lower instances of allergies and asthma. However, in even these places, respiratory allergies are still increasing, and food allergies are rising at a much higher rate.
So why? Why is the food that has sustained the human race for centuries now threatening the lives of so many of our youth? Dr. Nadeau from the NYT piece leans away from the hygiene theory and more towards the chemicals and toxins that saturate modern life. The idea is that environmental factors damage genes or transform them at a very fast rate. These genes are then passed down, which could explain why children of parents with allergies are much more likely to have allergies.
There is some evidence to support this theory - research pieces that show higher rates of allergies in children when allergic parents as well as others that demonstrate the development of food allergies in children who have immigrated with their parents and adopted a "western diet" (even when there is no parental history of allergies).
This brings me back to the "golden rice". I understand the potential of such a crop, but I also understand some of the dangers commonly levied against genetically modified foods. (FYI, a quick look through your pantry will likely reveal that about 30% of the processed foods you find have genetically modified substances in them.) Brushing these aside and focusing only on the allergy aspect, I keep coming back to a singular question. We do not know why many of the foods that we eat are threatening the lives of more and more children every year, so is it wise to push ahead by adding yet another variable into the mix? We have yet to figure out why the foods we currently eat are affecting food allergies and would most certainly have even less knowledge as to how these new foods could play into that mix.
When turn this question over in my head, I think of a chef who can't figure out why his dish turned out tasting so poorly, but instead of working his way back, eliminating ingredients and trying to find the culprit in the recipe, he simply adds more ingredients and hopes for the best.
To read the full NYT Oral Immunotherapy Story or the NPR story about "golden rice".
Author: K. Gilmore
So what are some common cross reactive allergens? Birch is one of the biggest culprits. A protein found in apple peels is very closely related to one found in birch, and this means the body can sometimes confuse the two. You may be diagnosed with an allergy to birch, but then, while eating a raw apple, you might experience tingling, swelling or itching around the mouth and lips. This type of symptom is most common for people with cross reactions to foods. Another example of this is with grass pollens and seemingly unrelated foods like kiwis, tomatoes, or peanuts. Sometimes referred to as "latex-fruit syndrome," a third common cross-reaction stems from a latex allergy and a sensitivity to certain fruits like bananas and kiwi.
Unfortunately, the problem with this can be felt year round. So while your spring allergy season may play hell on your birch pollen allergy, a reaction to eating fresh apples is likely to appear regardless of the season.
Challenges in identifying and categorizing these reactions can be difficult and cause false positive test results. Common allergen tests, like the skin prick test, can reveal a sensitivity to a particular allergen, potentially a cross reactive food, but then lead to a diagnosis of a full blown allergy to this food. Cross-reactivity does not mean that someone will have a reaction to ALL types of food that share a particular, similar protein. Because of this, eliminating an entire class of foods from the diet because of cross reactivity can sometimes be a bit unwarranted, though not uncommon.
One interesting away around this can be by cooking foods. While the cross reactions can be common when it comes to fresh food, cooked food often alters the proteins enough that the body no longer misidentifies them. This is not always the case (particularly with a cross-reaction to nuts), but this does explain why someone with a birch pollen allergy can feel a tingling in the lips and mouth when eating a fresh apple but experience no symptom at all when eating apple cobbler or drinking apple cider.
Without a doubt, cross reactivity complicates our understanding of allergies and the allergic response. Yet, solving the problem of allergies can't be solved until more is known, and cross reactivity is just another part of puzzle. If you think you may be cross-reactive, talk to your doctor or allergist. While the knowledge in this area is still rapidly expanding, he may be able to help further pinpoint the actual cause of the issue.
Author: K. Gilmore