Empowering Children to Manage Their Food Allergies
Daryl L. Minch, M.Ed., CFCS, Family & Consumer Sciences Educator, Somerset County

As a parent of a child with food allergies, I know the challenges of selecting safe food and the worry of giving my child more responsibility in managing his condition. When a child is young we have lots of control, but as they grow older we need to let go and teach them to make safe choices. Letting go is hard and making safe choices is not easy. A true food allergy is the body's allergic response to a food or one of its components. A person may react with hives, itching, or in the worst case anaphylaxis. Anaphylaxis is a severe allergic reaction involving the respiratory tract or multiple bodily systems at the same time. Anaphylaxis is a life threatening medical emergency. Individuals with an allergic condition must strictly avoid all foods that cause a reaction. Some people are so sensitive to certain allergens that the smell, touch, or airborne residue of the food will cause a major reaction. These highly allergic individuals often avoid all food away from home and carry emergency medicine at all times.

How will parents of a child with allergies know when their child is ready to be more independent? The answer is "it depends on the child".

Answering these questions can help:

• Does my child understand the severity of her or his condition and know what foods or ingredients are triggers to a reaction?
• Will my child ask questions about how a food is prepared? Or, are they too shy or embarrassed to ask?
• Can and will my child accurately read food labels?
• Will my child say "no thank you" when peers encourage her or him to try something?
• Does my child know the symptoms of the reaction?
• Does my child know where to get help for a reaction? Or, is my child able to administer her or his own medication in an emergency?

The more "yes" answers, the more confident parents can feel in letting their child make his or her own food choices. The challenge for parents is to empower children to make decisions, to teach them how to use available tools, such as food labels, and to instill confidence in their abilities. Children with and without food allergies need to feel special, but not apart from their peers. The hard part is that making safe choices is not easy even for a well-trained, vigilant person. Consider this situation: A parent takes a group of children to a fast food restaurant to get take-out (yes – fast food is ok on occasion). Everyone orders including a child with peanut, tree nut, and shellfish allergies. That child orders a burger, fries and drink. When they get home and start to distribute the food, the parent wonders, "were these French fries cooked in the same oil as the fried shrimp?" A quick call to the restaurant results in a "yes", so no fries for the allergic child. The cross-contact may be enough to cause a reaction. Cross contact is one of the major reasons for unintended reactions. Take, for instance, a person with shellfish allergies who purchases salmon in the supermarket, without realizing that the counter person just scooped out a pound of shrimp with his gloved hands and then wearing the same gloves picked up the salmon. An extremely sensitive person would probably skip buying fish, but minimally they could ask the counter person to change his or her gloves or use tongs to pick up the fish.

Ingredient label reading is another challenge. First, the print is small and the list is often long. Second, manufacturers change product formulas, so it's critical to read labels everytime. Third, some ingredients have unfamiliar names. It's easy to miss an ingredient that could cause an allergy. Fortunately, a new law requires food manufacturers to list common food allergens on food packages now. Because companies often run similar products on the same equipment, labels often state "run in a plant that processes peanuts" or "may contain almonds or other nuts". Allergic individuals must avoid these foods as well.

Teaching a child to read the fine print is not easy, even when a mistake could be deadly. It takes lots of practice, perseverance, and patience. Give your child many opportunities to read and compare labels. Point out allergenic ingredients on the label. Teach them the many words for soy or milk or other ingredients in a food.

Creative cooks are another problem. One must ask questions about food preparation and ingredients in restaurants and in other people's homes. In restaurants, it's important to inform the wait staff and have them tell the chef that you have a food allergy or talk directly to the chef. Here are some reasons why:

• Some chefs add peanut butter or nuts to dishes, without mentioning it in the description. One may find peanut butter in barbecue sauce or milk in sauces.
• Finfish, such as flounder, and shellfish are usually deep-fried together. Sometimes French fries are done separately, but not always.

Parents need to teach their children and teens to manage their own lives and health conditions. This includes asking questions, reading labels, making choices, and carrying and administering medications. Children and teens with allergies need to feel comfortable and secure in their ability to make those decisions.

My son eats at friend's homes and buys snacks in stores. I'm proud of his ability to read labels, ask questions, and skip tempting treats when he's unsure of the ingredients. I'm letting go, but still worry. After all, that too is my job.