While being a parent of a child with an allergy is a constant worry no matter the time of year, during the festive season, their anxieties are heightened and their stress increased.
“Many of the most common food allergens are especially abundant in the many delicious sweets and treats that seem inescapable at this time of year, including dairy products and eggs, peanuts and tree nuts, wheat, and sesame seeds,” says Dr Stuart Carr, chief medical officer at Snö Asthma & Allergy Centre.
“There are other common food allergens of course, such as fish and shellfish, soy products, and kiwi, and given the many amazing holiday buffets in the region, those with food allergies always have to be on high alert.”
But there’s no need to panic and shut your precious little one away for the duration of December because with the right advice and knowing what to lookout for it is possible to navigate through this potential minefield successfully and enjoyably.
Dr Carr explains exactly how to do this in a stress-free and safe way.
First, it is important to make sure you have an accurate diagnosis,” he says.
“Many people are told that they have a food allergy based on the results of a skin or blood test, even if they have never had a clear or convincing reaction to the food. It is always important to remember that the best test for food allergy is what happens when someone eats the food. If your child has been eating a food without any immediate, obvious, and consistent reaction, a ‘positive’ test is almost certainly wrong,” Dr Carr cautions.
“Testing for food allergies is not a yes or no process, instead these results reflect the probability that they may or may not have an allergy, and if the test is not carefully chosen based on a supportive clinical history, a ‘positive’ test will be wrong more often than not.”
Dr Carr explains that if your child has had a relatively recent immediate reaction to a common food allergen, and a subsequently positive skin or blood test, then they may very well be allergic to that food. But, adds that if not, the diagnosis may simply be wrong and should be revisited.
“In patients with an unclear or distant history, an oral food challenge may be necessary to sort things out, and this can be safely performed in an allergy clinic with appropriate training and experience. Successful food challenges are life-changing for allergy patients and their families, and without a doubt, one of the most satisfying parts of my day,” he says.
However, Dr Carr adds that if your child has a confirmed food allergy, it is very important that they avoid eating that food in all forms (unless they have been told otherwise) such as milk or egg contained in baked goods for some patients.
Reading labels carefully is of the utmost importance and Dr Carr also advices against making any potentially dangerous assumptions.
“That said,” he adds, “you don’t have to be afraid of your child being around these allergens, as anaphylaxis (a severe acute allergic reaction) would not occur from touching or smelling the food, only after eating. Also, most people with food allergies are only allergic to one or two foods, so that helps make avoidance a little easier.”
So, what should you be aware of if your child has a food allergy, and is going to a (small, socially-distanced) holiday gathering?
“It is always a good idea to speak to the host beforehand, and to consider bringing some snacks from home that you know your child can safely enjoy,’ Dr Carr says.
“At a restaurant, ask to speak to the chef or restaurant manager, and make it very clear that your allergy is a serious concern. A little effort before eating can mean the difference between an enjoyable meal and an unpleasant reaction.”
Dr Carr also highlights the importance of having an allergy action or management plan for any children with a food allergy, and emphasis that it should be reviewed and updated regularly.
“Not all people with food allergies have the same risk for anaphylaxis, so you may or may not need to carry an epinephrine autoinjector (such as EpiPen or Jext), however this is definitely an important conversation to have with your allergist,” says Dr Carr.
“You should carry a fast-acting non-sedating antihistamine for use with mild reactions, however these are not sufficient for more severe reactions or anaphylaxis.”
And ending on a positive note, Dr Carr says that there have been some very exciting developments in the food allergy world over the past decade, both in allergy prevention (a topic for a different day) and treatment.
“Oral immunotherapy (OIT) has been proven to be a safe and effective treatment for young children with food allergies, and a recent publication from a group I have been working with in Canada confirmed that peanut OIT was able to protect 98 percent of allergic preschool children from reacting to accidental peanut exposures,” he says.
“Even more exciting, we found that 75 to 80 percent of these young children were able to pass a full peanut challenge after only a year of treatment, suggesting that we may be on the cusp of a cure for some food allergies. As a result, we are now strongly advocating for OIT for many young children with food allergies, a truly life-changing option,” Dr Carr explains.
So, parents should go into December feeling more confident in light of this expert advice, but Dr Carr has one more thing to add: “Stay safe, wear a mask, and have a great holiday season.”
www.snoasthmaandallergy.com (800278462).
