How to manage food allergies at home

Because there are no cures for a food allergy, management is the best proactive measure for individuals and families to take.

Managing is based on avoiding the food and being prepared to treat an allergic reaction should the food be eaten accidentally. Anti-histamines can help mild symptoms such as itching and hives, but an epinephrine injection is necessary for severe symptoms or breathing difficulties (eg, throat swelling, wheezing). If epinephrine needs to be given, the person should be immediately taken for emergency medical care, or if necessary, 911 called.

In her book, The Family Food Allergy Book, author Mireille Schwartz outlines the eight primary food allergies, which are to milk, eggs, wheat, soy, peanuts, tree nuts, fish, and shellfish – some may also be allergic to medication. Even trace amounts of a food allergen can cause a reaction. Symptoms like breathing difficulties, trouble swallowing, fainting, or sharp increase in heart rate usually show up within minutes of exposure (although some may take several hours or even twenty-four hours). Therefore, early identification and strict avoidance of known food allergens are essential to prevent serious health consequences. Schwartz recommends observing children carefully for patterns and discussing them with your pediatrician. A colicky baby might be allergic to milk, or a diaper rash might show up every time after an infant eats eggs. Skin and blood tests are essential for a definitive diagnosis.

After Schwartz details the obvious and hidden sources of the eight main types of food allergies and shares savvy allergen-avoidance techniques, she devotes five chapters to various challenges and how to cope with them in schools and restaurants, on public transportation and other enclosed spaces, and during family vacations and holidays. Another chapter is chock full of recipes like chewy granola bars made without nuts or wheat, and homemade vanilla ice cream made without milk.

Besides providing a wealth of helpful advice, Schwartz's overall message is supportive and positive. "It's absolutely possible to live a full, active life with your food allergies," she said. "Arming yourself with information is the key."

Know that food allergies are especially dangerous for children. If your pediatrician believes there is any risk that your child could have a severe allergic reaction (an anaphylactic reaction) to food, your pediatrician will recommend that you—and your child, when old enough to use it by himself—always carry an epinephrine autoinjector device in case of an accidental ingestion of the food. It is essential that you review with your doctor how and when to use this medication. The devices are easy to use and the medication is safe, but it is important to be familiar with the device being prescribed so that there are no delays in providing emergency treatment. A child at risk for anaphylaxis should also wear medical identification.

There’s only one sure way to prevent food allergy symptoms, and that’s to avoid the problem food altogether, in all forms, at all times. Sometimes this is easier said than done. Product labels must be read carefully each time to ensure the allergic food is not an ingredient. Read the label each time because ingredients may change. This is extremely important for patients with severe food allergy.

At home, avoid cross-contact of safe foods with an allergen. For example, a knife used in peanut butter and then in jelly may leave peanut residue in the jelly jar that could cause a reaction when the jelly is used another day. Similarly, be careful when preparing foods and using cutting boards, mixing spoons, and heating surfaces. In restaurants, have a careful conversation with the waiter to be sure that the allergen is not an ingredient or contaminant of your child’s meal, although this may not be guaranteed.

It’s a fairly simple matter to keep a problem food away from a very young child who eats meals and snacks under the watchful eye of parents or caregivers. However, it is more difficult with an older child who has less supervision while eating. Not only your child but also his friends and their parents should understand how serious the condition is and how important it is to avoid the allergen in any form. Above all, children should be warned never to share or taste another child’s food.

Be sure to provide full information about your child’s food allergy to school and camp personnel and child care providers. Update information regularly at the start of each school year and as new facts become available. In this regard, it is important to report accurate information, ie, definite food allergies, not minor food sensitivities.

Next we'll take a look at common myths and misconceptions about allergies. 

To learn more about managing food allergies, pick up a copy of The Family Food Allergy Book at www.basichealthpub.com or www.amazon.com