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How to Talk to Kids About Severe Food Allergies

Image source: Thinkstock
Image source: Thinkstock

Nearly 6 million children in the United States have a food allergy, which is an exaggerated immune response to a foreign substance. As the diagnosis of food and other allergies increases in children, so does the risk of anaphylaxis.

This is especially scary for children with severe allergies, however it’s important to discuss these things with everyone — food allergies or not — so we can all look out for each other.

Teach your child compassion by packing a nut-free lunch so she can join her friend at the peanut-free table. Remind your child that getting sick isn’t any fun and that there are ways to help friends avoid their allergens.

Kids need to know as much as possible about their certain allergies because they are their own first line of defense. There are ways to explain allergies to children so it sinks in — and not in a scary way. Here is some advice from experts:

Keep it simple

“All kids have experienced being sick, so a non-allergy child can relate to it,” says Ayelet Schieber, RD, MS from the Department of Pediatrics, NYU Langone Medical Center. Whether you have a stomach bug, ear infection, or sore throat, Schieber says being sick feels yucky and no one wants to feel that way — that’s why it’s important to keep foods that can make our friends sick far away from them. Compare it to a time a sibling was sick and you asked your child to play in another room and wash up often with soap and water to ward off germs.

Try not to be emotional

Whether you’re explaining a newly diagnosed allergy to your child or why a friend could get sick from a certain food, don’t get emotional. “Remember, kids can feel your stress,” says Schieber. “The more you let the situation affect you, the more it will rub off on them.”

She says to make the conversation informal enough to avoid any hint of fear around the topic and to have the talk in a quiet and focused environment. So if an allergy friend is coming over for a playdate, hop on your child’s bed for a quick one-on-one talk to explain what you’ll be serving and why.

“Rather than going deep into the dark depths of scientific explanations, focus on the main take-home points,” explains Schieber. Something like, we can’t have peanut M&Ms or chocolate milk when your friend is here, but I got watermelon, apple juice, and peanut-free mini cupcakes. Make a point of telling your child she is not permitted XYZ while her friend is over.

Talk to your child with a food allergy about symptoms of a reaction

“Have your child repeat back to you some of the symptoms associated with their allergy,” says Schieber. Get in the game and say stuff like: Pollen makes me sneeze! All this dog hair is making me so itchy! How do you feel if you eat a nut by mistake?

Schieber says your child should be able to identify the following:

  1. I have an allergy and should avoid:
  2. I carry my epinephrine auto-injector and other medicine in my:
  3. I need an epinephrine auto-injector when I feel:

Also, get your child in the habit of asking adults if the food is allergy-friendly.

Avoid birthday party drama beforehand

Don’t let your non-allergic kid be a party pooper when his friend with a super cool cupcake his mommy made shows up to the bowling alley. He brought it to the party because it’s safe for him to eat, not to be a showoff. Schieber says to approach the topic honestly: “‘He brought a different cupcake because your cupcake might have nuts in it. Nuts make him very, very sick.’ Let your kids ask you questions until they (and you) feel confident with the answer.”

Explain why everyone needs to wash their hands

“Any food allergen, including peanuts and tree nuts, can be transferred to tables, door knobs, playground equipment, and other surfaces through touch,” says David Stukus, MD, a physician with the Section of Allergy and Immunology at Nationwide Children’s Hospital. “Soap and water or cleaning wipes containing detergent/soap are the only effective way to remove food allergens.”

He says it’s important to note that alcohol gels, paper towels, or plain water will not remove the food.

Bottom line: “It’s important for kids eating nuts to wash after lunch/snacks to make sure they don’t accidentally transfer the food they were eating with their hands to something that their food-allergic classmate may then touch.”

Make sure your child with a food allergy knows what anaphylaxis is

“The symptoms of anaphylaxis include hives, itching, nausea, and throat constriction. In the worst cases, it can lead to shock — a dramatic decrease in blood flow to the body’s cells that can be life-threatening if not treated immediately,” says Dr. John Pauls, an allergy and immunology specialist with Sharp Rees-Stealy Medical Group.

OK, so that’s the adult version. Dr. Pauls’ description may sound scary, but your child needs to understand the symptoms of a reaction so they can ask for help or alert someone.

To make this conversation a little gentler, ask your child if they have “the itchies” or if their throat feels “weird,” like maybe a winter scarf is wrapped too tightly around their neck. Have your child breath in and out normally to show that this is what normal breathing feels like, and if they can’t breathe like this at any specific time, they need to ask for help or alert someone by signaling to their neck.

Talk to your doctor about when your food-allergic child should learn to use an epinephrine auto-injector

Talk to your doctor and go with your gut, because if you think your child is old enough to  handle injecting himself in an emergency, that’s a great relief.

“Despite the importance of this medication, recent studies have reported that a high percentage of patients prescribed epinephrine auto-injectors are unprepared to use the device correctly. Researchers at the University of Texas recently found that [among a group of 102 patients] only 16 percent of patients were able to demonstrate all of the steps needed to inject the medication properly,” says Dr. Pauls.

So the sooner they learn to use it, the better.

Don’t underestimate your child’s empathy

Your child’s best friend has a bad allergy, huh? Don’t feel like you need to protect your kiddo from the dangers of his friend’s allergy. “Children are naturally empathetic and caring. One way to help children understand their peers’ allergies is to use this built-in strength,” says Sherry Coleman Collins, MS, RDN, LD.

“Children are also very interested in truth and facts. By educating children about food allergies in age-appropriate ways, they can become advocates for their food-allergic friends. Here’s an example: ‘Sally, your friend Amanda is allergic to milk. This means Amanda can’t have anything to eat or drink that contains milk or it could make her very sick. Would you like to learn more so that you can help her avoid her allergens?’ Sally’s care and concern for Amanda will naturally make her want to learn more.”

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