Please Read This in the Event You Have to Save My Kid's Life With an EpiPen

Knowing the signs of anaphylaxis and how to administer an EpiPen can reduce some of the associative fear of using one.

In season two, episode one, of Showtime’s series, “Billions”, Lara Axelrod is at her children’s school when she spots a small crowd of kids gathered around a girl lying on the floor outside the nurse’s office.
The girl struggles for breath, her face is covered in red blotchy spots, and her forehead dotted with perspiration. The nurse is on the phone calling emergency personnel, saying the girl came into her office complaining of nausea, then she vomited. The nurse tells Lara the girl is having a seizure.
“She’s in anaphylaxis,” Lara says with certainty as she kneels next to the girl and searches her backpack for the girl’s EpiPen. Lara finds it while the camera focuses on her face and the squirming girl on the floor trying to breathe. She presses the Epipen into her thigh.
“Listen, you’re having a reaction,” Lara tells the girl, “but I gotchyou.”
In the midst of this commotion, there’s a moment when the viewer sees the nurse’s eyes widen in horror as she realizes she failed to recognize anaphylaxis. The scene is particularly compelling because it touches on a universal fear most of us have – that we wouldn’t know what to do if we were with someone else’s child having a life-threatening allergic reaction.
The fear is understandable. When I first learned our first child was allergic to peanuts and tree-nuts and the concept of an EpiPen was new to me, I imagined scenarios of having to save his young life, raising my arm, EpiPen in hand, ready to jab his thigh to administer an injection of adrenaline as he clutched his throat with both hands.
I was relieved to learn you don’t ever jab an EpiPen, but rather, hold it to the person’s thigh and press.
I see a similar fear in the eyes of the parents of my son’s friends when I drop him off to play at their house for the first time. I dread this moment. It’s awkward. I try to defuse the moment by saying you probably won’t use it, but he needs to have it with him just in case.
My wife and I have three children with food allergies and are fortunate they are not as severe as other children’s reactions. We’re fortunate that we’ve never had an episode.
At some point, active parents who volunteer in the community will be with children who have been prescribed an Epipen because of allergies to bee stings, food, latex, or another trigger. The idea of being with someone else’s child experiencing a serious allergic reaction can be an overwhelming concept. Knowing the signs of anaphylaxis and how to administer an EpiPen can reduce some of the associative fear of using one.
“Some people hesitate to give the EpiPen because they are unsure if a serious reaction is happening,” says Dr. Jalkut, M.D., of Pediatric Healthcare Associates. “Many parents ask if they can give Benadryl and wait and see before giving epinephrine.”
Especially if the child has had a reaction before, and an adult suspects a serious allergic reaction, “it is imperative that epinephrine be given as soon as possible.” Dr. Jalkut stresses that “epinephrine helps to give time to get to the hospital. Benadryl is not a substitute for epinephrine.”

Know the signs of anaphylaxis

Some indications can vary and reactions can take many forms, but you should take the following symptoms seriously:

  • Trouble breathing
  • Hoarse voice or wheezing
  • Hives, a raised rash that itches
  • Severe itching or flushed (red) skin
  • Swelling of face, lips, mouth, or tongue
  • Fast heart beat
  • Weak pulse
  • Feeling very anxious
  • Confusion
  • Vomiting and abdominal pain

“Another clear sign of anaphylaxis is if symptoms involve two systems,” says Jalkut, “like hives and vomiting, or wheezing and abdominal pain.”
The nurse in the scene from “The Billions” made an especially egregious error when you consider the girl having the allergic reaction exhibited multiple signs from two systems.

How to administer an epinephrine auto-injector

1 | Flip open the cap and slide the EpiPen out of the tube.
2 | Pop off the blue cap, keeping your hand away from the orange tip where the needle comes out.
3 | Form a fist around the EpiPen. Hold the child’s leg in place with your free hand. Place the orange tip to the side of the child’s thigh and press until you feel and hear a click. Hold in place for three seconds.
4 | Release the EpiPen and massage the place where the injection occurred for 10 seconds.
Despite the valid anxiety that lives in the mind of most guardians, you will be equipped to react to a child in anaphylaxis like Lara Axelrod if you remember the signs and the simple steps of how to use an EpiPen.

6 Tricks to Make Halloween Treats a Non-Issue for Your Allergic Kid

If you’re also wondering how to enjoy trick-or-treating without being spooked by potential allergens, here are some tips.

My daughter has multiple food allergies. I’m not talking about food sensitivities. I’m talking about taking an EpiPen with us everywhere we go, knowing our bright, curious daughter could die were she to accidentally eat a rogue cashew.
At two she was old enough to enjoy trick-or-treating with her big sister but too young to understand that, with the exception of Skittles, Smarties, and Tootsie rolls, her Halloween candy would mysteriously disappear.
And that was fine with me.
Now she’s three and she “gets it.” I know she understands that she must ask me or her dad before she eats anything at a party. I know she’ll wait for me to give her a special, safe treat that I’ve packed just for her instead of accepting a slice of birthday cake. What I don’t know is how to handle Halloween.
If you’re also wondering how to enjoy trick-or-treating without being spooked by potential allergens, here are some tips.

1 | Create your own traditions

You don’t necessarily have to replicate the Halloween experience of your youth for your child to love the holiday as much as you did. As a parent, you have the freedom to invent your own family traditions.
Jennifer Roblin takes her seven-year-old non-allergic son trick-or-treating while her husband stays home with their daughter, who is four and has multiple food allergies. Her daughter loves dressing up and handing out plain potato chips (which are safe for her). Says Roblin, “I asked her if she wanted to go trick-or-treating this year and she cried, saying ‘No Mommy, I dress up and hand out tato chips.’”
Leigh Goodwin Furline, who has one child with food allergies and one who does not, gives her kids the option to trick or treat or not. Last year, they decided to skip trick-or-treating in favor staying home to watch a movie. They also received some safe candy and a toy of their choosing.

2 | Trade candy for a toy

Trading candy for a toy means not only can parents bypass label-reading, candy-sorting, and the risk of cross-contamination, but they also avoid the hassle of candy rationing, candy-hiding, kids begging for candy, and all other candy-related problems. Sarah Jean Shambo lets her son choose whatever toy he wants in advance, but she waits until Halloween to purchase it. This way, she explains, “he’s excited about the trade and it doesn’t have to be a fight.”
While the Shambo family takes a DIY approach to the switch concept, many parents call on the official Switch Witch, who needs candy to keep warm through the winter. Developed by a mom who struggled with the piles of candy her kids brought home from trick-or-treating, the toy is designed for parents who want to limit their kids’ sugar consumption and for those who need to keep their food-allergic kids safe.

3 | Trade unsafe candy for safe candy

If a Halloween without candy sounds as depressing to you as a birthday without presents, trading your child’s Halloween candy out for safe treats is a sweet solution. If you’re concerned about the possibility of cross-contamination, you could do what Sarah Hodges does. Instead of sifting through all of her son’s candy and reading all of the labels to determine what’s safe, she replaces everything with Enjoy Life Halloween candies. Megan McDavitt has two children, ages four and two, who between them are allergic to milk, peanuts, tree nuts, and sesame. She encourages them to take non-candy or safe items if any are available. Once they get home, she lets them keep any safe candy and replaces anything they can’t have with No Whey Halloween candies.
Kim Schmid, who has one child with allergies and one without, does it a bit differently. She combines the contents of her two kids’ candy bags and then sorts it. Her allergic daughter gets to keep whatever is safe for her. The rest of the candy goes into her non-allergic son’s bucket.

4 | Just say “no thank you”

As parents of kids with food allergies, we all hope our kids will outgrow them. In the meantime, we share the hope that our kids have the maturity and the confidence to speak up for themselves anytime they could be exposed to an allergen. For some families, Halloween is no exception. In fact, it can be an excellent opportunity to give a child the chance to practice having these conversations.
This Halloween, Adrianna Shook plans to help her almost four-year-old daughter say, “Trick or treat, we have allergies to peanuts and tree nuts. Do you have something else?” Many parents I spoke to said that they were happy to politely ask neighbors if their treats were peanut-free when their kids were little but now that they’re older, the kids do it themselves. Not only that, but it turns out a little education goes a long way. Charlotte Eugenio said that after a couple years of polite no thank you’s in a row, she noticed some houses started offering a separate selection of nut-free options.

5 | BYOC

For parents of younger kids who want their kids to experience as much of the “normal” (read: allergy-free) Halloween experience as possible, a little benign trickery goes a long way. Jennifer Devine Pirozzoli usually takes her kids to the homes of other family members, which gives her the opportunity to run up to the door with an entire bag of safe candy from which her child can choose, without ever knowing that that mom hand-picked it in advance.
Other parents, like Victoria King, who plans to take her two-year-old son trick-or-treating for the first time this fall, will carry safe treats for their food allergic kids to munch on as they walk.

6 | Cash for candy

There’s no reason a kid shouldn’t have the chance to cash in on his treats. Parents like Toni Gaudisio are happy to buy back their kids’ candy. Says Gaudisio, “My kids (who are eight and 11) are allowed to swap out five pieces of candy for safe candy and the rest I buy back for 25 cents. We usually take them [shopping] a few days later to purchase toys with their Halloween money.”
Other parents, like Becki Rice and Cristina Salazar Rafferty, enjoy the benefits of getting rid of the candy without having to pony up – their family dentists are pay for Halloween candy.
Life with allergies can certainly be scary. But Halloween doesn’t have to make it even spookier. A little creativity goes a long way when it comes to making Halloween fun for everyone, no matter what they can or can’t eat.

The Best Question to Ask When Interviewing a Pediatrician

The best question you can ask your child’s potential pediatrician has nothing to do with credentials or office policies.

As an expecting parent, one of your first big research projects is to choose a pediatrician.
You’ll probably start with logistics. Does the pediatrician accept your insurance? How long will it take to travel to the office? What are the office hours? Are there designated times of day for certain age groups? Are there separate waiting rooms for sick and well children? Are there weekend appointments for urgent care? What hospitals does the office admit to? Will your child see the same pediatrician each time, or are there multiple doctors? Is this an academic practice? If so, will your child be cared for by medical students and residents? Can you e-mail or call the pediatrician with questions?
You’ll want to ask about a prospective pediatrician’s credentials: where she trained, what accolades she has received, whether any disciplinary actions have been taken against her.
You may also want to know about the philosophy of the office. What are the pediatrician’s philosophies about breastfeeding and co-sleeping? Does the office have a specific vaccination policy that aligns with your own preferences?
These are all great questions. But you shouldn’t be asking them when interviewing a pediatrician.
All of these questions have clear, straightforward answers that you can find on your own. Want to know where the doctor trained? Check the American Academy of Pediatrics or American Board of Family Medicine databases. Want to know the office hours? Call the office or visit the pediatrician’s website.
Answering all of these questions before you interview a pediatrician will save those precious 10 minutes of time for questions you can’t find the answer to anywhere else.
The best question you can ask has nothing to do with credentials or office policies. It’s “what do you read?”

Why academic reading is important

According to a survey of American Academy of Pediatrics members, the average pediatrician read between 145 and 184 academic journal articles each year. The majority of those articles came from journals the pediatricians personally subscribed to.
All of that reading – a rate of about three articles per week – is important because the field of medicine is constantly changing. Those changes can mean that what was once considered true is untrue. What was once considered unsafe is now considered not just safe but helpful.
A survey conducted by the medical professional network Doximity found that 75 percent of physicians alter their practice because of something they read in medical literature at least every three months. For example, prior to 2015, pediatricians advised parents to wait to introduce peanuts to children until at least age three in order to prevent peanut allergy. The Learning Early about Peanut Allergy (LEAP) trial, the first results of which were published in 2015, found that early introduction of peanuts actually reduces the rate of peanut allergy. This finding has led pediatricians to completely reverse their earlier recommendations.

The big question

Academic reading is absolutely crucial to a strong medical practice. But because doctors are authority figures, it may feel awkward to ask a prospective pediatrician about her reading habits. That’s especially true if you do not have any medical training or do not know much about academic publishing.
It will help to remember that you’re not looking for a “right” answer. There isn’t a “right” academic journal to read, or a “right” number of academic journal articles to read. What you’re looking for is a sense that your prospective pediatrician keeps up with the changes in her field.
There are a lot of bad ways to ask a doctor about her reading. “Do you read academic journals?” is a terrible question, because it pins the interviewee between the clearly right (“yes”) and clearly wrong (“no”) answer. Asking this question is going to get you a “yes.” But even if it’s true, that “yes” won’t really teach you anything, because you won’t learn anything about what or how often your prospective pediatrician reads.
Likewise, you’ll want to avoid “what academic journals do you read?” The question is imprecise because you won’t know whether the pediatrician has a 20-year stack of unread Pediatrics issues collecting dust in a filing room or if she is meeting that three-article-per-week average.
Instead of asking about general reading practices, ask about a specific article. “What’s the last interesting academic article you read?”
Asking this question can tell you almost everything you need to know in order to choose a pediatrician. First, if your prospective doctor lights up and tells you about the latest research, you’ll know she has recently been keeping up with her field. If your candidate answers that she hasn’t read in years, or that she doesn’t trust anything she reads in the whole of academic medicine, you may want to move on to the next candidate. (Of course, you can interpret “read” broadly here. Many pediatricians keep up to date by listening to medical podcasts like PediaCast or Peds RAP.)
The second reason this question is so helpful is that it will tell you whether or not your doctor can describe a complex medical issue to you in plain language. Nearly every parenting website with advice for choosing a pediatrician asks you to think about rapport. BabyCenter notes that “only a face-to-face meeting will show you whether this doctor has the warmth, sensitivity, and professionalism you’re seeking.” The Bump encourages you to ask yourself “Did the communication feel natural? Was the doctor easy to understand?” A great test of rapport is whether or not the pediatrician can explain a recent academic journal article to you in terms you can understand. When that happens, you’ll know that, should your child ever be facing a complicated medical problem, you’ll be able to understand what the doctor is saying about it.

Two follow-up questions

If you’re feeling brave, you can follow up by asking your pediatrician to tell you about a time he changed his practice based on something he read.
The pediatrician’s answer will give you insight into that doctor’s position relative to new and contradictory information. Although we expect pediatricians to be experts in their fields, part of that expertise also requires them to be flexible in their practice. You’ll want to know that, if tomorrow a new study revolutionizes the way we think about childhood nutrition, your pediatrician will be on top of the changes.
Some parenting websites advise interviewers to ask prospective pediatricians about their health care philosophy. That is a great question, but it’s a huge question. Imagine if someone asked you that same question right after introducing herself. It would be nearly impossible to answer.
But you can gain insight into your pediatrician’s philosophy of practice with by asking what you should be reading. What books does she recommend for parents? What books would she steer you clear of, and why? What medical issue has been reported in the news lately that she thinks parents are overly concerned about? The answers to these questions will give you added insight into your pediatrician’s philosophy of care, far better than either huge questions about her overall philosophy or narrow questions about breastfeeding or vaccine policies.

6 Kids Books for Families With Food Allergies

As the mom of a kid with food allergies, I know how stressful a food allergy diagnosis can be. These books can make it easier, though.

As the mom of a kid with food allergies, I know how stressful a food allergy diagnosis can be, for both parents and kids.
These books can make it easier, though. Kids will identify with the characters, who, like them, have to be cautious at school, friends’ houses, birthday parties, and everywhere else. Parents will welcome the chance to spark conversations about safety, the importance of being assertive, and more.


The Peanut Pickle: A Story About a Peanut Allergy

Written by Jessica Jacobs
Illustrated by Jacquelyn Roslyn
Age range 4-8

“The Peanut Pickle” features our sweet yet assertive protagonist, six-year-old Ben, who has a peanut allergy so severe he can’t even be in the same room as a peanut without getting sick. Ben is quick to admit that he is sometimes nervous about speaking up about his allergies, but that he always feels better once he does. In this story, Ben confronts a number of situations where he has to advocate for himself. He consistently makes his needs known in a way that is both clear and kind. Most of the time, his friends and family are happy to accommodate him. Even when his grandmother forgets about his peanut allergy, Ben doesn’t take it personally. In one instance, he has to leave a pool party because there are just too many peanuts around.
This book is chock-full of realistic scenarios, conversation starters, and it even has reference sheets at the back, including rules for parents and children (e.g., always carry your epinepherine injector, always check food labels), a note on peanut allergy statistics, and a list of safety guidelines for parents and caregivers.


The BugaBees: Friends with Food Allergies

Written by Amy Recob
Illustrated by 64 Colors
Age range 4-8

There are eight BugaBee friends, and each one has an allergy to one of the eight major food allergens – peanuts, tree nuts, shellfish, fish, milk, eggs, soy, and wheat. Written in rhymes, it tells the story of each friend as they encounter situations where they have to avoid allergens. Scenarios include Halloween trick-or-treating, encountering an allergen on the school cafeteria menu, and parties. Kids will love the fun pictures and relatable scenarios. Adults will love the second half of the book in which each of the eight common allergens has its own page. Listed are pictures of several different foods, along with questions like “Which of those foods would probably be safe to eat?” or “How can you know for sure if a food is safe to eat?” and “What are some signs that you are having an allergic reaction?” These pages serve not only as a vehicle for assessing your child’s understanding of his allergies but they also provide parents and caregivers a chance to educate kids in a low-pressure way.


Food Allergies (New True Books: Health)

By Christine Taylor-Butler
Age range 7 and up

This book is great for the child who understands that he has a food allergy and what basic safety precautions to take to stay healthy, but wants to elevate his knowledge about allergies. Taylor-Butler covers topics including the immune response that causes allergic reactions, allergy statistics, the nuances and dangers of cross-contamination, common foods where allergens often hide (soybeans in peanut butter, for example), what an allergic reaction can look like (including photos), and how to stay safe (including detailed information on how to read food labels). At the back of the book are resource lists, including recommended books for further reading, organizations and websites, and information on the Agricultural Research Service (ARS) national visitor center.


Horace and Morris Say Cheese (Which Makes Dolores Sneeze!)

Written by James Howe
Illustrated by Amy Walrod
Age level 4-8

Horace, Morris, and Dolores are a trio of mouse friends who are crazy about cheese. They can’t get enough of it. But after Dolores breaks out in hives, she receives the unfortunate diagnosis of a dairy allergy. And the timing couldn’t be worse. The Everything Cheese Festival is about to come to town. Any reader who enjoyed a string cheese, grilled cheese sandwich, or a quesadilla before being diagnosed with a dairy allergy will identify with Dolores’s struggle. Initially she has a hard time accepting her diagnosis, but sure enough, every time she eats cheese, she gets sick and ultimately decides cheese isn’t worth it . When she realizes that she has to say goodbye to cheese once and for all, Dolores comes up with a tasty alternative that proves to be quite popular – even among the cheese-o-philes at the Everything Cheese Festival.


The Princess and the Peanut Allergy

Written by: Wendy McClure
Illustrated by: Tammie Lyon
Age range 6-9

In this children’s story, we face a familiar situation – a birthday party. The trouble begins when our young protagonist Paula finds out her best friend’s princess birthday party menu will feature foods containing peanuts … including the castle cake. The problem is Paula has a severe peanut allergy. Unlike most of the other books in this vein, in which the allergic child tells a friend about the allergy and the friend easily accommodates their need for another food option or a change of venue, in this instance Paula’s best friend pushes back. Paula is tempted to shove the issue under the rug, but her dad encourages her to speak up for herself, no matter how much tension it creates. The stakes are too high to stay quiet. Spoiler alert: Paula’s bestie comes around and even marches over to the local bakery to change her order so that Paula can enjoy the cake with all the other kids.


Word Nerd

By Susan Nielson
Age level 9-12

“Word Nerd” is the story of twelve-year-old, socially awkward, severely peanut-allergic Ambrose. Living in a basement apartment with his loving but overprotective single mom, Irene, our adolescent hero runs into trouble when kids at his school place a stealth peanut butter sandwich in his lunch bag and he nearly dies as a result. His mom then decides to home school him, a path that threatens to make Ambrose’s isolated existence even more lonesome. But when Irene goes to work in the evenings, little does she know, Ambrose is forming an unlikely friendship with the upstairs neighbor’s son, a 25-year-old ex-con, Cosmo. Cosmo and Ambrose bond over their shared love of Scrabble and soon Cosmo starts taking our hero to a weekly Scrabble club meeting, where Ambrose learns about community and acceptance – but not without some twists and turns along the way.

The Simple Food That Could be the Answer For Underweight Kids

Forget an apple a day. A nutrition study in Ecuador suggests that eating one egg a day for six months helped underweight children catch up.

Forget an apple a day.
A nutrition study in Ecuador suggests that eating one egg a day for six months helped underweight children catch up. Even more importantly, those incredible edibles may reduce future rates of stunting by close to 50 percent.
Collaborators from the U.S. and Ecuador created the Lulun Project, named after the Kichwa word for “egg.” The first results from the project were published in the July issue of Pediatrics.
Infants in Ecuador’s Cotopaxi region aged six to nine months were randomized into two groups. The treatment group received one egg per day for six months. The control group received no eggs. All of the children’s households received social media marketing about the project.
At the end of six months, the children in the treatment group had higher length-for-age and weight-for-age than their non-egg-eating counterparts. The researchers also found that children who ate eggs consumed fewer calories from sugar-containing foods than the children who did not consume eggs.
The study also offers reassurance about the relationship between age of egg consumption and future egg allergy. Although parenting lore suggests that parents should not give children eggs for fear of inducing an allergy, the researchers did not identify any egg allergies in any of the children enrolled in either the egg-eating or non-egg-eating groups.
Although stunted growth is on the decline globally, it still affects a huge number of the world’s children. One World Health Organization estimate puts the number at 127 million children under age five in 2025.
Unfortunately, once it develops, stunting is nearly impossible to reverse. According to UNICEF, the first 1,000 days of a child’s life (pregnancy through second birthday) are the most important in preventing stunting.
Stunting has lifelong consequences, not just on children’s height and weight, but on their minds. On average, children who are stunted complete less school and have lower cognitive function than their non-stunted counterparts.
That lack of education has enormous economic impact. Economists estimate that a stunted population can reduce a country’s GDP by as much as three percent.
The results of the Lulun Project are exciting because the intervention – an egg a day – is so simple and inexpensive. This nutritional intervention may lead to increased health for the children of the Cotopaxi region, which may in turn contribute to a brighter economic outlook.
Stunting is comparatively uncommon in the United States. The World Health Organization estimates that in 2012, stunted growth affected 2.1 percent of U.S. children. But the findings of the Lulun Project are useful to any parents who are concerned about their children’s growth.
Because eggs are considered safe to eat up to five weeks beyond their packaging date, they have a longer shelf life than other proteins. That makes eggs a great source of nutrition for families living in food deserts, who might need to travel a long distance to fill their refrigerators. Any family looking to save money on grocery bills can benefit from the humble egg. And families of picky eaters will find that eggs are versatile crowd-pleasers: Kids who don’t want to eat them boiled might like them scrambled, poached, or fried.
Lulun Project II is now underway, following the children a year and a half later. You can follow their progress on the Lulun Project’s Facebook page.

I'm the Allergy Mom, and Yes, I Know You're Not Thrilled

A few tips and pieces of advice that I’ve honed over the years that can hopefully help if you have an allergic kid in your child’s classroom.

Dear Fellow Parent,
You’re probably really annoyed at me. Well, not me, but my kid. And I know, I know – you aren’t actually annoyed at my kid either. Just the way things are today.
It is my kid who is the reason the teacher sent home that note in your beginning-of-the-school-year packet. The one that says, “Due to an allergy in the classroom, please do not send your child with any peanuts or tree nuts in their lunch. This includes peanut butter.”
I know you know it includes peanut butter. But you’d be shocked by how many people didn’t.
There are other variations on this letter:
“Please do not send any homemade treats for school parties due to children with allergies.”
“Please do not send any birthday snacks to school. You may send stickers instead.”
“If you bring food to the classroom for sharing, please ensure that it is tree nut-free, egg-free, wheat-free, soy-free, dairy-free, peanut-free, fish and shellfish-free.”
I know you aren’t thrilled to get that letter. I know you aren’t personally the kind of person who leaves horrible comments on articles about allergies, but I know they are out there. People think my kid should just learn to deal with it because hey, that’s life and the world doesn’t revolve around them. They think I should teach him better and not rely on others to parent for me. They think it’s not fair to their kid who is normal. They think that because they read some study suggesting parents expose kids to peanuts earlier, my kid shouldn’t avoid peanuts anyway.
My stomach goes into knots and I sit my four-year-old down for yet another lecture on how he can never take food from anyone unless I personally say it’s okay and he must ask about the ingredients before he takes a bite of anything and he must always tell a teacher right away if he his throat hurts or stomach itches and if he can’t talk he needs to bang on something loudly until they notice.
By then he’s terrified and I’m trying not to cry in front of him.
Trust me, we’ve talked to him about the dangers of eating something he’s allergic to.
I still need you, fellow parent. I can’t do this alone.
Peanut butter is sticky and it ends up on fingers and door knobs. It ends up on the rim of the juice cup that accidentally gets switched when two kids sit beside each other. It ends up in the belly of a four-year-old who really can’t resist just one tiny bite of that Reese’s cup cupcake everyone else got but him.
I know it’s annoying. I know it’s a huge inconvenience to receive that note. We’ve been doing it for years – foregoing family favorites like the peanut brittle my mom used to send me every Christmas, checking the label on every single item that our child eats, spending extra time in the grocery store looking to see if they have any chocolate chips that don’t contain dairy.
In some ways, it’s more stressful for you. I have the brands we can eat memorized by heart. I know nut-free, dairy-free versions of any childhood favorite. We’ve been given tips and advice from our allergist. My kid is used to hearing “no” when it comes to having something he really, really wants. But when you haven’t had to deal with allergies before, they can certainly throw you for a loop.
Here’s a few tips and pieces of advice that I’ve honed over the years that can hopefully help if you have an allergic kid in your child’s classroom.

1 | Know that it matters

Special diets are certainly more common these days, which might cause some eye-rolling. But despite their increased prevalence, allergies are still a life-and-death scenario. They cannot be taken lightly.

2 | “Contains” and “may contain” are both bad news

Federal law requires the top eight allergens to be listed either in the ingredient list, or separately at the bottom of the ingredient list. Allergic children are instructed to avoid foods that are said to either “contain” or “may contain” the allergen. “Processed in a facility that also processes…” labels are not required by law. Some foods without that warning may also be processed in a facility or on shared equipment as an allergen. Parents will have different comfort labels with that label. To further complicate things, know that dairy can go by many names – casein, whey, and sodium caseinate. If you are dealing with a dairy allergy, it’s best to read the entire ingredient list even if you don’t see a “Contains Milk” warning at the bottom. Also note that “lactose free” is not the same as dairy free. Lactose is a sugar, but a kid with a dairy allergy is likely allergic to the protein.

3 | Think of how your kid would feel

If you are tempted to cheat and send your kid to school with a peanut butter sandwich, think of how your kid would feel if their lunch sent someone to the hospital. There’s no way a parent would want to put that guilt or stress on their kid. It’s easier to just do ham and cheese (again).

4 | Know I don’t expect you to accommodate my kid

Don’t spend all night searching through Pinterest for the perfect gluten-free soy-free cupcake to bake for your son’s birthday party. It’s his birthday! Let him have what he wants! My kid is not your responsibility. Trust me, I prefer it that way – it’s pretty gut wrenching when someone says “No, trust me, this doesn’t have any milk any it! Just butter.” I’ll bring a treat for my kid to your party. Just tell me what color frosting so I can coordinate.

5 | Tell the teacher if you plan on bringing in a snack

Like I said, I have no problem providing allergy-friendly treats for my own kid. But I hate the look on his face when everyone else at the school pick-up has frosting-stained lips and he is holding a piece of gum his teacher dug out of her purse. If you plan on bringing in a special treat, please let the teacher know ahead of time so she can pass on that info to me and I can be prepared.

6 | Allergy friendly snacks are out there – I promise!

You don’t have to pass out celery on Halloween. Here are a few suggestions of allergy-friendly treats my kids have never said no to:

  • raisins
  • grapes
  • fruit leathers
  • clementines
  • berries
  • juice boxes
  • applesauce
  • plain potato chips
  • jelly beans
  • lollipops (not Tootsie pops however)
  • fruit snacks
  • gummy bears
  • Swedish fish
  • Sweethearts
  • candy canes
  • Smarties
  • Lifesavers
  • Skittles
  • Starbursts
  • Jolly Ranchers

Don’t forget non-edible treats like tattoos, pencils, special erasers, bouncy balls, and stickers.
Lastly, I wanted to say thank you. It takes a village to raise a child, and I know it can be a pain when someone in that village has a need that disrupts your routine. You are making the choice to save my kid’s life, and that is something I am deeply grateful for. If it’s any comfort, I do know how you feel. I would give anything to send my kid to school with a peanut butter sandwich, too.
From the bottom of my heart – thank you.
The Allergy Mom

Autumn Allergies: Common Myths You Might Still Believe

A number of myths surrounding the effective management of allergy symptoms routinely make the rounds this time of year. Let’s debunk a few.

Back-to-school time is nearly here. Moms everywhere are mourning in advance. The long, lazy days filled with nature walks, gardening, backyard barbecues, and sleeping under the stars will soon be at an end.
While other moms are thinking about where they can get the best deals on those ridiculous school supply lists, if you and/or your kids are allergy sufferers, your thoughts may lie elsewhere. Perhaps your highest hope for back-to-school season is that you and your kids survive it, impacted as little as possible by the endless sneezing, sniffling, itchy eyes, and wheezing that autumn allergies inevitably deliver.
Unfortunately, a number of myths surrounding the effective management of allergy symptoms routinely make the rounds this time of year, and some sufferers may be tempted to employ their well-meant but inappropriate advice. Some of the myths sound very believable. Unfortunately, none of them contain a lick of truth.
At best, following the advice contained in some of these myths may result in a net neutral: no benefit, no gain. But at worst, their advice may lead to unforeseen complications. By knowing the facts, you can steer clear of these myths altogether, and instead focus your efforts on choosing a treatment approach that works. You and your kids will be better for it.

Consuming local honey can treat allergies

The reasoning goes like this: Bees transport pollen, the supposed culprit for many who suffer from seasonal allergies. The honey these bees produce can be used in a way similar to a vaccine. Hopeful patients ingest a tablespoonful of local honey believing that by doing so, they are developing an immunity to regional pollen causing their symptoms.
Sadly, although the reasoning seems sound, there is no scientific evidence to support this claim. In fact, in their double blind, placebo controlled study, University of Connecticut Health Center researchers found no differences in symptomology among patients consuming local unfiltered honey, commercial honey, and a honey-like placebo.

A rain shower is an allergy sufferer’s best friend

You’ve probably heard it a thousand times. Meaning well, friends or family try to encourage an allergy-suffering child or adult by pointing out that rain is predicted soon. Their reasoning is that since there will be less pollen circulating in the air, allergy symptoms will abate.
Although this may be true for some sufferers, it is not true for all. Many allergy sufferers report an increase in symptom severity following a rain shower. A heavy rain may temporarily clear some pollen from the air, but it can also spur grass growth, particularly in summer and fall, causing more problems for those allergic to grasses. Ragweed and mold, other common allergy-causing culprits, can also get a boost from a strong rain.

A good antihistamine is all you need

Years ago, antihistamines were among the only other-the-counter treatment options for allergy sufferers. Although the newer generation antihistamines (e.g., Zyrtec, Claritin, and Xyzal) can provide significant symptomatic relief, particularly when coupled with a decongestant, antihistamines alone are not enough for some sufferers.
For some, the addition of a leukotriene modifier (e.g., Singulair) can make a significant difference in symptom management. Leukotrienes attack allergic symptoms at their core by blocking the chemicals that cause the inflammatory reaction that leads to excess mucous and blocked airways with which so many allergy suffers are painfully familiar.
Back-to-school doesn’t have to mean back-to-allergies. Although dealing with seasonal allergies can be challenging, by arming yourself with the facts, you can make better treatment decisions for yourself and your family.

Managing Serious Allergies During the Tween Years

Six years after dianosis, we are now in the thick of dealing with the social elements of food allergies with a tween.

My daughter was diagnosed with Celiac disease at two, making all foods and items that contain gluten off-limits for her. We began the tedious process of cleaning out our pantry, relearning how to cook, and constantly monitoring our daughter, Wren. She was malnourished, and our primary job was to make sure she didn’t ingest any food that would act as a poison when it hit her body.
Sleep deprived and also caring for her six-month-old brother at the time, I longed for the days when she knew better than to pick up a Goldfish cracker off the ground and eat it, when she could read gluten-free labels and monitor her own food intake.
“This won’t be such a challenge when she’s older,” I told my husband. “She will know how to handle her condition, how to handle food, and the constant mental strain from being the overseers will lift a bit.”
He agreed, and we pushed through the years when Wren didn’t know how to avoid cross-contamination and didn’t know why Play-doh was on the never list for her. We took over, kept her safe, and taught her how to do the same as she grew ready. She learned and largely took charge of her food journey, understanding what was safe for her and what wasn’t.
But the journey became difficult in other ways even as certain aspects were simplified. Six years later, we are now in the thick of dealing with the social elements of food allergies with a tween.
My daughter proudly took her banana to the Sunday school class I supervised when she was a toddler. She ate it as all the kids around her consumed gluten-filled animal crackers and never complained. The source of the pain she had endured was in that cracker, and she didn’t want it.
“Social situations are easy,” I idiotically bragged to a friend. “She doesn’t mind being unique, and she hurt so much in the past that she doesn’t even want that food.”
Six years later, we have thankfully moved away from the pain, the malnourishment, the constant feeling of being physically unwell. But now I have a tween – a little girl one minute and an emotionally involved ball of big feelings that looks strangely like a teenager the next. We are deeper into the emotional component, the one I can’t fix with an alternative food.
This is not, in fact, easier.
Wren’s friend talks animatedly about the St. Patrick’s Day feast she wants us to attend next year even though it’s July and we are walking back from the pool in oppressive Texas heat. She tells of everyone bringing a dish, the table full of overflowing bounty, like the feast tables in the Harry Potter books.
Wren walks along, not speaking, looking at the concrete, and I wait for her to explain why she’s not excited about this. She doesn’t.
“We can’t do potlucks. They’re a bit tricky for Celiacs,” I say, kindly, knowing her friend didn’t think about this before sharing her excitement.
“What if someone brings gluten-free cookies?” she asks. And I know she would do this for Wren, just to make sure she was included.
“Cross-contamination – it’s too big of a risk. If other people have already touched them, well, crumbs can kill, right, Wren?” I say, shooting her a smile as I throw out the line we’ve drilled into her brain.
“Yep,” she responds, that older girl edge making an appearance. “This is why my life is bad.”
I don’t argue, though there are many reasons her life isn’t technically all that bad. We can afford the price of gluten-free food, the services of a naturopath when her thyroid or gut bacteria go off course. She is well, the hair she lost fully regrown, her distended stomach of the past now a normal size.
But I can’t argue that this component, being left out of food and the fellowship it brings, is bad. And it’s forever. Her friend was only talking about food peripherally when she spoke of this potluck. Her focus rested on the act of feasting, connection, and comparing notes on what tastes best. Food was just the medium to this fellowship – a medium Wren cannot enjoy.
I sit on hold for a full four minutes staring at the words in all caps on the medical release form. I signed Wren up for day camp four months ago, confident that she could carry her own snacks and lunch, wash her hands before meals, and partake with hundreds of other kids as they sang songs and played games from nine to four each day.
Then the medical release form landed on my computer screen four days before camp started, and I couldn’t breathe.
“I can’t sign this,” I told the woman on the other end of the phone. “It says I have to give you permission to administer medication to my daughter, and I can’t. Besides being allergic to tons of meds, most of them contain gluten. I would need to be contacted first. I can’t sign this.”
I expect her to say she understands and that this is a common problem. Instead, she puts me on hold with an unsteady voice that tells me this may mean trouble.
What can I offer to fix this? I think as I sit waiting. If she can’t go to camp, what will I do? How can I bargain her out of the emotional hole that she will fall into? Ice cream every day? The puppy she’s been begging for? More swim lessons?
I know even as the possibilities float into my mind that all of them will fail because I can’t replicate this experience. She will blame her Celiac, and she’ll be right. There is no replacement for a week at day camp with other kids doing normal things. It’s not as easy as replacing a gluten-filled graham cracker with a gluten-free one.
“Ma’am,” I hear as the girl comes back on the line. “We can work it out. Your daughter can still come.”
I release the breath I forgot I was holding as tears fill my eyes.

Surviving Your Baby’s Dairy Allergy While Breastfeeding

As I started researching, I realized how all-encompassing “dairy” was, and I wondered briefly: How much do I really like this kid?

“Don’t freak out. Don’t freak out. Don’t freak out.” That’s what I kept telling myself as I totally and completely freaked out. There was blood in my baby’s diaper. I thought I’d seen something suspicious in the last couple of diapers, but nothing like this. This was blood, and I was in full panic mode.
Do kids ever get sick during the week? Or even during the day during the week? Nope. It’s like they keep a copy of the pediatrician’s office hours stashed in their onesies. So, Sunday afternoon found us on the road to the ER – my husband driving, me in the backseat as if sitting next to my baby might actually help the situation. My husband dropped us off while he parked so I could start the check-in process. I nervously rocking the baby carrier as I filled out the paperwork. He wasn’t crying. He was just sitting there looking all tiny and helpless.
Ever since we brought Jacob home from the hospital he had had “tummy issues” of one variety or another. Tummy issues also meant sleeping issues and eating issues and crying issues and mommy-crying issues and daddy-looking-at-mommy-like-she-is-a-crazy-person issues. But we’d made it through the last five months. Until now.
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The ER doctor came in to talk to us, and basically made us feel like overprotective newbie parents, took a sample to run some tests, and told us to call the pediatrician the next day. Oh, and they gave him a single dose of over-the-counter ibuprofen that cost around $60. Very helpful. we went home with exactly zero answers.
Our pediatrician is the best, and when I brought Jacob in on Monday along with the most disgusting pictures of every diaper he’d had in the previous 24 hours (I’ve had major trouble getting those off the Cloud, by the way, so bloody dirty diaper pictures still pop up every now and then), she was so nice. She also got angry when she found out that the sample that the hospital staff had taken had apparently just gone in the trash, because no test had been run to figure out what might be wrong with my child.
Her anger made me so happy. It meant that someone else cared that something bad was going on in my kid’s body and it was about time we figure it out. She took another sample and ran some tests to rule out some of the scarier options (all negative), but she also told me that there was a good chance this was an allergy to something I was eating and that dairy was a likely culprit.
She suggested I cut it out entirely and see if that helped.
Why not formula? Well, there were a few reasons that was not my first choice. The health benefits of breast milk were a consideration of course, but also Jacob and I had finally found a good groove when it came to breastfeeding, and I liked the fact that I didn’t have to do any sort of prep work in the middle of the night when he wanted to eat. (Basically, laziness played a major role.) Breastfeeding was also one of the best tools in my arsenal for getting him to sleep. But cost was a real factor for us, too. Could we have swung formula if we had to? Sure. But I was now a stay-at-home mom and we were a family of three on a tight budget. If we could make breastfeeding work for us, I wanted to. (So, to sum up: lazy and cheap.)
A second side note to moms who formula-feed: You do what works for you and your kid, and don’t expect any judgment from me. Cool? Cool.
As I started researching, I realized how all-encompassing “dairy” was, and I wondered briefly: How much do I really like this kid? I mean, he did cry a lot, but he was pretty dang cute, so I began. No milk, no sour cream, no cheese, no butter. Even non-dairy coffee creamer, while lactose-free, has the milk protein I had to avoid.
Dairy is in everything, and it has a million different names in the food industry. I had to totally change the way I cooked, which meant I had to totally change the way I shopped for groceries. I dropped Jacob off with Grandma and spent two-and-a-half hours at the grocery store just reading labels. I found websites, many of them vegan, and started trying things. I really found a lot of great recipe ideas in “Cooking for Isaiah: Gluten-Free & Dairy-Free Recipes for Easy, Delicious Meals” by Silvana Nardone.
Miraculously, his tummy issues subsided, slowly at first, but then more noticeably. I’m sure part of the improvement can be attributed to his gut developing with age, but the removal of dairy really did make a huge difference. The bleeding had been one of the first things to stop (thank goodness), but he also stopped spitting up as frequently, cried less, was less gassy, and slept better.
There were some low-points in our journey. My favorite cookie recipe – the cookies that I would occasionally come home and make on my lunch break when I was working because they were so quick and easy and good – use a whole stick of butter and a half cup of sour cream. So I tried some variations. Oil instead of butter. Almond milk instead of sour cream. Trash instead of my mouth. Then Febreze the kitchen to get rid of the lingering smell.
I’m sorry to say I never did find a good way to make those cookies dairy-free. But there were some successes, too. I found a good pancake recipe (in “Cooking for Isaiah”), and I found some pasta bakes that don’t rely on cheese to hold them together. We even lived through the holidays. My family was so sweet and tried using a butter substitute to make some of our traditional family recipes, and it somehow made me feel better knowing that everyone else was also eating green beans that tasted like they had been cooked in a tire factory. (Dairy-free can make you a little mean at first.)
Mercifully, most babies outgrow their dairy allergies, and Jacob was not an exception. The pediatrician had me reintroduce dairy a couple of times to see how he responded, and finally, when he was about a year old, he stopped having reactions. I made cookies to celebrate. We nursed for a little while longer, and when he was a little past 13 months, we finally stopped. It was the right time for us. Like so much since becoming a mother, going dairy-free was not something I planned for, but you do what you have to for your babies, even if it means missing out on cookies for a while.
This article was originally published on the Motherhood Collective blog.

Sugar Intake During Pregnancy Could Trigger Kids' Allergies Later On

A new study tells us that eating too much sugar may also trigger allergies and asthma in our kids down the road.

What kind of cravings did you have while you were pregnant?
When I was pregnant with my second, I would walk around at three in the morning eating granola bars because I couldn’t sleep and was absolutely starving. I know this wasn’t the smartest habit because those granola bars were packed with sugar.
Our doctors warn us about keeping our sugar intake in check during pregnancy to avoid gestational diabetes. Now, a new study tells us that eating too much sugar may also trigger allergies and asthma in our children down the road.
Researchers from Queen Mary University of London set out to investigate the possible connection between mothers’ diets and their children’s allergies. They analyzed data gathered from nearly 9,000 mother-child pairs in the Avon Longitudinal Study of Parents and Children, an ongoing research project that tracks the health of families.
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They calculated the amount of free sugars consumed by the women during pregnancy based on their answers to a written survey. Free sugars are naturally present in honey, syrups, and unsweetened fruit juices, as well as those added to food and beverages. They do not, however, include sugars found in whole vegetables and fruits.
The researchers focused specifically on allergies that produce respiratory and skin symptoms. Asthma and allergies are the most common chronic illnesses for children in the United States. The American Academy of Allergy, Asthma & Immunology reports that worldwide sensitivity to one or more allergens among children is approaching 40 or 50 percent.
Interestingly, the researchers observed that the intake of free sugar and high fructose corn syrup has also increased substantially during this same period.
The research team looked at how the mothers’ sugar consumption compared with allergies and asthma diagnosed in the children beginning at age seven. Here is what they found:

  • 62 percent of the children did not have any allergic conditions, but the remaining children had one or more maladies or symptoms.
  • 22 percent of the kids had a common allergy.
  • 16 percent had eczema.
  • 12 percent had asthma.
  • 11 percent had wheezing with whistling.
  • nine percent had hay fever.

Next, the researchers compared the children of moms who ate the least amount of sugar during pregnancy (less than 34 grams, or seven teaspoons, per day) with the children of moms who ate the most (between 82 and 345 grams, or 16 and 69 teaspoons, per day).
The children of women with the highest sugar intake during pregnancy had a 38 percent higher risk of allergy diagnosis. Kids of the moms in this group had a 73 percent increased risk of being diagnosed with an allergy to two or more allergens. The allergic asthma risk increased by 101 percent for children of moms in the high-sugar consumption group. This risk was double that of kids born to women in the low-sugar group.
With such strong results, the team is continuing to examine the issue to try and replicate the findings among additional groups of children. It is unclear from the study findings how strong the effect is, so more studies will be needed to determine if there is a direct causation between sugar intake during pregnancy and children’s allergies.
If they do see the results repeated, then the next step will be to design a trial to test whether childhood allergies and asthma can be prevented by reducing the amount of sugar consumed by mothers during pregnancy.
Nonetheless, too much sugar during pregnancy is problematic. Pregnant women should follow the nutrition guidelines from the World Health Organization and the U.S. Department of Agriculture and eat healthy diets to reduce the risk of developing gestational diabetes.