Macaroni and Peas

Allergy Kit from Check My Tag

Ria Sharon over at Ria Sharon over at Check My Tag wrote a great post about how she found out her son had allergies. I think she summed up nicely the panic that goes through a parent’s mind when they realize their child has severe allergies. Check My Tag was born from this experience. Ria now offers a variety of shirts and other allergy management tools.

I love that everything she offers is field tested. The idea of shirts with allergy information on them is truly inspired. I don’t know many toddlers that will keep a wristband or necklace on without trying to eat it. Shirts…those are easier to keep on.

All of Ria’s stuff fits into a complete allergy management system and she talks a lot about that on her blog. Food allergies require a pretty big commitment, but they are very manageable.

Ria’s son has severe allergies to peanuts, tree nuts, eggs, and penicillin. Although an anaphylactic reaction is terrifying, it’s pretty clear what’s happening. Fortunately, these reactions are relatively uncommon.

Most food allergies present themselves as skin (eczema or hives) or tummy (gas, bloating, vomiting, cramping, etc.) problems. As you know, skin and tummy problems go hand in hand with children. So how do you know if it’s food allergies?

If your kid is really sick or has bad hives, please take them to the doctor immediately. Hives can cause enough swelling that breathing becomes difficult and excessive vomiting can cause dehydration.

Assuming your kid is not headed to the emergency room, you’re probably looking at a milder, chronic problem. First thing’s first, you need to rule out non-food causes. Was your kid exposed to poison oak or recently given a new medication? Have you begun using a different soap or brand of milk?

No? Then it’s on to the fun stuff.

At this point, I usually recommend that parents go to an elimination diet. It sounds gruesome and torturous, doesn’t it? It’s actually a pretty simple concept. Remember when you first introduced your baby to solid foods? Your pediatrician probably advised you to wait a few days after trying a new food before you introduced a new one. That’s so you can spot any reactions and immediately know what caused them. We’re going to employ the same principle for the elimination diet.

The big difference between introducing your baby to solid foods and doing an elimination diet with your older kid. Your older kid is probably suffering from an allergic reaction right now. You want to keep them on the most strict version of the elimination diet until all their symptoms go away.

Then, slowly introduce one new food at a time, watching closely for reactions. Keep track of what you add and how they react. Which foods you choose to introduce and how will have an impact on whether or not you can rule them out as allergens. For example, don’t add egg noodles until you’ve ruled out both eggs and wheat as allergens.

If you’re interested in putting your child on an elimination diet, send me a note. We’ll work together to decide which package will help you with your specific concerns. If we can’t find a good fit, I’ll get you in contact with someone who can help.

Does your kid have a food allergy? How about an allergy to medication, bees, or latex? If so, it might not hurt to create an allergy kit. Basically, an allergy kit tells your kid’s caregivers (daycare provider, teacher, camp counselors, etc.) what they need to know to help care for your kid. It’s easier than you’d think.

Supplies

• smallish bag
• epi pen
• antihistamine
• index cards
• a pen

1. Pick a bag that’s small enough for your kid to carry around and just big enough to hold everything. The bag should close securely (zipper, drawstring, etc.).
2. Write your name and all the ways someone can contact you on a card. This should include your home phone, work phone, cell phone, and email.
3. Create a similar contact card for anyone else who can care for your child if you’re unavailable. These are usually spouses, grandparents, aunts, and uncles.
4. Create a similar contact card for your child’s doctor and another for any other doctors you see for allergies. Include the hospital you would prefer to use if necessary.
5. Write your child’s name and address on a card. Add a description that includes current height, weight, hair and eye color, and any distinguishing characteristics (being cute as a button does not count, no matter how true it is).
6. Write down each allergy on its own card. Note how your child reacts to each allergy. Some kids just get a rash while others go into anaphylactic shock. It’s important to know the difference.
7. Write instructions down on how to use the epi-pen if necessary. If you’ve got the instructions that came with the pen, put them in the bag. If possible, include the dummy pen so you can show people how to use it.
8. Write down the proper dosage for the antihistamine you’re putting in the bag.
9. Put everything together in the bag.

Viola - you’ve got an allergy kit.

Tips and Tricks

For example, your kid is allergic to peanuts and penicillin. Eating with peanuts puts him into anaphylactic shock. Touching them or their residue gives him a rash and causes swelling. Penicillin gives him hives.

One card would say “Peanuts - eating causes anaphylactic shock (administer epi-pen and call me ASAP), touching causes rash and swelling (give antihistamine and call me).” The other card would say “Penicillin - hives (give antihistamine and call me).”

Try to keep the text on the cards neat and brief. Think bullet points - the people who’ll be using this kit won’t have time to read through paragraphs. They need simple, clear instructions.

If you can, laminate the cards. They’ll stay clear and easy to read over a much longer period of time.

Speaking of time…you’ll want to update the card describing your kid as things change (for example, right now, my son has a mohawk…three months ago, it was a blue mohawk - that’s a pretty big change). You may even want to include a fairly recent picture.

Consider making multiple kits. Keep one with your kid at all times. You might want to give one to your child’s daycare provider, teacher, summer camp staff, etc. The more severe your child’s allergic reaction, the more people need to have a kit and know how to use it.

Make sure your kid knows how to use the epi-pen if they need it. The allergy kit does not in any way replace the epi-pen that needs to be on your child’s person at all times.

What else might you want to include in an allergy kit?

For more information on protecting your child at school, check out Ria’s posts on Section 504 plans.

I read a great article over at GNMParents today. Megin Hatch writes about the social side of food allergies. Her son has a severe peanut allergy and she shared some of the social stigma he’s had to endure as a result. Go read the article before you read more of this post. Yes, now. I’ll be here when you get back.

Isn’t she a great writer?

My Back Story

My son does not have any food allergies. No one in my immediate family does. I feel lucky in that respect. This is primarily due to my strong fondness (ok, obsession) with peanut butter. I’m also a big fan of pasta, bread, milk, and other stuff rife with allergens.

I used to write product specifications that included allergen labeling information for a food company. As a result, I learned about how documentation on each ingredient in a food is reviewed to see if allergens are present. Actually testing a food for allergens is expensive and most companies don’t go to that level of testing. However, they do track where each of the ingredients in the product came from and require their suppliers to have robust allergen control programs.

I also learned about the steps food companies have to take to segregate allergens within their facility. I’m sure you’ve seen the warnings that say an item is produced in a plant that processes peanuts and/or tree nuts. That’s really important for people like Megin and her son because of the severity of his reaction. Peanuts are the only allergen that manufacturers have to tell you is anywhere in their plant. If a manufacturing plant produces items with soy in addition to stuff without soy, they have to keep the soy separate from the rest of the ingredients in the plant. They also have to clean their equipment after using soy ingredients before they can produce the non-soy items.

As you can imagine, that presents a host of problems for food manufacturers. Companies that market their foods as allergen free go to great lengths to ensure their products are safe. Many plants have gone to the extent of banning peanuts and other nuts in employee break rooms. That means no peanut butter and jelly sammiches for those workers.

That job taught me a lot about allergens, government regulations, and the way manufacturers deal with them. It really opened my eyes to the difficulties faced by people with allergies.

Peanut Free Schools

Schools strive not only to educate their students, but to provide a safe atmosphere in which to grow. What exactly does “safe” mean then? It’s a no brainer that safety includes things like preventing strangers from hangin’ around the school, ensuring playground equipment isn’t faulty, and shoveling sidewalks in the winter. Some schools have gone to the extent of banning peanuts throughout the school.

I’m not sure a school wide ban is appropriate, even in elementary school. Megin’s post got the wheels spinning in my head around allergies and schools.

My Experience

My son’s school does not ban peanuts. Each year, we have to fill out a form advising the school if our child has any food allergies, medical concerns, special needs, etc. As far as I know, there is no special effort made to give kids with allergies an allergen free area to eat lunch. Each classroom is on its own in terms of whether or not they allow allergens.

In my son’s class, each student brings in snacks for the rest of the class on a rotating schedule (it works out to three or four times a year). The teacher has asked people to bring healthy snacks, but it doesn’t quite work out that way. The school does not allow us to bring homemade snacks for any occasion. We must purchase individually packaged items from the store. That means a lot of people end up buying snack cakes, cookies, crackers, or chips.

Although, my son did tell me that someone brought bananas today. Instead of buying packaged junk food, this kid’s parents bought bananas. Easy, cheap, and healthy…plus, my son said all the kids loved it.

A huge number of store bought, individually packaged items contain peanuts or were processed in a plant that also contains peanuts. Finding snacks that meet the school’s requirements and don’t contain peanuts is very difficult. The grocery stores in our small town are making more and more room for specialty items including allergen free foods. These foods are more expensive and often not individually packaged, making it more difficult for parents to purchase appropriate snacks.

Last year, there was one child in my son’s class that was allergic to peanuts. His parents brought extra snacks for him to eat in case the snacks brought by other students contained peanuts. The first time my son and I went shopping for a snack for his class, I asked if anyone in his class was allergic to peanuts. I was surprised when he said yes. I guess I expected a note from the teacher explaining that someone in the class was allergic to nuts.

During snack time, kids are given a choice between low fat white milk, low fat chocolate milk, or orange juice. The orange juice is the one concession made for students who are allergic to milk. Of course, it’s up to the student to pick out the drink they want. Given that my son’s school only has preschoolers, kindergartners, and first graders, I’m not sure that’s a very effective solution.

Other Allergens

What about that kid who’s allergic to dairy, eggs, sesame, fish, soy, wheat, or shellfish? Granted, most kids who are labeled as “allergic” to dairy are actually lactose intolerant…which is a whole different animal. Because more kids have peanut allergies and their reactions are often life threatening, peanuts get a lot of attention.

If a school decides to go peanut-free to protect its students (and teachers, aids, etc.) with peanut allergies, why shouldn’t they also ban the other big allergens? I think we need to balance the need for safety with desire to save time and money.

My Suggestion

It’s important for kids to eat every three or four hours. Well, honestly, it’s important for everyone to eat every three or four hours. Eating at regular intervals helps keep you from getting too hungry between meals. Hungry kids can’t focus or pay attention.

I suspect most schools are pretty good about providing food at regular intervals. My son’s school has an optional breakfast at 8:40am. My kid eats breakfast at home at 7am. School starts at 9am and lunch is between 11am and noon. Snack time is between 2pm and 3pm.

I realize I keep bringing up my son’s school, but it’s the only one I have experience with. I’d love to hear how your schools are handling these issues.

Rather than have food in the classroom where it’s difficult to control and segregate allergens properly, why not have the kids go to the cafeteria to eat?

While eating in the cafeteria (for breakfast, lunch, or snacks), it makes sense to set aside certain areas as peanut free. A lot of effort should be put into making sure the kids sitting at these tables don’t feel left out. All the tables in the cafeteria should be cleaned with actual cleanser (not just wiped down with a wet rag) between groups of kids. This is as much for basic food safety as allergen control.

A school cafeteria should provide balanced, nutritional meals for every student whose parents choose to purchase lunch there. That means there need to be options for kids with various allergies (not just nuts) as well as other dietary requirements (vegetarian, Kosher, Halal, diabetes, etc.).

I love the idea of celebrating holidays and such with non-food activities. It reinforces the idea that food is not a reward and that we don’t need frosting to have a good time.

For more on allergies and schools, check out these posts:

• School Bound with Food Allergies
• Check My Tag by Ria Sharon
• Nuts! by Adjustafresh over at Dad-o-Matic
• Nuts and Peanut Allergy over at Kids Health

Does your child have food allergies? A huge number of kids in the US alone have food allergies. Teachers, administrators, and other school employees are becoming more and more familiar with them.

Preparing Your Kid

By the time a kid is old enough for school, they should know all of this:

• What they’re allergic to.
• How to tell an adult what they’re allergic to.
• How to use an epi-pen (epinephrine).
• What happens to them if they eat the food they’re allergic to.

I know it seems like its asking a lot from kindergardeners to use an epi-pen, but they can do it and it may save their life.

Preparing Your School

Make sure the nurse at the school is intimately familiar with your child’s face and allergies as well as how to administer epinephrine (or whatever your pediatrician recommends for allergic reactions). You want the nurse to know who your kid is and what he’s allergic to without having to look it up.

The other key person in your school is your kid’s teacher. Make sure she knows exactly what allergies he has and how to treat them. Many teachers will send home a note at the beginning of the school advising you of allergies within the class.

My son’s teacher asked that we bring snacks (something fairly healthy - more on that later) and mentioned that one of the children in the class is allergic to nuts. His parents provided a cache of snacks that he wasn’t allergic to in case someone brought something with nuts. Knowing its not fun to be the only kid not eating whatever snack everyone else gets, I made an effort to buy nut free stuff.

Check My Tag

Ria Sharon over at Check My Tag has some great information about kids and food allergies. In particular, these posts relate well to today’s topic:

• My Kid with Nut Allergies
• Food Allergies in Schools
• The Importance of Carrying Epinephrine