According to the Center for Disease Control and Prevention, an estimated 15 million people suffer from food allergies, and approximately six million of them (and counting) are children. Most are allergic to one or more of eight types of food: milk, eggs, peanuts, tree nuts, wheat, soy, fish, and shellfish. Together, these allergens are responsible for nearly 90 percent of all allergic food reactions in children. While some food allergies disappear by the time a child turns five, allergies to peanuts, tree nuts, fish and/or shellfish can stick around and remain with a child for life. An increasing number of parents each year must confront additional concerns and obstacles, beyond typical parental anxieties, as they work to keep their child safe from potentially dangerous foods inside and outside the home each day.

There is no way for even the most responsible and hyper-aware parents and caregivers to keep a child with food allergies 100 percent safe. Food can easily become contaminated, packages can be labeled improperly, and human error can unintentionally expose a child to harmful food allergens. While there may never be a fool-proof system for protecting such a child, surrounding him or her with a team of knowledgeable advocates and keeping these folks on the same page when it comes to awareness and treatment can help to keep a child safe. This team may include teachers and school administrators, babysitters, playmates, and other parents – all of whom need to be fully informed of the situation at hand and how best to help a child to learn and play in a healthy environment.

Below are some recommendations that parents of children with food allergies may want to consider as their child moves from one environment to another in the course of their normal activities. More information about food allergies and strategies for managing them in children can be found at Food Allergy Research & Education, Inc.

Parents should speak with their health care provider and educate themselves on what ingredients/ foods need to be avoided and what medicine to give a child with food allergies and when. All members of the family should wash their hands before and after eating to reduce the likelihood of food contamination. Along these lines, foods may need to be prepared separately and all counter tops and preparation tools should be properly cleaned before and after each use. Foods containing any allergens should be labeled properly in the refrigerator or pantry. And some families may choose to create separate shelves or spaces for such foods.

It can be challenging when only one child in a family has food allergies. Many families in this situation often choose to ban the food allergen(s) all together from the home. This can make food preparation easier and the affected child feel less isolated. Sometimes, though, this is not a realistic solution and families may instead choose to create certain areas where potentially harmful foods are not allowed. Each family needs to speak with their health care provider and select the best approach for them. Strong and open communication among all family members is critical as the whole family needs to be on alert to keep their loved ones safe.

School & Daycare
Schools and daycare centers have varying ways of addressing children’s food allergies. Some ban certain foods from the grounds altogether, others have children with allergies sit in certain tables or areas of the lunchroom. Parents should educate themselves on what plans and procedures a school or daycare has in place before the child starts. In addition, it is important for them to provide the organization, especially the teachers and nurses there, with the child’s medical history and any prescribed medications, including potentially an epinephrine auto-injector or inhaler in case of emergencies. The parents and school should work together to develop an emergency care plan if the child does have an allergic reaction. All key stakeholders should be aware of the plan and how and when to implement it.

Toddler and school age children also need to be taught not to share food with classmates. In addition, children should be encouraged to tell any person who is giving them food or preparing it for them that they have food allergies. This includes speaking openly and directly to other parents and care providers when they are having a play date with a friend. Obviously, such specific communication is more challenging with younger children, but even youngsters can be trained to speak up in order to protect themselves. All children should be encouraged to wash their hands frequently, especially before and after meals.

Out and About
Going out to eat and taking vacations are certainly possible when you have a child with food allergies, but they both may require a bit more advanced research and preparation. It is generally recommended for children with food allergies to stay away from food buffets, given that foods are placed close together and could mix with each other. Bakeries are also not recommended for them because top food allergens are generally among the list of ingredients in many baked goods. For children with nut, fish, and/or shellfish allergies, it may be best to avoid Asian and seafood restaurants altogether. Chain restaurants offer the benefit of consistency, which can be helpful for a parent dealing with a food allergy. If a child can eat certain foods safely at one McDonalds, for example, he or she generally will be able to eat the same foods at another McDonalds because the food is typically cooked the same way at every location. Parents should also feel free to call restaurants ahead of time and ask to speak to the chef if they have any specific concerns or questions.

Parents may also want to call ahead to airlines and hotels before vacationing to learn if they have food allergy policies in place. It is always helpful for parents to know if they need to pack additional food items for just the flight or for the entire duration of the trip. Typically, it never hurts to bring a selection of safe snacks just in case. Parents should also make it known to airline and hotel staff that their child has a food allergy. Expanding the team of individuals who are aware of a child’s medical condition can never hurt in the ongoing effort to keep a child out of harm’s way.

Until a cure for them is found, food allergies are likely to remain a part of our national public health discourse well into the future. With the proper education and communication, children with food allergies can lead very happy and safe lives. Just as it takes a village to raise a child, it takes the right team with the right information to protect and nurture a child with food allergies.

About the Author:
Gladys Ruiz is the Director of Little Children Schoolhouse in Brookline, MA. After more than 10 years working in Early Childhood Education, Gladys opened the Little Children Schoolhouse to provide a nurturing, loving environment—an extension of her student’s home and family life—in Brookline. Pre-K, Preschool and Daycare programs for toddlers and infants include extra activities, such as weekly music, yoga, cooking, science activities, and field trips. Both full day and part-time enrollment are available.