By Nancy Ripton
From the print edition, March 2012
Letting go is never easy, but for parents of an anaphylactic child, relinquishing their role as a protector can be terrifying. Preteens and teenagers are at the highest risk of any age group of dying from anaphylaxis, a life-theatening type of allergic reaction. Not only are they in charge of their allergies for the first time but changes in brain function during puberty can lead to poor decision making and risky behaviour. How can parents pass the food torch without being worried their child will make a life-threatening error?
• Educate your child early and often
Teaching your child to make safe food choices should start as soon as they’re old enough to understand how serious their allergy is. “I’ve always spoken to Nicholas as if he was an older child when it comes to his tree nut and fish allergies,” says Karen Jones of her son, now 12. Now that he’s going out for lunch solo, the Toronto-based mom is confident he will ask the right food questions.
“Open lines of communication are key,” says Kyle Dine, program coordinator for Anaphylaxis Canada. The organization maintains and operates WhyRiskIt.ca, an allergy website that helps teens cope with the social pressures of dealing with allergies. Dine believes it’s never too early to talk about risk management strategies, such as avoiding potential triggers, ensuring they have a clean eating surface, not sharing food, utensils or cups and being open with others about the severity of the allergy.
• Always carry an auto-injector
“My biggest fear is that Nicholas will forget his EpiPen,” says Jones. “Before he leaves for school each morning I ask if he has the one he carries around his waist with him; half the time the answer is no.” According to a study published in the Journal of Allergy and Clinical Immunology, only 61 percent of teenagers carry an epinephrine auto-injector with them at all times. Parents should teach children from a young age to always carry their auto-injector with them and be familiar with how to use it, says Dine. “Make it a routine to check for it before leaving the house.”
A combination of forgetfulness and wanting to fit in make always carrying an auto-injector a challenge. “At this age children learn best by making mistakes,” says Jones. “But we can’t take that approach.” Which is why, in addition to carrying an extra EpiPen in his backpack, Nicholas knows how to use it (he was taught by his allergist using a demonstration model) and he has a cellphone should he need to call 911 if he has an anaphylactic reaction.
• Be aware when dining out
In middle school, children start eating out with their friends and going to homes where parents and peers may not be familiar with their allergy. “Children need to feel confident telling people about their allergies and asking if food is safe to eat,” says Dr. David Hummel, a Toronto-based allergist. That includes checking the ingredients on a label every time since they can change without notice. (It is at the manufacturer’s discretion whether to list a warning such as “may contain traces of peanuts/nuts.”)
Jones’ son Nicholas says allergies are so commonplace with kids at his school that he’s usually not the only one asking questions when out to eat. “My friends also understand about my allergy and don’t pressure me to eat anything I’m uncomfortable with.”
If not accompanied by an adult familiar with his food allergy, your preteen should be asking restaurant staff about their allergy policy and safe menu options. Calling ahead to speak to the chef or manager is always a good practice. When kids start participating in overnight excursions, parents and their allergic child should discuss any precautions in advance with supervisors.
A child with food allergies should not accept food from others and must always read food labels and look for any alternative names of potential allergens. Above all, have a rule that he can’t eat any food if he forgets his auto-injector.
• Discuss dating now
Experts say you should start talking to your allergic child about potential sensitive social issues (e.g., dating, going to parties or out with their friends) as they mature. “Kissing can also be a huge issue,” says Dine. Food proteins can stay in the saliva for a few hours after eating so anyone with a food allergy has to ask what their partner has had to eat beforehand.