Once you’ve finished Jen’s piece, share your own thoughts on food allergies on this article’s Family Jewels blog post!

I was sitting in the hairdresser’s chair when I first read the story. I was getting a full head of high and lowlights done, so I brought copies of the December 2009 issue of Chatelaine and a new issue of The New Yorker, and set a challenge for myself to see if I could get through every word before I was blonde again. It was halfway through when my face turned beet red and the colourist stopped quickly, wondering if I was having some kind of allergic reaction to the hair dye. It turned out I was having a reaction to Chatelaine’s story about food allergies, specifically peanut allergies — a subject very close to my heart.

For anyone who hasn’t read the piece, its author, Patricia Pearson, accuses parents of overestimating and overreacting to the threat that food allergies pose to children. She questions the prevalence of peanut allergies, the accuracy of allergy tests and the decision to make schools peanut-free. Basically, in a whiny
I’m-hard-done-by-because-my-son-who-is-a-picky-eater-can’t-bring-a-PB&J-sandwich-to-school
tone, she manages to offend everyone with a life-threatening food allergy — and those who care about people with that condition.

Not surprisingly, the magazine’s website has 629 comments responding to the article, most of them condemning the piece from parents of anaphylactic kids. (According to Statistics Canada, close to 90,000 kids are allergic to peanuts.) On cbc.ca, a well-crafted, fact-filled response from Allergic Living magazine’s editor Gwen Smith solicited another 263 comments echoing a similar disdain for the Chatelaine article. Pearson’s account, says Smith, “skewers the hard-won accommodations in schools to protect food-allergic children, confuses facts and statistics, and never pauses to speak to a principal or a parent of a child who has experienced anaphylaxis, the most serious form of allergic reaction.”

As a mom of a school-age son with an anaphylactic peanut allergy, I agree with Smith and find Pearson’s comments disheartening, irresponsible and dangerous.

shoulda, woulda, coulda

My husband and I discovered that our son, James, now five and a half, had an anaphylactic allergy just after his first birthday. Hoping to introduce a new food into his diet, I put a very small dot of peanut butter on the tip of my baby’s finger for him to lick. Within a minute his body and face puffed out into a full rash with hives. He looked unbelievably frightened and began to vomit. I tried to remain calm and kept watching closely to make sure his airway remained open. I had the phone in my hand and pressed 9-1-, ready to press the other 1 if he began choking. I gave him a bottle with formula in it and a sippy cup with water, hoping he would drink lots and flush the “toxin” out. About two minutes later I put him in the bath to try to calm the swelling and rash. From the moment I put him in the bath, his condition didn’t get worse, but it didn’t get better either, so using an eyedropper, I gave him a few drops of adult-strength Benadryl, and over the next few hours, slowly the swelling went down.

This is not a do-what-I-did story and, in short, I did everything wrong. I completely underestimated the danger of a peanut and despite years of first-aid training, was not at all prepared for the chance that my baby would have an anaphylactic reaction. What I learned later from our pediatric allergist, Dr. Charlotte Miller, who works with the Toronto Allergy Group and The Hospital for Sick Children, is that first, I should have fully researched all of the symptoms of anaphylaxis and, noticing any of the signs (not just airway constriction), I should have called 911.

Before I even opened the jar of peanut butter, I should have thought about how likely it would be that he would have a reaction. Since my son’s diagnosis, I have consumed hundreds of articles about anaphylaxis and peanut allergies from both medical and non-medical sources and have read quite often that women with a family history of food allergies should avoid those foods during pregnancy. (Fail: My husband’s brother has an anaphylactic allergy to all nuts and legumes and I ate peanut butter every single day of my pregnancy.)

second time around

His second reaction was more traumatic than his first, mostly because it happened at his daycare (without me there) in what was a nut-free environment. He was a teething toddler and very interested in putting every toy in his mouth. What we suspect is that a classmate had peanut butter for breakfast and didn’t have his hands or face washed well afterwards, then either had contact with James or touched a toy that James then played with. I don’t know if he ever ingested any of it or if it was just skin-to-skin contact, but my little guy instantly developed that same puffy rash over his body, vomited and became totally freaked out.

By the time the school had called and we figured out what had happened, the symptoms were not getting worse so we didn’t administer the EpiPen, but according to our pediatrician, we should have. The shot of epinephrine should be administered as soon as a reaction is recognized, even if it’s been half an hour.

Note: If your child eats peanut butter for breakfast, you should wash hishands and face, brush his teeth and change his clothes before he goes to school.

labels don’t lie

I’ve heard that each reaction gets worse, and that was certainly the case when James had his third reaction two years ago on Easter. Vigilant about where the chocolate was made and what the other kids were eating, I was less cautious about what was in my pantry and gave him a bowl of the yummy new corn chips we had just featured in the magazine and loved. At the time I bought the package, I read the ingredient list and noticed that it was “made in a factory that also processes nut products” but had always dismissed that
warning as a statement that a team of over-cautious lawyers insisted on including.

Not true in this case. Within a few minutes of eating the chips he began to complain of abdominal cramps, felt so weak he could barely sit up and had an excruciating rash covering his body (especially lower back and bum) that looked as though he had just been burned with scalding water.

Because these symptoms were so different from the ones he had before (and because I forgot about the connection between the chips and the peanuts), I didn’t recognize right away that it was an anaphylactic reaction and I treated him with children’s Benadryl instead of using the EpiPen. We brought him to his pediatrician’s office the next day and the doctor instructed us to give him two doses of Benadryl per day until the symptoms were gone. That went on for three weeks, and by then his little body was so worn down that he caught a bad cold that lasted another three weeks. Quick math reveals that my poor judgment cost my son six weeks of good health and put him at risk of having an even more severe reaction to his next peanut
exposure.

natural reaction

My biggest fear in the world is the thought that if I missed the signs of an anaphylactic reaction so many times, how could I expect someone else who has never witnessed one to do so and act appropriately? Unlike Pearson’s perception that a school’s peanut “laws” are strictly monitored and enforced, I worry that these institutions are not vigilant enough. For the record, “vigilant enough” in my eyes would include daily lunch bag checks, peanut-sniffing dogs and mandatory sanitization showers for every kid who has eaten a nut in the last 24 hours.

Overreacting? Not much. Even in 2010, I feel like a pioneer as I educate the staff at my son’s school about the dangers of his allergy and work with them to establish new rules. Living in Ontario where we have Sabrina’s Law, a policy that requires the province’s school boards to formally establish strategies to reduce the risk of exposure to anaphylactic triggers in classrooms and common school areas, does give me some peace of mind. (The policy is named after a young girl who died of anaphylactic shock following exposure in her school — she had a milk allergy.)

My second-biggest fear is that the term “allergy” has been used so loosely and made synonymous with “intolerance,” “dislike” and “sensitivity.” While I don’t relish the thought of any child (or adult for that matter) feeling uncomfortable as a result of something he ate, it hardly equates to the reaction a person with anaphylaxis has. And hyper-helicopter parents who instruct their kids to notify teachers and play date hosts that they are “allergic” to preservatives, pesticides and red dye don’t help this cause. By definition, the term “allergy” means “a disorder of the immune system,” not something you don’t care for, either taste-wise or health-wise.

So I’m the mom who disinfects the tables at restaurants (over and under and on every square inch of the chair — what if someone left a trace of peanut butter somewhere?) and a part of me worries every day he’s at school, especially when the home baking comes in for birthdays or other special celebrations.

Short of putting him in a bubble (not a bad idea), the only treatment right now is education and avoidance. So my husband and I remind our son to ask everyone (even Grandma!) if there are any nuts in what he’s eating and to refuse food he’s not sure of. We meet with teachers, instructors and coaches to explain the symptoms and how to react to them. All I can do is hope that Ms. Pearson and some of her Chatelaine readers will read this and learn something new from one family who lives with anaphylactic food allergies.

The Facts

We asked Dr. Jeremy Friedman, chief of pediatric medicine at The Hospital for Sick Children in Toronto, for the facts about anaphylaxis.

CF: What is anaphylaxis?

JF: Anaphylaxis is a severe, potentially life-threatening condition caused by exposure to an allergy-causing
substance, which usually develops within minutes.

CF: What can cause anaphylaxis?

JF: The most common allergic triggers are foods (peanuts, tree nuts, fish, shellfish), bee stings and medications.

CF: What does an anaphylactic reaction look like?

JF: Typical signs and symptoms involve the skin (hives, itchiness, swelling, flushing), breathing (swollen lips or tongue, difficulty and/or noisy breathing), heart (fast heart rate, pale, dizzy, low blood pressure) and stomach (vomiting, diarrhea, pain). Anaphylactic reactions usually involve a combination of signs and symptoms from different parts of the body.

CF: How do you treat it?

JF: The best way to deal with a known allergy causing anaphylaxis (for example, peanuts) is of course avoidance. The best treatment once the exposure has occurred and the symptoms have begun is self-injectable epinephrine (such as EpiPen Junior) which should carried at all times with/by a child thought to be at risk of anaphylaxis (Be sure to check the expiry date.) A MedicAlert bracelet with this information is essential.