It was a regular Saturday, and nothing was out of the ordinary. In between cutting the grass and gawking over our “brilliant” 6-month-old’s new tricks, we were in the process of introducing solid baby foods for the first time. On the menu that day was a simple, harmless vegetable: green beans.
But this quiet Saturday afternoon in June, 2008, ended up changing our lives forever.
It never, ever, not one time crossed our minds that this would be the day that our child would encounter death for the first time. And all because of one single piece of food.
I don’t remember how long we waited to put him down for his afternoon nap after he ate the green beans, but I know we didn’t see any signs of distress at all. We couldn’t have. We were “those” first-time parents who called the doctor for every sniffle and went into full-out panic mode for the smallest bump on the head.
We completed our naptime ritual as usual. We kissed his toes, rubbed his back, read him books and did all the things brand-new parents do with their sweet babies. Then, in total “new parent exhaustion,” we decided to take a nap, too. After all, sleep when the baby sleeps, right?
When we woke up from our nap and didn’t hear him stirring, we tip-toed into his nursery to check on him. What we saw in that moment is something no parent should ever have to endure: our firstborn baby boy lay lifeless and unresponsive in his hand-me-down crib.
His eyes were rolled back in his head, he was covered in a rash from head to toe, and he was laying in a pool of his own vomit. We didn’t even have time to scream. Shock set in, but so did the adrenaline. We scooped him up, jumped in the car and drove as fast as we could to the ER. By the time we got to the hospital, his body had turned grey and he still wasn’t moving.
He didn’t die that day, but it took us a long time to figure out what the culprit actually was. Initially, the doctors believed he had a virus, and this was how his body reacted to it. No one ever mentioned food allergies or even asked us what he had eaten that day. We didn’t even know a family who had a kid with a food allergy, so it never crossed our minds to ask. We believed, like the doctors, it was a one-off, randomly crazy event. But it wasn’t. Instead, it was the beginning of a medical journey that would completely alter the trajectory of our lives.
Over the course of the next four years, odd things kept happening, and with the help of a team of doctors, he was eventually diagnosed with dozens of severe food allergies and a white blood cell disease called eosinophilic esophagitis. A few months later, his little brother was, too.
It’s been a scary decade, trying to navigate and understand the intricacies and seriousness of their conditions. But we, like so many other families, have learned to manage, cope and thrive — despite all of the uncertainty.
WHAT IS A FOOD ALLERGY?
According to Food Allergy Research and Education (FARE), a food allergy is a “serious and potentially life-threatening medical condition affecting 32 million Americans.” Research also shows that one in 13 children have a food allergy, or two kids in every classroom.
Whether or not food allergies have touched your family, you’re bound to know someone with one because they’re on the rise. A study by Blue Cross Blue Shield shows that “there has been a substantial increase in the most severe anaphylaxis allergic reactions in children which has largely been triggered by foods. This increase in severe anaphylaxis reactions coincides with a steep rise in ER visits for this condition.” In fact, the study also shows that the rate of children who visited the ER in anaphylaxis has grown by 150 percent between 2010 and 2016.
Stacy Dorris, M.D., a pediatric allergist and director of the Food Allergy Clinic at Monroe Carell Jr. Children’s Hospital at Vanderbilt, says the influx of food allergies may be the result of a too-clean society.
“It’s a working notion of the hygiene hypothesis — that we as a society have become too good at being clean, and if the immune system is idle, it can get itself in trouble,” Dorris says. “That idea in combination with the type of our air pollution — which also promotes allergy — is where the research is pointing right now,” she adds.
But what’s actually happening to the body when an allergic reaction occurs?
An allergic reaction happens when our immune system thinks it’s being threatened after ingesting a certain food. The body’s response is to produce an antibody called immunoglobulin E (IgE), which in turn causes the allergic reaction. While someone can be allergic to almost any food, the most common allergens include milk, eggs, peanuts, tree nuts, wheat, soy, fish and shellfish.
Food allergies are not the same as food intolerances or food-related diseases like celiac disease or eosinophilic esophagitis. While food intolerances can make life very uncomfortable, they are typically not life-threatening and do not involve the immune system in the same way allergies do.
DISCOVERING FOOD ALLERGIES
Now that food allergies are becoming more common, parents are looking at every bump, rash and stomach pain in a new light. What is this bump by his lip? Why is she scratching her head when she eats? Why does my child have a stomachache every time he drinks milk? It’s true parents need to be diligent, but it’s also important to remember that not every symptom will result in a life-altering diagnosis. Therefore, knowing the signs of a true allergic reaction to food can be life-saving information.
Food allergies can range from very mild to extremely severe and life-threatening. Typically, a severe allergic reaction will not be subtle. In other words, the symptoms will come on strong and quickly, usually within two minutes or, in my son’s case, in up to two hours. If you suspect your child might have a food allergy or you have a family history of food allergies, make sure to keep a close eye on your child as you introduce new foods.
Dorris says to look for these symptoms of an allergic reaction:
- Swelling on the eyelids, tongue or lips
- Respiratory distress: trouble breathing or shortness of breath
- Severe stomach pain or vomiting
If your child has two or more of these symptoms (meaning two bodily systems are involved), he is most likely having an anaphylactic reaction and will need immediate emergency care.
If you repeatedly see symptoms that cause concern, call your pediatrician — he can direct you to the right pediatric allergist for a proper diagnosis.
DIAGNOSING A FOOD ALLERGY
Because symptoms of food allergies can also mimic symptoms of other medical conditions, you cannot self-diagnose a food allergy. You’ll want your child to receive a thorough examination by an allergist to confirm, diagnose and treat his possible allergy.
“The most valuable information for an allergist is a detailed food history. It’s part of your food story, and it can help us determine if there is a true allergy,” says Dorris.
Capture your child’s food story (history) in a journal that includes: suspected symptoms (skin irritation, stomach problems, rashes, breathing problems, etc.), foods eaten and times/days when the symptoms occur and any new foods introduced that cause issues.
The allergist will conduct one or more diagnostic tests:
- Skin prick test (injects allergen under surface of the skin) for reactions.
- Blood test: Determines whether IgE antibodies are present.
- Oral food challenge: Ingesting small amounts of a suspected allergen. If no symptoms occur, he will continue to eat in larger doses.
- Trial elimination diet: The process of temporarily eliminating foods from the diet to see if symptoms go away.
The doctor will use the information gathered from the diagnostic testing in combination with your provided and detailed medical history to make a proper diagnosis.
MANAGING A FOOD ALLERGY AS A PARENT
Once your child receives a food allergy diagnosis, your next step is learning how to manage it. Honestly, it can feel like a tough job. It will be your responsibility to educate yourself, your family, your food allergy child, his caregivers and teachers, and your family’s circle of support. And if you’re like me, you’re also a never-ending advocate, researcher and all around ninja-parent. I know; it feels overwhelming, so putting a plan into place will help make the transition easier.
- Find the right doctor: Finding the right medical support for your family’s needs is like finding the right spouse — the most important thing is you need to feel seen, supported and heard.
- Create a plan for your home: Whether or not you keep the allergen in your home is a personal decision. “Think through the way you live and make a choice,” says Dorris. “If you eliminate the allergen from your home, you will have little to no risk of exposure. Some families decide to take a more normalized approach and choose to educate and label foods. It depends on your children’s ages and personalities (i.e. will they sneak or ‘cheat’?). There is no right or wrong way to do it; just make a functional plan and stick to it,” she adds.
- Be prepared: Going out to eat and attending functions with food will become more difficult for your family, so you will have to plan ahead. Bring a cooler of food with you if necessary, and always keep safe snacks in your purse or car. Take a medical bag with all the necessary medicines at all times and never leave home without it. If you go out to eat, call ahead or go at “off” times so you have plenty of time to talk to the wait staff or chef about your situation.
- Advocate for your child and educate your support system: Don’t worry about bothering people with your child’s diagnosis. You are your child’s number-one advocate, and his safety is your number-one concern. Educate people in a gentle, but firm way. Be direct and repetitive until everyone is comfortable with the information. Anyone who cares for your child should know about his food allergies and what to do if they suspect he has come in contact with an allergen.
- Get involved in the food allergy community: It might help you and your child to have support from other people who know exactly what you’re going through. Connect with other food allergy families through Facebook groups, support groups or nonprofits like Food Allergy Research and Education (FARE).
TEACH YOUR ALLERGIC CHILD TO SPEAK UP
As you are navigating your child’s diagnosis, remember this is new for him, too. He will need support and education as he learns how food allergies will affect his life.
Teach him to speak up and ask questions. It’s important to teach your child the language he needs to communicate his food allergies to anyone who may be handling his food. Teach him to ask about ingredients before he eats anything. While his caregivers are there to protect him, he DOES need to learn to advocate for himself at a young age.
Once your child can read, teach him how to read a food label, and get him to do it as often as he can. Make sure you double check it for him as he learns. Companies change ingredients all the time, so don’t assume a food is safe. Read and re-read ingredients every time — both of you!
If you’ve got young children and you’re wondering about feeding them high allergic foods like peanuts, don’t fret. While in the past, the school of thought was to strictly avoid foods like peanuts until about age 3, new guidelines published in The Annals of Allergy, Asthma and Immunology now recommend giving children pureed peanut products as early as 4 months old, depending on your child’s history.
“Don’t avoid foods if you don’t have to,” Dorris says. “If you have a normal healthy baby, feed him everything. Of course, you’ll want to avoid choking foods like a whole peanut,” she adds. If you have a family history of food allergies or are nervous about introducing certain foods, your doctor can help you come up with a plan to introduce the food in a safe, controlled way.
If you find yourself facing a food allergy in your child or children, there is hope that they can potentially grow out of their allergy. Dorris says 60 - 80 percent of children outgrow a milk or egg allergy before they turn 5 - 6 years old, and 20 percent of children with a peanut allergy will outgrow it in their lifetime.
And as for the future of food allergies? As even more studies emerge and our understanding of food allergies evolve, doctors are moving toward alternate methods like oral or patch immunotherapy, notably not FDA approved yet. While it’s not a cure, it might make food allergies more manageable.