I had given my granddaughter the chocolate chip cookie that triggered her first allergic reaction. She was 4 and had just enjoyed a family dinner at my house.
Soon after she came back to her house with her sister and parents, she began coughing, then vomiting. Her parents – my daughter and son-in-law — figured she had the flu. But as a journalist who’s written about kids’ health, and as (I admit it) an over-anxious grandmother, I wondered. Can a food allergy show up this way? Were there nuts in that innocent-looking cookie?
There were. And a few months later, the allergist confirmed what I’d suspected: She was allergic to all tree nuts, except macadamias. How allergic? Highly. How does this happen? No one knows.
Sure, there are theories. One study links nut allergies to breast-feeding. Other studies point to environmental factors. Then there’s the “hygiene hypothesis,” which blames the sizeable increase in food allergies — they increased 50 percent between 1997 and 2011 — on our excessive cleanliness (think Purell), saying we’ve somehow interfered with the way our immune systems are supposed to develop.
But it’s the third theory I’m buying into. When my granddaughter was a baby, the American Academy of Pediatrics (AAP) told parents to delay introducing potential allergens (such as nuts) to a child diet — often until age 3. But later they reversed those recommendations, acknowledging the “delayed introduction of solid foods may increase the risk of food allergy…and the early introduction of allergenic foods may prevent food allergy in infants/children.”
Yeah, thanks for nothing, AAP.
Of course, we’d already figured all this out. She’s allergic to every tree nut except macadamias? Of course! That’s because (according to our highly unscientific theory) our granddaughter came to Hawaii with her family as a baby and toddler – where macadamia nuts are embedded in pretty much everything, including those minute morsels of muffins she’d love to nibble.
That’s the way our odyssey began. It’s been quite a ride.
Here’s what I’ve learned so far: 1. People who don’t have kids with food allergies don’t get it. 2. They need to get it.
These are some key points everyone should know, excerpted from the book Food Allergies: A recipe For Success At School, by Jan Hanson:
- A food allergy involves an abnormal response of the immune system and causes the body to produce antibodies to a particular food protein. The most severe form of this reaction is called anaphylaxis.
- If not treated promptly, anaphylaxis may result in death.
- The amount of allergen needed to cause a reaction varies from person to person.
- A food intolerance is not the same as a true food allergy.
- Most reactions happen after eating an unexpected or hidden ingredient or ingesting the allergen from cross-contamination.
- Symptoms of a reaction, such as vomiting, hives or respiratory distress, may vary from person to person.
- Symptoms may progress from mild to severe in several minutes.
My granddaughter’s allergy, tree nuts, can be found in foods ranging from ice cream, candies, breads, and salad dressings, to pesto, cake mixes, cereals and chips.
In other words, practically everything kids eat.
That means she (or we) have to ask exactly what’s cooked in the cuisine she orders at restaurants, we buy at a bakery, or another mom or dad serves her for lunch. It means sometimes we have to speak to the chef, or scrutinize the brownie mix or tell her she can’t have the birthday cake or the special treats parents bring (endlessly!) to school for the party.
It means any adult she’s with must be handed an EpiPen, even though she keeps one around her waist at all times.
It meant that, for the first few years at school, until we all felt she was old enough to ask the right questions, she sat at a “nut free table” at lunch, which removed her from her friends and the lunchtime social scene.
And it’s meant several runs to the ER, even after all the asking, the checking, the fretting and the scrutinizing.
Now let’s talk about you
It’s been hard not to notice that few parents grasp the dangers and implications of food allergies unless there’s a close relative around who has one.
But isn’t that the case with so many things in life?
I’ve seen people treat this potentially life-threatening condition as if it were a neurosis (writes columnist, Joel Stein, “Your kid doesn't have an allergy to nuts. Your kid has a parent who needs to feel special”).
I’ve read about kids bullying classmates who have food allergies — and grown-ups getting angry about being asked to accommodate these kids in schools. CNN reports that one reader wrote, in response to a story on kids and allergies, “how about you keep your sickly kid home? That is what homeschooling is for. We don't have to accommodate your sick kid.”
I’ve had friends assure and reassure me that the cupcake or pasta or pancake they made — and that my granddaughter was about to eat — contained no tree nuts, when it actually did. That’s because they didn’t realize that any boxed mix can contain tiny, trace amounts of nuts or nut oil.
Actress Julie Bowen of Modern Family would like people to recognize allergies and allergic reactions — and what to do about them — the way they understand choking and how to perform the Heimlich maneuver. Her son Oliver, she told me, is allergic to peanuts. Bowen is working to raise awareness (she’s a spokesperson for Get Schooled in Anaphylaxis) and to make sure every school not only stocks epinephrine auto-injectors, but if a child needs one, uses it. (See the New York Times column by author Curtis Sittenfield on this topic.)
What do parents whose kids have food allergies ask of other parents? Understanding would be great — education even better. Best of all? Empathy. The kind that’s role-model-worthy; that’s just a bit self-sacrificing; that’s lasting and impactful. Even columnist Joel Stein found empathy after his son was diagnosed with a nut allergy.
In an edgy and yes, sometimes mouthy blog, parent Karen Alpert writes, “Why should my love muffin have to stop bringing banana nut muffins to school because some other kid has allergies? I’ll tell you why. It’s called compassion. It’s called putting yourself in another mother’s shoes. It’s called teaching your kid that maybe, just maybe, her desire to take peanut M&Ms to school isn’t quite as important as a boy’s life.”
Couldn’t have said it better myself.