For the millions of kids with food allergies, new efforts to improve product labeling and provide easier access to life-saving medication should make getting back to school a little easier.
Just this summer, long-awaited legislation was passed by Congress that requires food companies to clearly label packages that include any of the eight most common food allergens -- wheat, soy, milk, fish, shellfish, eggs, peanuts and tree nuts. Currently, many food labels list the chemical names of an ingredient that has a food allergen in it -- like hydrologized vegetable protein instead of soy -- posing the risk that a child or parent won’t recognize a potentially dangerous allergen. That can be particularly important for youngsters serving themselves out of vending machines or while making choices in the a la carte line at the cafeteria.
Accidental ingestion of food allergens by allergic children and adults results in 150 to 200 deaths and 30,000 emergency room visits each year, according to the Food Allergy and Anaphylaxis Network (FAAN), an advocacy group based in Fairfax, Va.
Companies will be required to have their new labels in place by January 2006, but many food firms will start complying immediately, and some large food manufacturers already make the allergens clear on their labeling, says Anne Munoz-Furlong, CEO of FAAN.
Easier access to epinephrine
Labels are not the only improved feature for kids with food allergies. The American Academy of Pediatrics recently updated its policy guidelines on medications in schools to recommend that some children with certain medical conditions, including food allergies, be allowed to carry their medications with them to class. For kids with food allergies, that medication is epinephrine, usually in the form of an injectible EpiPen, which can reverse an allergic reaction.
The academy says the permission should be given to children who have shown that they know when and how to take the medication and can be responsible for making sure they have it with them. One reason for the new policy, according to the group, is that budgets have forced many schools to cut back on the hours for school nurses, or even cut positions entirely, which means no professional is available should a child need medication.
Unfortunately though, Milgrom says, the only new treatments are in the experimental phase, which means the best approach is actually preventing ingestion.
That takes time and the cooperation of school officials, say parents of kids with food allergies.
Muriel Cooper, a media relations specialist with the AARP who lives in Maryland, has children in their teens with food allergies and has been dealing with their food needs since they were little.
"The best way to make sure your child's environment is safe is to notify the school administration immediately upon registering your child, work with the school's dietitian and let them know you are holding them accountable for your child's safety during the day,’’ says Cooper.
She says her kids have not had a bad experience at school with their food allergies, which she attributes to making the principal, teachers and medical staff aware of the kids’ allergies, having lunch menus sent home so they could decide which meals the kids could buy and making special arrangements for school trips and other situations where the kids might be exposed to a food to which they are allergic.
Avoiding problems
If you're the parent of a child with food allergies, some additional tips can help you swerve around potential problems, says Dr. Clifford Bassett, a pediatric allergist at New York University Medical Center in New York City:
Get your child tested. If allergies run in your family, have your youngster screened to determine which, if any foods, must be avoided since many children who are allergic to one food may be allergic to others. For example, people who are allergic to peanuts are often allergic to legumes, such as peas and beans.
Educate your child. Discourage your child from sharing food or utensils. Even though it is especially difficult for young children to stay away from foods their friends are eating, your mantra should be "No Food Sharing Allowed." An individual who has had a severe reaction to certain foods must never taste them again since reactions can become more severe with time and exposure. Teach kids to ask about ingredients if they are unsure what is in a certain dish.
Be a label detective. Bear in mind that shaving creams, moisturizers, shampoos and lipsticks may contain peanut, almond or soybean oils that can cause allergic reactions when transmitted through kissing or hand contact. People with milk allergies often react to canned tuna, which may contain a milk protein as a preservative.
Stock up on safe foods. Keep a supply of safe snacks for home and travel, and place a small sign on the refrigerator indicating prohibited foods.
Be vigilant. Children who are prone to food allergies are more susceptible when they are suffering from colds, upset stomachs, stress or hay fever.
Know what to do in an emergency. Depending on the severity of the allergy, reactions can vary from minutes to hours. Children who have experienced severe allergic reactions should wear a Medic Alert bracelet, obtainable by calling 1-800-IDALERT (432-5378). Contact your pediatrician or allergist for a plan to follow in the event of an allergic reaction.
Get support. Unfortunately, parents with food allergic children have lots of company. Join a support group such as FAAN. Two other good sources of information are the American College of Allergy, Asthma and Immunology and the American Academy of Allergy, Asthma and Immunology.
Become an advocate. Schedule meetings with school caregivers and offer to develop a written policy regarding food allergy issues, such as peanut-free environments. New York City, for instance, is considering implementing such a policy in its public schools. Some schools across the nation already ban peanut butter.
And you don’t need to wait for all the food firms to get their labeling to change to get your child or yourself the information you need. FAAN sells $2 cards that list synonyms for the eight most common food allergens (for instance, edamame is another word for soy) and should be taken on every grocery store trip. And check the FDA web site that discusses foods that have been recalled because the label didn't list a food allergen.
Francesca Kritz is a freelance writer in the Washington, D.C. area who has written for the Washington Post, Parenting, BabyTalk and other publications.