FOOD ALLERGIES

More and more, we are hearing about children who are allergic to certain foods. For some of them, these food allergies are life-threatening – a matter that can be particularly worrying for parents when these children go to school or daycare.

Allergies to peanut butter and nuts, for example, are particularly frightening because even the tiniest amount can cause death within minutes in an allergic child. Other foods including shellfish, fish, eggs, and milk can also cause severe reactions. Some, but not all, children who are allergic to nuts may also be allergic to legumes such as chickpeas or green peas.

Anaphylaxis is the most severe type of allergic reaction. It is sudden, violent and life-threatening. An anaphylactic reaction can begin with itching or swelling of the eyes, face, lips, tongue or throat. The face or body may become flushed and tightness in the throat, mouth and chest may occur. Other symptoms may develop such as difficulty breathing and swallowing, dizziness, stomach upset and vomiting.

If the reaction is not stopped at this point, the symptoms may become more severe leading to a drop in blood pressure, loss of consciousness and even death. Children with severe allergies need quick access to their EpiPen (an emergency epinephrine injector) and medical attention to treat an anaphylactic reaction.

The frequency of fatal and near-fatal “anaphylactic reactions” has increased over the past several years and is likely to continue to rise. This is especially true of food-induced reactions. In Canada about one person in 100 is estimated to be at-risk and there may be as many as 50 deaths a year.

If you have school-age children you may already have been asked to refrain from bringing certain foods such as peanut butter or nut products to school because a child at school is allergic.

That child’s food allergy is not a trivial matter. Parents who have a severely allergic child have done their best to provide the safest possible atmosphere for their child at home. Most have declared their homes a nut-free zone despite the fact that other family members may enjoy peanut butter and nut products.

When an allergic child goes to school, cooperation from the entire school community is needed to help reduce an anaphylactic child’s exposure to foods that can be harmful to them.

Peanuts and peanut butter are the most likely foods to trigger a full-blown anaphylactic reaction. Some children are so sensitive that even the smell of peanut butter or nuts can cause problems.

Peanut butter is also sticky and greasy. It very difficult to clean peanut butter from surfaces such as tables and desks. Peanut butter on a friend’s hand could be transferred to a crayon, pencil, soccer ball or skipping rope handle.

For these reasons, nut-containing foods should not be eaten in a classroom used by a child who has been diagnosed with peanut or nut allergies. Children who eat in a peanut/nut allergy child’s class should be encouraged to bring nut-free lunches or eat in another classroom.

Anyone who does eat peanut butter or nut-containing products at school where there is an anaphylactic child should be encouraged to wash their faces and hands immediately after eating.

There are many hidden sources of nuts and nut oils in foods that also pose a threat to peanut/nut allergy kids. Some examples include cookies, muffins, cakes, pastries, doughnuts, sweet rolls, granola bars, some cereal bars, trail mix, candies, chocolate bars, cheese spreads, some puddings and ice cream, Nutella, Chinese food, snack crackers and chips.

Older children with peanut/nut allergies may already know which foods they cannot eat and are adept at reading food labels. Younger children however may still be keen to accept treats or sip on a friend’s drink. To reduce their exposure to offending foods children with food allergies should only eat foods that they have brought from home. All children need to be cautioned about not sharing snacks, especially with allergic children.

If you are concerned that your child will not be getting enough protein at lunch without peanut butter, you’ll be happy to know that they’re probably getting more than enough protein each day already. The following foods have approximately the same amount of protein as two tablespoons of peanut butter: one ounce of meat or cheese, one cup of yogurt, one cup of milk, one cup of raisin bran cereal, and one bagel. Just one slice of cheese pizza has almost two times the protein as two tablespoons of peanut butter.

The key to a balanced lunch is to have at least one food from each of the four food groups in Canada’s Food Guide to Healthy Eating.

Some lunch bag ideas include hard boiled eggs, leftover cooked chicken legs, cold cuts, chili, cream cheese, cheese slices, meat or vegetable stew, macaroni and cheese, leftover spaghetti or pasta, baked beans, soup, tuna or egg salad, or leftover pizza. Make lunch balanced by adding whole grain bread, bagels or pita bread, raw vegetables, fruit, and a serving of milk, yogurt or nut-free pudding.

A few cookies, fig bars, cereal bars and chocolate treats are nut-free. In order to help maintain a safe and nut-free classroom, just remember to read all food labels carefully and avoid sending foods that do contain nuts or peanut butter.

If you would like additional information about coping with food allergies or anaphylaxis contact:

Anaphylaxis Canada
2005 Sheppard Avenue East
Suite 800
Toronto, Ontario
Canada M2J 5B4
Tel: (416) 785-5666 Toll Free: 1-866-785-5660
Fax: (416) 785-0458
Email: info@anaphylaxis.ca

Allergy Asthma Information Association (AAIA)
295 The West Mall
Suite 118
Toronto, Ontario
M9C 4Z4
Tel: (416) 621-4571 Toll Free: 1-800-611-7011
Fax (416) 621-5034
Email: admin@aaia.ca

Other Resources:

Canadian Pediatric Society

Canadian School Board Association for a copy of “Anaphylaxis: A Handbook for School Boards”

Canadian Food Inspection Agency for information on food recalls and allergy alerts.