Grandparent’s Guide:Caring for Grandchildren who have Food

Allergies

Food Allergy Basics Food Allergy vs. Food Intolerance Common Food Allergens Food Allergy Reactions Treating a Reaction Epinephrine Storage How Grandparent Can Help:

◦ Awareness◦ Education◦ Be Prepared◦ Advocacy

Grandparent’s Guide

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Food Allergy Basics Affects as many as 15 million Americans

◦ Nearly 6 million or 8% of children have food allergies with young children affected most

◦ 2 million school-aged children (aged 5-17)◦ An estimated 9 million, or 4%, of adults have food

allergies

Prevalence appears to be increasing among children under 18

There is no cure; strict avoidance is the only way to prevent a reaction

Managing one’s food allergy on a daily basis involves constant vigilance

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What is a Food Allergy? A food allergy is an immune system

response to a food protein the body mistakenly believes is harmful

When a person eats an allergy-causing food, the immune system releases massive amounts of chemicals, such as histamine, that trigger many symptoms that can affect the skin, respiratory, gastrointestinal, and cardiac systems

Reactions can be fatal

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A Food Allergy is NOT: A food intolerance (lactose intolerance)

◦ An intolerance does not involve the immune system; it involves the digestive system. For example, those with lactose intolerance lack an enzyme needed to digest and process lactose.

◦ Symptoms of intolerance include gas, bloating, and abdominal pain.

A dislike of food

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Anaphylaxis Potentially life-threatening allergic

reaction

Symptoms can begin within minutes to hours after ingestion

Food allergy is leading cause of anaphylaxis outside of the hospital setting

Other causes include insect bite/sting, medication, latex, exercise, and unknown causes

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Common Food Allergens

In the U.S., eight major food allergens account for 90% of all reactions:◦ Milk Eggs◦ Peanuts Tree nuts (e.g., walnuts, pecans)◦ Wheat Soy◦ Fish (e.g., salmon, halibut)◦ Shellfish (e.g., lobster, shrimp, crab)

Almost any food can cause a reaction Emerging food allergens include sesame and

other types of seeds

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Treating a Reaction Reactions are treated with epinephrine

(adrenaline) Epinephrine is prescribed as an auto-

injector device (EpiPen®, Adrenaclick®) Prompt administration of epinephrine is

crucial to surviving a potentially life-threatening reaction

Epinephrine is a safe medication; transient side effects such as pallor or tremor mean that the epinephrine dose has been absorbed and is working all over the body

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Food Allergy Reactions Trace amounts of an allergen can trigger a

reaction Anaphylaxis is a severe allergic reaction that is

rapid in onset and may cause death

◦ Inject epinephrine immediately and call 911 (See Food Allergy Action Plan)

◦ Reactions can occur within minutes of ingestion or up to two hours after

◦ A biphasic reaction (in which symptoms disappear and recur without further ingestion of the food that caused the initial reaction) can occur hours after the initial reaction

Go to the emergency room after the reaction has been treated 9

Food Allergy Reactions Localized reactions caused by touch, such

as localized hives◦ Give antihistamine (See Food Allergy Action Plan)

Inhalation reactions possible, but rare. Smell alone cannot cause an allergic reaction; the food protein needs to be present◦ Cooking fumes (milk being steamed, fish being

cooked)◦ Peanut dust (airplanes)

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Food Allergy Action Plan

Mouth◦ Itchy, tingling, swelling of

lips/tongue Nose

◦ Hay fever-like symptoms: runny, itchy nose;

sneezing; and/or watery, red eyes

Skin◦ Hives, rash, redness, itching◦ Flushing (redness and

warmth)◦ Swelling of face or

extremities Gut

◦ Cramps/pain◦ Nausea, vomiting, diarrhea

Possible Symptoms of a Reaction

Throat◦ Hoarseness◦ Tightening of throat,

difficulty breathing, difficulty swallowing

◦ Hacking cough Lungs

◦ Shortness of breath, wheezing

◦ Repetitive, hacking cough Heart

◦ Low blood pressure, weak pulse

◦ Pale blue color◦ Dizzy, fainting

Mental◦ Anxiety, “sense of

impending doom”◦ Lethargy

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How a child might describe a reaction

My throat is itchy My throat feels thick There’s something stuck in my throat My tongue is hot (or burning) Something is poking my tongue It feels like there is hair on my tongue My tongue feels full (or heavy) It feels like bugs in my ear (itchy ear)

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Teens: A Special Consideration

Teens are at a high-risk:

◦peer pressure to be “normal”

◦not carrying medication

◦going off alone

◦not knowing what to do

◦not recognizing signs/symptoms

◦friends not knowing what to do

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Epinephrine Storage Store at room temperature Avoid extreme heat or cold – don’t refrigerate;

don’t leave in the car! Check for discoloration and expiration date

periodically (auto-injectors should be replaced yearly)

Always check expiration dates before leaving pharmacy and when caring for your grandchild

Should be quickly accessible by anyone responsible for handling an emergency

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How Grandparents Can Help

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Read food labels EVERY time – ingredients can change without warning

Understand food labeling◦ While the top-8 allergen foods are required to be

labeled in simple language (e.g., “milk” instead of “casein”), advisory statements such as “May contain” are voluntary FAAN’s FREE download “How to Read A Label” sheet FAAN’s FREE download “Chef Cards”

At restaurants, always speak with the chef and/ or manager

Awareness

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Post child’s Food Allergy Action Plan on refrigerator or on kitchen cabinets with the child’s allergies and emergency contacts

Ask your children where you can find out more information about food allergies

Inform others by participating in Food Allergy Awareness Week (FAAW)

Visit www.foodallergy.org

Awareness - continued

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Listen closely to what your children are saying about how food allergies affect their day to day lives and how they are dealing with it

It is IMPERATIVE that parents feel the child’s grandparents can be “trusted” to provide care

Learn the symptoms of allergic reactions

Read articles, books, online reports, medical journals, and FAAN’s (www.foodallergy.org) and Food Allergy Initiative’s (www.faiusa.org) websites

Education

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Cross-contact (sometimes referred to as cross-contamination)

◦Occurs when one food comes into contact with another food and their proteins mix. As a result, each food then contains small amounts of the other food that are often invisible to us.

Education - continued

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Sources of cross-contact:◦Cooking oils, splatter, and steam from cooking foods

◦When a food allergen comes into contact with a serving utensil, countertop, pot or pan, wash the item thoroughly in hot, soapy water Examples include: spoons, knives, spatulas,

tongs, cutting boards, bowls, sheet pans Do not forget fryers and grills

Education - continued

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Carefully and completely read ingredient labels

Offer to attend the grandchild’s doctor visit(s) to help understand the severity of the food allergy

Discuss grandchild’s food restrictions with others to alleviate any tension and make people more comfortable around the child(ren)

Anaphylaxis is possible even if you do not see hives and/or skin rash

Education - continued

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Follow parents’ directives If you suspect a reaction – DO NOT hesitate

– give epinephrine – call emergency medical services (i.e., 911)

Knowledge is POWER!

Education - continued

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Practice injection technique using an auto-injector trainer

Educate caregivers on the symptoms of allergic reactions when they care for a child with food allergies

Example – hives, swelling of the lips, difficulty breathing

Have a plan ahead before a reaction occurso Food Allergy Action Plan

Be Prepared

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Always carry epinephrine if prescribed for your grandchild

Preferably, carry two auto-injectors in case a second epinephrine dose is needed

Be Prepared

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Make sure you have grandchild’s medication (epinephrine, antihistamine, etc.) unless parent is bringing them◦ Pantry – store safe foods together

◦ Store allergy-containing foods out of the child’s reach or remove from the home

◦ Refrigerator – designate a shelf for allergy-free foods

Before Your Grandchild Arrives

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If the grandchild with food allergies lives close by, have “safe” snacks handy in the event of an unplanned visit

Customize meals for safety AND food preferences

Prepare meals that are allergen-free◦ Modify recipes using safe substitutes

Read all food labels; call the manufacturer with questions

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Before Your Grandchild Arrives - continued

Clean countertops thoroughly with hot, soapy water, using a clean, disposable cloth before preparing allergy-free foods to minimize the risk of prior cross-contact

When preparing food, always use separate utensils

Consider applying brightly colored stickers on safe food items

Beware of allergen-containing “surprises”:

o Pet foodo Lotions, hair care products, cosmeticso Play dough

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Before Your Grandchild Arrives - continued

If you are planning to dine out, call restaurant, identify yourself, and speak to chef and/or manager about the food allergy and appropriate menu choices Speak to manager and chef again when arriving at the

restaurant Remind the chef to avoid cross-contact

Many restaurants will prepare a special meal using separate utensils

If you take your grandchild on an “outing,” be aware of situations involving food (i.e., free food samples, animal feed at petting zoos)

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Before Your Grandchild Arrives - continued

BE AN ADVOCATE FOR YOUR GRANDCHILD

Learn about legislation/statewide guidelines on the FAAN Advocacy page: www.foodallergy.org/section/state

Become active in promoting food allergy awareness throughout your community

Join a local support group

Participate in a food allergy fundraiser, such as FAAN’s Walk for Food Allergy

Do your own food allergy fundraiser

JOIN FAAN!

Advocacy

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For more information,contact FAAN

www.foodallergy.org (800) 929-4040

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