If you are the parent of one of the nearly 6 million American children who have food allergies, you are likely well versed in how to recognize and treat the symptoms of an allergic reaction. However, people other than parents or guardians often care for children. Whether it is teachers, coaches, babysitters or friends, you’ll want to make sure they know how to keep your child safe from dangerous exposure to the foods they must avoid.
The American Academy of Pediatrics reports that food allergies happen when a child’s immune system overreacts to certain foods, such as milk, eggs, nuts, soy and grains with gluten. The reactions can be mild (itchy skin, sneezing, upset stomach) or severe (throat tightness, vomiting, loss of consciousness) — and can even lead to life-threatening anaphylaxis.
Dr. Rachel Klein, a doctor of internal medicine and pediatrics with Sharp Rees-Stealy Medical Group, offers these tips for managing your child’s food allergies when they are in someone else’s care and how to keep a child with allergies safe while in your care.
If you have a child with a food allergy, what should you tell adults who care for them?
First, you need to know the specifics of your child’s allergy and its severity. Any life-threatening allergy must be shared with your child’s school, sports league, scouting organization or other group leader. You should provide a list of foods that must be avoided and a written “emergency action plan” or “food allergy action plan” to the adult in charge so they know what to do if your child is exposed to the allergen. An example plan can be found at foodallergy.org.
You should always have more than one available epinephrine auto injector, commonly known by the brand name EpiPen, so that your child —if old enough — can carry one with them, and one can be held in the school office or with a responsible adult.
What is the greatest risk when a child with a food allergy is away from his or her parents?
For severely allergic patients, the greatest risk is exposure with subsequent development of anaphylaxis, which can cause severe brain damage and even death if not attended to immediately.
What actions should other adults take when told a child in their care has severe food allergies?
With the high prevalence of food allergies, it is always a good idea to ask parents if their child has any allergies and have a plan in place for those that do. Any adult caring for a child with food allergies should know what the typical signs of a life-threatening allergy are and how they should treat it — this is where the action plan comes in handy.
They should also ensure the child has an epinephrine auto injector with them, or have one themselves, and know how to use it. Even an older child may not be able to properly administer the epinephrine shot when an allergic reaction occurs.
At what age can a child be expected to manage their own food allergy and keep themselves safe?
There is no defined age, as every child is different, but the earlier you and your child’s doctor start teaching your child how to manage their allergies — reading labels, asking questions before eating anything, learning what the epinephrine auto injector is and how to use it — the better. Ultimately, it will be up to you, with guidance from the physician, on when your child is ready to self-manage.
However, even if your child is mature enough to manage the allergy and keep him or herself safe, there should always be somebody else who is aware of the allergy and knows where the rescue medication is located and how to use it — in case your child has a severe reaction, rendering them unable to administer the shot themselves.
Thankfully, many allergies are outgrown. Eighty to 90 percent of egg, milk, wheat and soy allergies resolve by the time a child is 5 years old. However, only 20 percent of children will outgrow their peanut allergy and even less outgrow a seafood allergy. Knowing how to recognize and treat allergic reactions and making sure those who spend time with your child know the same will remain important throughout their life.