In Kids, Allergies Trigger Physical Reactions, And Emotional Ones Too

Some top allergy doctors joined On Point for our show on kids and food allergies. Allergies are definitely on the rise, but doctors and researchers don’t exactly know why. But for the 1 in 13 children who are threatened by foods many of us take for granted like nuts, dairy, seafood, wheat and soy—the why isn’t as important as the how. How do you treat it and how can we minimize life-threatening situations from happening?

As more and more children develop a range of dangerous food allergies, it is increasingly becoming a community problem. Guest host Jane Clayson spoke with two doctors who are deeply entrenched in the issue.

Dr. Ruchi Gupta is a physician and professor of pediatrics at Ann and Robert H. Lurie Children's Hospital of Chicago. She is also the author of “Food Allergy Experience: Real voices. Real disease. Real insights,” and has a child with a food allergy herself.  She offered a combination of personal advice and clinical insight on caller Jay’s concern about the psychological effects of food allergies on his family.

JAY: One thing that my wife and I definitely struggle with is the psychological effects because everything is so food-centric – from family events to school events to going over friends’ houses. I’ve administered an epiPen twice to my daughter, and I know that it saved her life. Once just recently, two weeks ago while we were down in Mexico. And it’s an issue that we deal with every day. As well as the psychological effects on her, as well as my other daughter who doesn’t have any food allergies. And I don’t know if your panel has any advice or ideas on how to deal with this? Because you just want the one with food allergies to feel like everyone else. And it’s tough where you just can’t go out for an ice cream cone or you can’t go to… most places.

JANE CLAYSON: Even birthday parties for these little kids, sometimes. Jay, thank you very much. Dr. Gupta, would you respond?

DR. RUCHI GUPTA: I feel what you’re going through. It is such a significant issue because food allergies are so different than other chronic diseases. Because food is such a part of absolutely everything we do. And, a couple of things that I would recommend though are: you know, really make your child feel good about how responsible they are. And secure in the fact that they have safe places. And that may be your home, but often times-- ­and now it’s expanding--there are allergen-safe places to eat: ice cream shops, bakeries, and even restaurants, and if you find the few, you know, it doesn’t take a lot. But if you have your list of places that are completely safe, and your child can feel very good and safe about being there, I think that really helps a child.

You know, one thing, we did talk to many children, we published a book on this, and it talks about the child’s emotions. Not only can it help them cause anxiety and have these negative factors, but what we notice in these kids is that as they grow up they become incredibly responsible adults. And that responsibility really expands throughout their life. Not only in how they manage their food allergy. And so from a lot of older children with food allergy, we have found that they do turn out to be very strong, independent and responsible human beings, which is nice to see a positive part of food allergy.

We were also joined by Dr. Wayne Shreffler, the director of the Food Allergy Center at Massachusetts General Hospital. He not only diagnoses and treats young patients with debilitating food allergies, but he also is conducting cutting-edge research to try to find a long-term solution. In the mean time, he stresses  making a community effort at keeping children safe.

JANE CLAYSON: What counts as “discrimination” for a child with food allergies?

DR WAYNE SHREFFLER: I think you strike the balance really by having a rational, as much as possible, evidence-based discussion and I always encourage families to start there. Talk with the school. Things have really only improved over time. And to focus on where the risks are.

I mean frankly, the risks are not so much about even accidentally getting some contact exposure. The risks have mostly to do with accidentally ingesting something and it can be absolutely a trace amount. And policies like washing hands and surfaces after meals are quite appropriate. Or being very thoughtful and limiting food in the classrooms… They’re very appropriate. But it’s a conversation, and it not going to be sort of a one-size-fits-all for all school and all families.

It’s focusing on where the risks are greatest, which are accidental ingestion, and putting in place policies for that make sense for that school and that child to prevent that. And, on the other side of that, being prepared and educated about how to respond to accidental reactions because they will likely occur.

The goal is not zero risk, the goal is to mitigate risk as much as reasonably possible and to be prepared when accidents happen, because they will happen.

You can hear more here.