Dining Out With Your Young Food Allergic Child

Dining Out With Your Young Food Allergic Child

by Melanie Potock, MA, CCC-SLP

*This post was originally published on The Tender Foodie Blog.  The original article can be found here.

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DO YOU DINE OUT?

Many parents feel overwhelmed at the thought of bringing their child with food allergies to any restaurant for fear of exposing him/her to an allergen that could make them horribly ill or worse.  Yet, according to Restaurants USA Magazine,  Americans eat out for 4.2 meals per week! Dining out with our families and friends is part of our social routine.  It’s possible to enjoy this time together as a family, but it requires a bit of planning. One strategy that may soothe some fears is assembling your own “Restaurant Backpack” filled with everything you need to create a safe and fun dining experience for your entire family.

 

SETTING UP

While it might be tempting just to wrap the chair in your coat, as this parent has done (above picture), start instead with a washable highchair cover to shield your little one from those germy, possibly allergy-laced wooden restaurant highchairs.  Fisher Price™ makes a padded version that includes tether straps to attach to toys so they won’t fall on the equally dirty floors.  The carry pouch is included.  Tuck a package of sanitizing wipes in the carry pouch so that when you arrive at your seat, the first thing you do is wipe down the table, highchair and anything that is within reach of your child. Then add the cover, then add the kid. Speaking of toys, it’s ideal to bring quiet toys that won’t disturb the other patrons, lightweight toys that keep the backpack manageable and socially interactive toys that focus on you and your child being together and enjoying the moment.  My top three favorites?

MESS-FREE CREATIVITY!

Aquadoodle Travel N Doodle  is a soft, mess-free, portable and foldable drawing mat that includes a refillable “water pen” that magically makes red appear on one side of the mat and blue appear on the other.  The most your child gets on him/herself is a bit of water.  One suggestion: store the pen in a re-sealable plastic baggie or empty it before going home.  It can leak in the backpack.

 

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It Takes a Village – And Then Some!

It Takes a Village – And Then Some!

by Erica Leon, MS, RDN, CDN

While not easy, I somehow launched my children into college and beyond. With fellow empty-nester friends who are also health professionals and moms—one a nurse, one a psychologist—I took a walk down memory lane. We reflected on teaching children good self-care, particularly when they have health concerns related to food.

Photo Credit: woodleywonderworks via Compfight cc

 

Peanut Allergy:

Carpooling was challenging enough, but when I thought three-year-old Thomas had shared my son’s peanut rice cakes, I panicked! Thomas was severely allergic to peanuts as well as tree nuts. Still parked at the nursery school, I hoisted Thomas like a football, screamed for the teachers, and rinsed his mouth, hoping I did not have to administer his EpiPen. He never ate any of the rice cakes, but I learned a valuable lesson on scrutinizing food items when you have or care for a child with allergies!

According to Hildie Kalish, RN, an elementary school nurse whose child has a severe nut allergy, “Keep your child safe by constantly checking and then rechecking ingredients in food products. Never assume an item is safe as it is not uncommon for food manufacturers to change ingredients or processing techniques. As soon as children are old enough to understand, teach them to read labels and avoid sharing food with other kids. When they are responsible enough, have them carry Benadryl and their own Epi-pen or Auvi-Q, and make sure they know how to use them.”

Dehydration:

My nutritional skills were put to the test when I rescued ten-year-old Luke, my son’s friend, who was dizzy from playing baseball in the summer heat. Driving up with hydrating sports beverages and a mom’s wisdom, I remembered that Luke had an endocrine condition that made dehydration particularly dangerous. When a child exercises, their muscles generate heat, which in turn raises body temperature. The body cools itself through sweating, which must be replaced by fluid or the body will overheat.

Dehydration is more common in children, and young athletes are particularly prone to dehydration. Encourage your young athlete to drink fluids before, during, and after sports to prevent heat-related illnesses. Recommend fluid-rich foods such as fruits and vegetables and have your youngster carry a water bottle and drink a sports beverage when his/her physical activity level exceeds one hour.

Celiac:

I became a celiac expert when Rachel, a good friend of my daughter’s, was diagnosed. From that day forward, I stocked my cabinets with gluten-free items and helped her mom educate other parents about which foods to keep on hand for play dates.

 Merle Keitel, Ph.D, counseling psychologist and parent of a child with celiac, says,

“It is important to establish a support system that is aware of your child’s dietary restrictions and has food on hand that your child can eat if at their homes for an extended period of time.  In the case of celiac, fruits and vegetables work but if other children are having sweets, it is helpful for there to be chocolate or other gluten-free sweets so the child does not feel cheated and self conscious about being ‘different.’ Friends and extended family who are educated and willing to help can be a gift to the child with special dietary needs.”

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These real-life scenarios portray what can happen when a child has a chronic health condition. Says Kalish, “At school I work with families of kids newly diagnosed with Type 1 diabetes. I always say that education is key. I see parents overcompensating with extra treats for fear that their child will feel deprived. Diabetic children do not need extra treats. It is important to treat them like any other child and learn the merits of a healthy balanced diet with plenty of ‘everyday’ foods and occasional ‘sometimes’ foods.”

While we can try to protect our children from all types of threats, educating your child, caregivers, schools, and trusted friends about a chronic health condition is essential. Allow your child to take the reigns and manage his/her own health as soon as he/she are emotionally and intellectually ready. We want our kids to remember the lessons that we teach them at home, as they will eventually leave the nest.

5 Tips for Welcoming Herbivores to the Holiday Feast

From vegetarians to vegans and pescatarians to gluten-free, throwing a holiday feast can be quite challenging. If you are planning to host a dinner party this holiday season, rest assured, entertaining guests with multiple food sensitivities does not mean you need to toss out traditional or favorite Holiday foods. With a few modifications, many foods can be easily modified.  What should you do when welcoming herbivores to your holiday feast? We’re dishing out 5 tips you need to do and know before you start cooking this holiday season.

1. Confirm Your Guests’ Dietary Restrictions – First things first, before you start purchasing any ingredients find our what type of food preferences your guests have and if they have any allergies. Keep in mind that not everyone has the same food preferences. Some people will eat dairy but not eggs and vice versa. Knowing your guests’ food styles won’t just help you plan out what dishes you can serve, but it will ensure there is something at the table for everyone.

2. Always Serve A Main Vegetarian Dish – If you pass on confirming your guests’ dietary preferences, steer on the safe side by preparing a main vegetarian dish. This way, anyone who passes up the turkey or other main meat dish will still have something just as delicious and satiating as the latter. For large crowds, a dish like vegetarian lasagna can be appetizing for both non-meat and meat eaters alike.

3.  Make Your Side Dishes Veggie-Friendly – Make sure there are side dishes that everyone can enjoy. While you don’t have to dish out a whole chicken, turkey fish or tofurkey to meet all of your guests’ dietary preferences, side dishes are where you can make something suitable for everyone’s palates and preferences. To do this, keep an open mind by serving dishes other than a simple salad. Some side dishes can include sliced fresh fruits, cheeses, crackers, bruschetta, Brussels sprouts, cranberry sauce, deviled eggs, potato salad, roasted cauliflower, chickpeas, lentils, latkes, corn on the cob, cornbread, stuffed mushrooms, quinoa salad, garlicky kale or spinach.

4. Encourage Your Guests to Bring a Dish – After you letting your guests know in advance that you will be preparing vegetarian/vegan dishes, offer to let them bring a couple of dishes that they enjoy too. If you feel like you’re scrambling to find enough vegetarian/vegan dishes, allow your guests to bring dishes to share with everyone.

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5. Prepare Two Dessert Options – When dishing out dessert, consider eggs and dairy products. If possible, it’s best to prepare one non-dairy dessert option. If you plan to make the dessert yourself, there are a ton of substitutions on the market that add flavor and moisture to your baked goods. For egg substitutes, you can try applesauce, chia seeds in gel form, or EnerG Egg Replacer, which can be found at a health foods store or Whole Foods Market. To substitute cow’s milk, you can use soy, almond or hemp milk and vegetable margarine in many baked goods. For those who are new to creating sweet concoctions without dairy and eggs, know that it is possible to serve a scrumptious vegan dessert!

 

Have you ever hosted a vegetarian or vegan dinner? What tips would you give to new hosts?

No Tricks, Just Treats!

No Tricks, Just Treats!

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Halloween is around the corner and kids are looking forward to trick or treating for their favorite candies! Trick or treating is a great memory for kids to make and can be so much fun, but for children with allergies, the candy they get in their bags matters more than those without them. So your child does not have to miss out on any of the fun, here are some great allergy free options for your favorite witch or goblin!

Though these products are reportedly allergy free, always check labels to make sure!

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Peanut and Tree Nut Free

  • Skittles
  • Peeps
  • Swedish Fish
  • Altoids Mints, Original & Cinnamon (not Chocolate variety)
  • Mike and Ikes
  • Hershey (plain) chocolate bars, personal size only (not King size, not Minis) 
  • Hershey (plain) chocolate Kisses (not King Size, not Holiday/Seasonal Bags)
  • Laffy Taffy
  • Runts
  • Dubble Bubble gum
  • Tootsie Pops & Tootsie Rolls (anything made by Tootsie) 
  • Junior Mints
  • Smarties
  • Sour Patch Kids – all kinds!
  • Whoppers
  • Sweet Tarts
  • Dum Dum lollipops
  • Jolly Rancher hard candy, lollipops and gummi candy
  • York Peppermint Patties
  • Twizzlers
  • Rolos

These candies contain no wheat, peanuts, tree nuts, milk, eggs, fish or shellfish:

  • Smarties
  • Dots
  • Pixy Stix
  • Ring Pops
  • Skittles
  • Sour Patch Kids
  • Mike and Ike
  • Jolly Rancher Hard Candies
  • Jelly Belly Jelly Beans
  • Charms Blow Pops

This year, the Food Allergy Research & Education organization is asking houses offering non-food treats, such as toys, stickers, or crayons, to paint a pumpkin teal to show to parents of young ones with allergies there are safe options available! Check out the initiative here: Teal Pumpkin Project

Photo Courtesy of FARE

 

Disclaimer:

We only call it treats due to Halloween but they are really candy, food, or food with lower nutrition.

 

Going Nuts.

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Most parents are aware of the benefits of nuts, particularly almonds, peanuts and pecans, for our health and our kids’ health. These powerful pieces of nutrition provide essential fatty acids, proteins, fiber, and Vitamin E and help raise good cholesterol, known as HDL. However, the one drawback to this nutritious diet staple is that nuts can also cause a potentially fatal allergic reaction, known as an anaphylactic reaction.

Due to the potential seriousness of allergies, many schools have started to enforce restrictions on the kinds of foods students are allowed to bring to school. This raises some complicated questions for parents hoping to send their children off to school with healthy, nutritious food. What do we do as parents when our child’s school has banned nuts? For some kids, going without nuts means missing their vegetarian protein source. Should we pack our kids dairy every day and risk raising their LDL cholesterol? Should we send tofu and soy butter, which are more processed than natural nut butters? Should we send sunflower butter, which is also highly allergenic and can also cause anaphylaxis? Should we focus on peanut-free and not tree nut-free?

In addition to the immediate challenges these kinds of bans place on nutrition, they also have the potential to affect the ways our kids interact with one another.  Do we advocate for a nut-free table in the cafeteria, which would set kids with allergies apart? While a “nut-free” table would be organized with students’ safety in mind, in enforcing this rule we risk ostracizing them from their classmates. I have heard some moms in Connecticut are fighting with their children’s schools to allow their child with a nut allergy eat with the other kids. Do we go along with the nut -free school zone? Do we recommend establishing this nut-free zone on a class-by-class basis, pending if someone has an allergy?

Where do we draw the line? I understand this is a sensitive subject, and should be — the risks are very high. I do think a nut free elementary school is advantageous. However, when my son’s school proposed a ban on all food products made in a factory that may be in contact with peanuts (at a school where the children eat lunch in their classroom and there may be no allergy in many classrooms) I felt at a loss. I am a mom, RD, CDE and I am now going to have to take on the responsibility of feeding my kids as if they had an allergy, possibly decreasing their immunity to such foods. Busy parents are challenged enough as it is to feed their kids healthy, let alone nut- free food, and our choices are narrowed even further when we are expected to avoid products from facilities where peanuts may have been processed. I would gladly comply if a child in the class had a documented allergy, but to go through hoops and hurdles when it may not be necessary seems overboard.

This excessive caution seems all the more extreme when we consider how allergens and contamination are regulated (or aren’t).  Avoiding food processed in the same facility as nut products is not always effective. According to a recent article by a panel of experts from the National Institute of Allergy and Infection Diseases:

The FALCPA does not currently regulate voluntary disclaimers such as “this product does not contain peanuts, but was prepared in a facility that makes products containing peanuts” or “this product may contain trace amounts of peanut.” Such disclaimers can leave consumers without adequate knowledge to make objective decisions.

The EP identified 10 studies that examined whether standards for precautionary food labeling are effective in preventing food-induced allergic reactions. No study explicitly attempted to infer a cause-and-effect relationship between changes in frequency of severe symptoms from unintentional exposure (for example, to peanut) as a consequence of implementing food labeling. The identified studies mostly assessed knowledge and preferences for food labeling.1

If this labeling is voluntary, unregulated, and therefore possibly inaccurate, does it make sense for schools to use the kinds of labels to inform their policies regarding allergies? Many of my clients with peanut allergies still have tree nuts, and even peanut butter, in their homes and simply know how to prevent cross-contamination. Many of my clients with these allergies still eat foods processed in a facility that may share equipment with nuts, wheat and other common allergens.   So are our schools being too authoritarian? Are they smart for playing it safe, or is there such a thing as too much caution? Should sweets be forbidden from schools for fear of hyperglycemia or hypoglycemia, conditions that are just as threatening for someone with Type 1 Diabetes? Should grapes be forbidden since they are a choking hazard?

Instead, I recommend schools practice peanut/nut free or safe policies.  Focus on education, emergency plans for allergic reactions and having the epi pen to administer if there is an allergic reaction. Avoiding nuts or rather nut free facilities is not the best answer. Yes, precaution is necessary but we also need an action plan for as we know with voluntary labeling, kids still may be exposed and have an allergic reaction.

What do parents think? Do you believe in nut-free schools?  Do you believe in nut free schools banning food products made in a facility made that may have processed nuts?

 

1. “Guidelines for the Diagnosis and Management of Food Allergy in the United States” Report of the NIAID-Sponsored Panel.”  The Journal of Allergy and Clinical Immunology 126.6, Supplement (2010): Pages S1-S58.