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Having a child with allergies can be tough. Having some useful information can make it a little easier to manage.
Parker had a milk intolerance when he was in the NICU and in the early months of his life. Since I was providing breastmilk, this meant that I had to completely remove milk from my diet. I had never had allergies before and I quickly realized how challenging it is.
Parker has since grown out of his milk intolerance, but he is allergic to garlic and eggs. I have found garlic in particular to be a difficult allergen to avoid because it is so many pre-prepared foods and foods at restaurants. But I am lucky because Parker's allergic reaction is not life-threatening, he just has eczema break out. I can only imagine how scary it is to have a child with a life-threatening allergy as it can be very difficult to avoid allergens. I hope some of the tips below may be helpful though no matter what allergy and reaction your child may have.
How do I recognize if my child has a food allergy?
Parker's allergies showed up in two forms. When he was in the NICU, we found his milk allergy after he had blood in his stool. We found his garlic and egg allergies once he started eating solids. He was having eczema breakouts and his face would often turn red after eating.
According to Johns Hopkins Health, the following our symptoms of an allergy to look out for:
Note: Some allergies do go through breast milk, so your child could be having an allergic reaction to something you are consuming.
Hives
Asthma
Itching or swelling of the lips, tongue, or mouth
Trouble Breathing
Stomach Pains
Vomiting
Diarrhea
Cramps
Eczema
Swelling
Difficulty Breathing
Wheezing
Lowered blood pressure
How will the doctor diagnose an allergy?
According to Cedars-Sinai, the skin prick test is the most common allergy test. They will poke or scratch your child and if an allergy exists a bump will appear. Blood tests can also be done to determine if your child has an allergen. Neither test can show what your child's reaction will be. The allergist may also do a food challenge test where the allergist gives your child a small amount of the food orally to observe their reaction - this is usually done to see if your child might have outgrown an allergy.
For us, Parker's doctor started with a skin prick test and then ended up doing a blood test after we continued to have issues with his face turning red. My biggest advice with this from my personal experience is to keep following up and pursuing answers if you feel there is an issue. After the skin prick test, he tested negative but his face kept turning red. So we had to go through the individual foods causing issues with the doctor and have her order the specific blood test for those foods. Once we found the issue, we saw an immediate improvement in his skin. If your child is having a reaction, I recommend writing down the foods causing an issue.
If you are concerned that your child has an allergy, contact your doctor for a diagnosis.
Unfortunately, there are no cures for allergies. Your child (and/or you if breastfeeding) just have to avoid the food.
There are 9 allergens that cause 90% of allergies: milk, eggs, wheat, soy, tree nuts, peanuts, fish, sesame, and shellfish.
Tips for grocery shopping:
It can be hard with busy schedules to make every meal from scratch for your children. That is not something I do, I rely heavily on buying at least some components of a meal ready to go. So I have learned I have to be careful at the grocery store to read the food label.
One good thing about your child having one of the nine major allergies is that they are labeled on pre-packaged foods at the bottom and are usually easy to find online at chain restaurants. It's a bit harder if looking for an allergen that is not one of the major nine.
According to the FDA, there is a law that requires most foods to be clearly (in simple to understand language) labeled when they are made with a major food allergen. And so even ingredients that you would not immediately know are labeled clearly, for example, lecithin will be labeled as soy. It will be labeled in one of two ways:
in parenthesis following the name of the ingredient: lecithin (soy) OR
Immediately after or next to the list of ingredients in a "contains" statement (as pictured above).
It is important to note that not all products have the "contains" statement, so be sure to read the ingredients list. If not in a "contains" statement, it will say the major allergen (simply) somewhere in the list.
Another important note: Sesame became a major allergen in 2021, and it did not go into effect until January 1, 2023 - so it is possible to find products that do not list it as an allergen on the label - so double-check.
You may be shopping and notice that some packages say "Contain" and some packages say "May Contain," and you may wonder what is the difference?
"Contains" means the allergen is used in the ingredients. "May Contain" means that trace amounts of an allergen may be in the product because they make products with that ingredient in the same facility or on the same equipment (and they are concerned that even after cleaning the equipment there may be trace amounts). It is important to know that manufacturers are not required to put a "May Contain" statement, this is completely voluntary.
You can find helpful information and things to be aware of for one of the major nine allergens on the Food Allergy & Anaphylaxis Connection Team site. It gives excellent allergen-specific tips and foods to avoid including unexpected foods.
If you are shopping for someone with an allergy that is not one of the major nine allergens, you want to carefully review all packaging. Check everything because sometimes there are ingredients you would not take expect in an item. I also recommend looking at the ingredients on things you have checked and bought before. I served my son something he has had dozens of times and he turned red. Come to find out, the ingredients had changed.
If your child has an allergy to a spice (like garlic) it can be very frustrating to find out that many companies simply write "spices" on their ingredient list (I have found this usually means it has garlic in it). If you are ever not sure, err on the side of caution and don't buy it. I know it is super frustrating!
I recommend doing some research if your child has an allergy that is not one of the major nine allergens. Luckily my child's allergy is not severe, but I found that many people with a garlic allergy are also allergic to similar ingredients like onions, chives, leeks, and shallots. We have not seen any reaction to these ingredients yet, but since we know this is fairly common for people with a garlic allergy, we can be on the lookout for any reaction that may develop.
If there is no food label on something you are shopping for, it is recommended that you do not buy it or feed it to your child who has an allergen.
It is also a good practice to teach your child how to read a label from an early age. And teach them not to share food as soon as you can.
Cooking at Home
For my family, my little one is still very young and goes to bed early, which means he often eats before me and my husband do. This makes it easy for us to serve him something other than what we are eating when needed. But I always have easy and safe items for him in the freezer and pantry - dino nuggets, garlic-free meatballs, canned veggies, etc. This way, I always have something safe for him to eat that he likes.
I will also often make a small second batch of what I am cooking for him that does not include garlic. That way we can still have the seasoning we like and he can eat the same thing minus the garlic. For example, I made chili for dinner last night - before I add chili seasoning, I pull some out and cook it in a separate pot then make him chili seasoning from scratch so I can leave out the garlic powder.
According to FAACT, some other things to consider (particularly for severe allergies):
Will the allergen be allowed in the house?
Does there need to be an allergen-free shelf in the pantry and fridge?
How will you handle cooking on shared appliances (toasters, microwaves, etc.)
Be sure to communicate your house rules with all guests
Tips for Eating Out
Depending on where you are dining out and what your child's allergy is, it can be difficult to find options. For instance, we have found garlic to be a tough one to avoid at many restaurants, and often the server does not know what items do not have garlic. I hope the information and tips below will help though.
According to Food Allergy Research and Education (FARE) there are several tips to consider when going to eat out:
There are certain restaurants that are at a higher risk for children with food allergies because there is more likely to be cross-contamination:
Buffets
Bakeries
Restaurants that serve pre-made foods
If the restaurant uses your allergen in many foods (i.e. peanuts are widely used in Asian cuisine, fish allergies will be difficult to avoid in a seafood restaurant)
Serve a lot of fried foods - many restaurants use the same fryer for all foods
If you are planning ahead, call the restaurant:
Ask to speak to the manager
Choose a time (to call and visit) that is not their busiest time
Check the menu online to see food options
Bring a Chef Card - this is a card that lists your allergens so the chef knows the allergen and to avoid cross-contamination - you can find a template here
Be prepared with an epi-pen or other medication in case an accident happens
Once you are in the restaurant:
Wipe down the table before sitting your child down
I pretty much always have sanitizing wipes in my purse/diaper bag and I wipe down the table and high chair as soon as we arrive. My little guy is a pandemic baby, so some of that stems from my fear of germs, but it is also a good way to clean off any allergen particles that may be on the table.
Always tell the server (and maybe a manager too) about the allergy, present your chef card
This is absolutely necessary and a mistake my family has made. In an effort to not be "difficult," I decided I would choose something that I didn't think would have garlic, but of course, it turned out that it did. So my husband and I realized we always need to tell them there is an allergy. We also find that often the server does not know the ingredients and will try to guess, sometimes you need to tell them to please go ask or to bring the manager over so you can be clear and get accurate information.
Keep it as simple as possible to avoid errors
We try not to make any extra substitutions or changes, so the focus is on avoiding the allergen.
Avoid fried foods
Most fried foods are all cooked in the same fryer and oil.
Beware of desserts
Often desserts have hidden allergens. Also, many restaurants do not make dessert there, so they may not know the included allergens.
Don't assume you know what the ingredients are
Recently, I wanted to treat my little one to a trip to get ice cream, which we had never done before. I assumed there would not be garlic or eggs in the ice cream. After his face turned red, I researched and found that some ice cream does in fact have eggs in it. So, always ask!
If you have a great experience, let the staff know!
It is a good idea to reward those who are being careful to make sure you have an enjoyable and safe experience.
Sometimes it is easiest to bring food for your child
I have brought a lunch box with food for my little one to eat at a restaurant before. This way my husband and I get to enjoy the food we want and we do not have to fear him getting an allergen in his food.
If you are eating at a chain restaurant, you can usually find an allergen menu online that at least lists the major allergens. Sometimes finding an ingredients list is more of a challenge. Many chain restaurants prepare and cook items the same, so this can be a good option when traveling. But always do your research! When I was avoiding milk, I was shocked to realize how many fast food items include milk, and because we were constantly driving to go to the NICU we were eating a lot of fast food. I ate a lot of Burger King because they were one of the few options I could eat.
Allergies at School
My little one goes to a daycare that provides food. At first, we provided all of the food because of his allergies. We eventually worked it out for them to provide the food, but it does mean he eats the same thing often because they have to make a lot of substitutions. It also means he is often eating something different from his peers, so his teachers have to be careful he doesn't grab other food on the table.
Some things to think about if your child has an allergy and goes to daycare or school:
According to Kids with Food Allergies and The National Center for Safe and Supportive Learning Environments, there are a few ways to help you manage your child's allergy at school:
Communication is essential - talk to your child's teacher, administrators, and those involved in the food portion of your child's day.
Timing - contact the school before your child begins to make any needed arrangements
Ask questions - how will they manage the allergy, what safe practices do they use, etc.
Have a care plan - be sure everyone knows what is needed if your child is in contact with their allergen
Teach your child age-appropriate skills for managing their allergy:
Not sharing food
Reading labels
How to use their epi-pen
Handwashing
Signs and symptoms they are having an allergic reaction
How to communicate to an adult they are having a reaction
Discuss allergy-safe seating arrangements
Discuss steps they will take to prevent and manage any food allergy-related bullying
Discuss hand-washing procedures
If your child will be riding the bus, how will they avoid their allergen on the bus (discuss this with the school even if they do not ride the bus daily, because they may end up using buses for field trips)
One Last Note
One challenge that may arise from an allergen is that your child may not be able to eat what other kids are eating. My little guy is not even two yet, so this is not yet a problem. However, I started thinking about it when we were at a birthday party this weekend and he could not eat the pizza that every other child was eating. So though this may change as he gets older and I have to navigate this more, my plan to deal with these situations are:
Prepare my child ahead of time - discuss that there will be food everyone else is eating, but that he can't eat.
Communicate with the parents or person in charge of food ahead of time - I can plan to provide him with something similar to what other children are eating.
Provide other foods he likes better anyways when possible.
Luckily, he was perfectly happy to eat goldfish while the other children ate pizza. But I know this likely won't last when he gets older.
If you have tips for dealing with these situations, I would love to read them in the comments!
Resources to Check Out
If you have questions and/or need more information, talk to your child's doctor.
Remember Mama, you are doing a great job! You got this!
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