All parents need to juggle protecting their children from harm, while also preparing them to one day be independent. For allergy parents, this has the added challenge of day-by-day teaching children how to manage their allergies successfully. At Anaphylaxis UK we want to support you through this process, finding learning experiences every day, so when it’s time for your child to spread their wings, they’ll be ready.
This is our parent’s guide to teaching children how to live with food allergies. It’s based on the idea that learning must start early. Toddlers are taught not to touch a hot stove or to put small objects in their mouths. Likewise, it’s important to start teaching children as soon as possible about avoiding certain foods and knowing what to do if they eat something they react to. This will prepare them for when they reach their teen years.
Staying calm is very important. Your child is likely to pick up on any anxiety you feel. To reduce your own anxiety, become well-informed on the subject of allergies. Talk through any concerns or problems with your doctor and with our team at Anaphylaxis UK.
Be matter-of-fact. Keep calm and be aware of your tone of voice and the unspoken messages you are sending your child when you educate others.
Be careful of the language you use when you talk about the risks. Although it’s important to convey seriousness, constant references to death will not help.
Involve your child when teaching others. Avoid talking about your child’s allergies as if he/she is not present.
Remember that the aim is to help your child to feel empowered to handle people and situations. Be careful not to instil panic or fear, which may overwhelm and stifle your child.
In handling situations involving food, you may be tempted to take total control and focus strongly on what needs to be done to keep your child safe. You may find yourself asking all the relevant questions and reading food labels for your child. But remember you are building for the future. Being over-protective and taking all the control may send the signal that you think your child is not capable of handling situations. Your child may end up lacking confidence and may find it hard to assess risks, avoid risky situations and ignore unwise advice. Letting a child know from an early age that he or she has a say in decisions gives them the confidence to speak up. This can be done gradually. When you feel your child is ready, you could hand over a small part of this control and gradually build it up so your child doesn’t feel overwhelmed.
From an early age, start to teach your child the importance of reading food labels, asking questions about food, identifying certain foods, and not accepting food from anyone other than known, trusted adults.
Each time your child remembers to read a label, or ask questions or recognise an allergy word, reinforce it with words of praise.
If your child is too young to read, then you can read the label ingredients aloud and ask your child to stop you when he or she hears an allergy word.
Children with allergy to a food need to know what the food looks like. When you go to the shop, you could point out the food on the shelf (for example, a packet of nuts) or alternatively show them a colour picture of the food.
It’s also important from an early age to show them what words to look out for (for example, milk, dairy, nuts, egg, allergies). One helpful idea is to make an allergy scrapbook with your child or create flashcards. List in large, colourful letters the foods or substances that cause the problems.
Ideally you will be informing your child’s school about their allergies, but there may be times when well-meaning parents or teachers forget. Encourage your child to speak up. Say you will support his or her decisions about not eating certain foods, despite what other people may say.
As children enter school, they can be encouraged to recruit friends. Friends can help allergic children avoid risk and can speak up for them. They can turn out to be your child’s best safety net.
This is a time when children are beginning to take more responsibility for managing their allergies and are developing their confidence and independence.
Young people are in a high-risk group when it comes to managing allergies, sometimes feeling reluctant to share information about allergies, not taking their adrenaline auto-injectors (AAI) out and about and may experiment with foods they are allergic to. Dr Liz Angier is a GP with a special interest in allergies and talks with Simon Williams about some of her work with young people.
Dr Helen Evans-Howells (née Howells) is a GP in Bournemouth. Helen's interest in allergies grew when her eldest son Ethan developed milk and nut allergies. In order to ensure he received the best care she undertook a Master’s degree in Allergy at Southampton University. Dr Helen understands first hand how hard allergies can be for a family. Dr Helen now runs Dorset Allergy – a private clinic for adults and children in Bournemouth and Dorchester.
Do be supportive of your allergic friend’s food decisions.
Do encourage the allergic friend to read the label each time before eating – ingredients can change.
Don’t say things such as, “It’s probably OK…”
Do find out what to do in the event of a reaction.
If a reaction occurs, do make sure an ambulance is called.
You and your allergic child will become more confident if you are proactive. Remember that other caregivers and parents aren’t living with allergies as you are. Encourage your child to get into the habit of reminding caregivers about their allergies at the start of the playdate, along with where their medical kit is. Caregivers and other parents may need to know which foods contain allergens – for example, they may not be aware that pesto sauce is likely to contain cashews or perhaps other nuts. Make sure your child knows which foods they should avoid. Hopefully, they will be confident enough to suggest a simple alternative if necessary.
There is no quick and easy answer to the problem of bullying. But encouraging your child to include their friends in their allergy management will help if someone tries to tease or bully them. And encouraging them to talk to you if they have difficult experiences at school will also help. In some cases it may be necessary for the school to intervene.
It is natural for you to want to maintain tight control in restaurants. But once again – build for the future. Don’t wait until your child is 12 to begin lessons on how to order a restaurant meal. Your window of opportunity appears when children are much younger.
Expose your child to new dining situations – those they will encounter when they are older. Allow the child to order food while you are able to supervise, at places such as fast-food restaurants, sports events, cinemas, holiday sites, etc.
Before you do this, make sure your child has seen how you order food in restaurants and the way you ask all the relevant questions. Then in a gradual way, build up the child’s confidence. For example, you could start by encouraging them to order their food in a restaurant they are familiar with. As their confidence grows, they could then try to do this at a new restaurant.
Don’t become too anxious when your child makes mistakes at first when ordering food. Use these mistakes as an opportunity to educate. Be sure, however, not to embarrass your child in front of the restaurant staff or friends. To minimise the possibility of mistakes happening, discuss menu ideas at home before leaving for the restaurant. Once there, let your child do the ordering. If a question has not been asked, bring it up discreetly.
Ask your child before you leave for the restaurant how you would handle a difficult situation. For example, what if the waiter doesn’t take you seriously? If the waiter doesn’t quite get the point, encourage your child to ask to speak to the manager or chef.
Your goal is to build your child’s confidence in asking the right questions and making the right decisions. Although choosing a meal will be less time-consuming if you make all the decisions, your goal is a long-term one – to prepare your child for when you’re not there. You want it to become second nature for your child to ask about meal preparation and ingredients.
As adults, we learn how to work with difficult people. Teach your child how to do the same. Discuss how to handle challenging situations, like those that may arise at a relative’s house. Be ready to step in to help if things get out of control. Your priority is to give your child a sense of accomplishment and control. Don’t wait until the child feels defeated before helping out but do so discreetly and give control back to your child once the situation is cleared up. Make sure they know you will back up their decision to say ‘no’ to eating a particular food product.
Talk about situations that may arise when you are not there. Help your child learn how to politely, but firmly, refuse to eat certain foods. Explain that there will always be people that don’t “get it,” so it’s up to your child to take responsibility for avoiding risky foods.
Teach your child what symptoms to expect, with words appropriate for their age. For example, a toddler may only need to know, “nuts will make you very poorly.” A 12-year-old should know in more detail the symptoms that may occur. However, be careful not to be so graphic that your child develops a fear of eating. Stress the importance of getting help quickly if a reaction occurs.
At some point, allergic children need to know how to treat a reaction themselves. As soon as your child is ready to understand what treatment entails, you could explain what their adrenaline auto-injector is for. Using a ‘trainer’ injector, go through the procedure of administering it.
From the beginning, teach your child never to leave home without prescribed medications.
Trainer pens are a useful tool to help you and your child practise using an adrenaline auto-injector, so that you can feel confident administering one in an emergency.
This information was produced by Anaphylaxis UK, based on a booklet originally written by the Food Allergy and Anaphylaxis Network in America (now the Food Allergy Research and Education).
Special thanks to:
Professor John Warner, Professor of Paediatrics, Imperial College, London and Hon. Professor University of Cape Town, South Africa
Anne Munoz-Furlong founder and past president of the Food Allergy and Anaphylaxis Network (FAAN)
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