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Getting Rid of the Food Allergy Fear Factor

This article originally appeared in the Huffington Post on April 5, 2013.

By Ruchi Gupta, M.D.

Fear seems to rule the battles between families with food allergy and those without. Parents of children with food allergies fear leaving their child with others, knowing that a life-threatening allergic reaction could happen at any time. People without food allergies -- friends, teachers, coaches, and school staff -- often don't want to believe it could possibly be that bad. If it is, that means a child's life could be in their hands. And yet parents of children with food allergies must let their children go to school, go on playdates, and get involved in extracurricular activities such as sports and dance. They must hand over control to other responsible adults -- while ensuring that those adults are willing to take responsibility for preventing or dealing with an allergic reaction. So how are those fears to be overcome?

Here's what this looks like on the ground. I recently dropped my daughter off at a playdate. As I explained her food allergy, possible reactions, and how to use the epinephrine auto-injector, the other child's mother looked at me and said, "I am not going to really need this, am I?" I saw her fear. My guess is that she really wanted to say, "I am not comfortable taking on the responsibility of dealing with a severe reaction."

Perhaps I can offer a way of seeing it will make that responsibility feel a little more bearable. Children with food allergies need to carry their medications (antihistamines and epinephrine) in the same way that kids in a car need to wear their seatbelts. Most of the time, they won't need it. But there may come a time when those protections save the children's lives.

And perhaps I can show you how manageable such a situation actually would be. If a child under your care accidentally ingests a food they are allergic to, or if the child comes to you feeling bad in a way that worries you, here's what you should do:

• Look at the child. Does he or she have hives, swelling, or a rash?
• Ask the child: How are you feeling? Anything hurting? Any trouble breathing? Do you feel dizzy?
• If the child has only a skin reaction like hives but otherwise is feeling fine without any other symptoms, give the oral antihistamine, and call the parents.
• If the child has trouble breathing, if her throat is closing, or if he is light-headed or fainting, he or she needs the epinephrine auto-injector immediately, followed by calls to 911 and the parents.
• To use the EpiPen, take off the cap. Slowly swing it into the outer thigh over the child's clothing. Inject and keep in place for 10 seconds before removing. Note that you will never see the needle.
•Always stay with the child.
• Keep in mind that an accidental ingestion requiring the epinephrine is rare -- as rare as needing a car's air bag. But just in case, you are safer knowing the facts. And with the facts, you can feel less fear and anxiety about food allergies.

As parents and caretakers we all want to make sure all children are safe. Because food allergy involves food, it involves everyone who comes in contact with those children. By decreasing our own fear and the fear of those around us, we can help these children live happier, healthier lives.

- Ruchi Gupta, M.D., is an associate professor of medicine at Northwestern University.

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