Back in December 2016, I posted a blog article called ‘Safe Christmas Treats for Your Child with Food Allergies’. In that article, I mentioned a news story about an 11-year-old boy who had died over the Thanksgiving weekend due to an anaphylactic food reaction. We can only imagine the pain and heartbreak the boy’s parents and family must feel. In reading this story, what really struck a chord with me was the parents saying:
“We don’t feel like we were properly educated.”
After they realized their son had consumed a food allergen, they immediately gave him Benadryl, the typical “go to” medicine most parents have been told to use. Benadryl (the brand name for Diphendramine) is an antihistamine used to relieve the symptoms of allergies (hives, nasal congestion, rash, etc.). However – and tragically for them – while Benadryl can help curb some allergic symptoms, it cannot prevent an anaphylactic reaction when someone is severely allergic. Unfortunately, his parents, like so many others, were not adequately informed about how to respond to a serious food reaction.
I too have a son with deadly food allergies. Speaking as a parent, when I read stories like this, I feel devastated. It’s heartbreaking, and it’s scary.
But speaking as a naturopathic physician who specializes in deadly food allergies, I also feel frustrated and angry – because those parents were so right. Parents, family members, teachers AND the children themselves all need – and deserve – to be better educated about the seriousness of food allergies and anaphylaxis, so they can prevent people from dying.
Thus, in today’s article, I’ll be discussing some of the things I believe to be absolutely essential (but, sadly, are often lacking) in any educational program on the dangers of food allergies.
One of the most important things parents need to understand is the process of anaphylaxis.
Upon exposure to an allergenic food, your child’s immune system – which is designed to protect us from foreign invaders like bacteria and viruses – reacts against that food. First, it stimulates a type of white blood cells (B-cell lymphocytes) to produces antibodies (IgE antibodies). The job of those antibodies is to attack the foreign protein (called an “antigen”) and remove it from the blood. Antibodies can remember each foreign antigen, so the next time we are exposed to it, our immune system can quickly kick into gear and defend us against this foreign invader. While this memory can help give us immunity to some diseases after we’ve been exposed to them (like measles, mumps, etc.), it doesn’t work that way with foods. Once the immune system has created a specific IgE antibody in response to a specific antigen, your body will always produce an allergic reaction.
IgE antibodies have the potential to trigger a powerful inflammatory response caused primarily by histamine released from a type of immune cell called a “mast cell”. This is called a “Type-1 IgE mediated sensitivity” or, more commonly, “anaphylactic reaction”. It can be triggered not only by food, but also by insect bites and certain drugs.
Anaphylactic reactions can occur within seconds of eating an allergenic food, which contributes to their deadly and violent effect. The most common reactions during anaphylaxis include (but are not limited to):
It might seem strange that an allergic reaction can look like hives on one person and cause a heart attack in another. It’s all because of inflammation caused by histamine. Sometimes the swelling occurs in parts of the body you can’t see, such as your lungs and digestive system. Thus, you may think you have a mild case of the hives on your face, but your respiratory or digestive system is also swelling up. This “hidden inflammation” is why a “mild” reaction can turn deadly so quickly.
Swelling of the throat (and consequent difficulty breathing) is one of the most common causes of death in people with a Type-1 IgE mediated sensitivity. But an anaphylactic reaction could also cause your blood pressure to drop too low, which can subsequently result in a heart attack. Then, if the heart does not have enough blood or pressure to pump, the brain might become deprived of oxygen, ultimately resulting in brain death.
Sadly, that’s what happened to the 11-year-old boy who died over Thanksgiving. His external reaction didn’t look severe at first. That’s why his parents gave him Benadryl. But the parents didn’t realize something serious was going on inside his body. Severe internal inflammation caused a heart attack, leading to lack of oxygen to the brain and, ultimately, death. Based on the parents’ comments in the news article, I can only assume nobody ever fully explained the process of anaphylaxis to them.
It’s crucial for parents to know that even the smallest food allergen consumption can have deadly consequences for their child. That’s why, rather than reach for the Benadryl, I recommend giving an EpiPen immediately after your child has ingested food allergens. When administered quickly after allergenic food exposure, an EpiPen can help prevent the progression of anaphylaxis, and hopefully save your child’s life.
These days, most teachers have been trained to give an EpiPen immediately after a child has been exposed to a food allergen, or if a student shows any signs of allergic reaction. An EpiPen is easy to administer and requires no special training. Once an EpiPen is given, the teacher should call 911 so an ambulance can take the child to the hospital.
While knowing how and when to give an EpiPen is essential basic knowledge, there is still a lot more that teachers and school administers need to know about food allergies if they want to ensure our children stay healthy. I have met many teachers and other school staff who are unfamiliar with all the hidden sources of allergens. For example, on the last day of school before the last holiday break, my allergic son’s school gave all the children a treat bag filled with candy. In the bag was a milk chocolate bar. The teachers and staff at the school know my son is deadly allergic to dairy. However, to someone without a food allergy, chocolate doesn’t “look like” milk, even if it says “milk” right on the label.
I was irate that the school had given my son a candy bar with a known and documented food allergen. When I tracked down the source of the goodie bags, I found out that another student in the class had made them for everyone in the class. Apparently, the teacher had informed his parents what was and was not acceptable in these bags, but somewhere along the communication pathway, somebody forgot (or didn’t realize) that “milk chocolate” was lethal to a member of their class.
Fortunately, my son is old enough to read and is very cautious about not consuming foods he has never tried before. Whenever he encounters something new, it always examines the ingredients before risking it. So when he saw the candy contained milk, he didn’t eat it. Still, I was angry. What if my child were NOT so aware and cautious?
As soon as my son told me about the goodie bag, I went to discuss the situation with his teacher. In doing so, it became immediately apparent to me how important it is to give better education to our teachers, AND that teachers make sure they pass on information about allergens to the parents of other children. Improving communication about food allergies is key if we are to minimize allergenic food exposure for our school-age children.
Another important group of people who need to be educated about the dangers of food allergies are other students at your child’s school.
Most parents are aware that bullying can cause problems for their children, but these days FOOD bullying has also become an issue for my son (and, I assume, for other kids with food allergies). For example, my son has told me multiple stories about “friends” holding allergenic foods in front of his face and asking him if he wants some. Sometimes they say things like, “You’re not really allergic to this. Go on, eat it. I dare you.” As this typically occurs in the lunchroom, teachers many not even be aware it’s going on.
Any kind of bullying is scary. But food bullying is terrifying for us parents with children who have allergenic food reactions. The only way to stop food bullying is for teachers to become more vigilant about spotting it, and for all school children to be taught just how dangerous food allergies can be.
Finally, the most important person who needs to be educated about food allergies is your allergic child. As soon as children are diagnosed with food allergies, they need to know – in simple terms – how to recognize the symptoms of an allergic reaction. Even more, they need to be encouraged to communicate with you or their teachers as soon as they don’t feel right.
Kids may not be able to describe what they feel using grown-up vocabulary, but they can let you know something is wrong by saying things like, “I don’t feel well,” “My throat hurts,” or “My skin is itchy.” Recently, my son told me the first symptom he gets during a reaction is itchy armpits! Obviously, if he’s wearing a shirt, I can’t see that his armpits are breaking out in a rash. Unless he tells me, “My armpits itch”, I have no idea he is experiencing an allergic reaction.
Children also need to be skilled and confident about using an EpiPen during an allergic reaction. The idea of sticking a needle in their legs is scary and may cause them to be hesitant to administer the lifesaving medication. The best way to make them feel comfortable about it is to have them practice using a “demo” EpiPen. This way, they are less likely to be hesitant to use the medicine when they are experiencing a genuine food reaction.
Something I noticed in reviewing the data about children who died from an anaphylactic food reaction is that most deaths seems to occur between the ages of 11 and 20 – pre-teens and teens. If you think about it, it makes sense. This is the age when children are becoming independent and are more in charge of what they eat. They may think they are “strong enough” now to deal with a food reaction, and become less careful in their food choices. Fully educating our children when they are young is our best chance of helping them stay safe during these risky teenage years.
At the beginning of this article, I mentioned that the parents who lost their child to an anaphylactic food reaction said they did not feel they had been given adequate education about anaphylactic shock and treatment. The fact that food allergies are a growing epidemic underscores our need for better education about food allergies – what they are, how to prevent them and how to treat them. The more knowledgeable parents, teachers and children become, the more lives can be saved.
On this note: