Unlike many chronic conditions, food allergies can impact not only the child and family members that are coping with food allergies but also those that interact with the child.
Children with food allergies interact with their communities on a constant basis, and food plays a major role in lots of social activities and daily life.
Also, kids have the important job of "just being kids" and participating in sports, parties, play dates, and all the activities that kids need to thrive.
They interact with a number of individuals throughout the day and can't only be under the care of their parents or other family members.
Coaches, teachers, hosts of play dates and parties, baby sitters, relatives... lots of people play a role in the routine days of all children, whether you have a food allergy or not.
Michael Pistiner, MD, a pediatric allergist from Boston, discusses the important part the community plays in keeping your kids safe from food allergies. More information about Medical Home Chapter Champions Program on Asthma, Allergy and Anaphylaxis
RadioMD Presents: Healthy Children | Original Air Date: May 13, 2015
Host: Melanie Cole, MS
Guest: Michael Pistiner, MD
This is Healthy Children brought to you by the American Academy of Pediatrics on RadioMD.com. Here's Melanie Cole, MS.
MELANIE: Food allergies are increasingly common and they have the potential to be really life threatening and very scary. They're affecting children in all of our communities and, unlike other chronic conditions, food allergies can impact not only the child and the family that are coping with it, but those that interact with that child as well. My guest today is Dr. Michael Pistiner. He's a pediatric allergist from Boston and he has a special interest in food allergy and anaphylaxis education and advocacy. He's the father of a child with a food allergy. Welcome to the show, Dr. Pistiner.
So, tell us a little bit about food allergies. What in our communities do people not tend to think about? All they know is at the schools there's that "peanut-free" table and those kids sit over there and the rest of the kids seem not to worry about it. What's going on in the community? What do you want the community to know about children with food allergies?
DR. PISTINER: Well, thank you so much for having me. The community plays a huge role in the lives of children with food allergies. Now, first off, kids with food allergies are kids, first. They go to school, they need to learn, they need to interact with their surrounding community. Now, what the community can do is have an understanding of the certain things that children with food allergies need to do to stay safe.
It's really important for people to know that these are "must dos." This isn't a choice. This is something that these families and these children need to do on an everyday, all the time basis. No matter who is responsible for the kid and no matter what the kid's doing. So, this'll be at the drop-off party, the drop-off play date, at school, at the baseball game, you name it. These strategies will need to be done at all times to keep kids happy and safe.
MELANIE: So, what are some of those things that you want the community to do? What's food allergy management?
DR. PISTINER: All right. So, what it looks like is the things that people need to do to prevent an allergic reaction and to be prepared for an allergic emergency. These are the pillars of food allergy management. So, for prevention, someone is going to be able to need to know how to read labels. Someone is going to need to understand about hidden ingredients, how you can't just look at an item and know what's in it. You're going to need to ultimately have someone who's skilled in label reading before that child is fed or the food is prepared. You'll also need somebody who's going to understand this concept of cross-contact; when a hidden allergen can potentially get into something because it came in contact with it. This can happen through saliva; this can happen through food splatter; this can happen through sharing something that someone else had that had the allergen on it.
So, these are principals of prevention and now, they also need to always have somebody who is ready for an allergic emergency. Someone who can recognize anaphylaxis, which is a severe, life-threatening allergic reaction, who then knows how and has access to Epinephrine. Epinephrine is the treatment of choice for a severe allergic reaction and it treats it quickly, swiftly, and is safe. Someone will need to know how to administer it and it comes in auto-injectors. And, someone's going to have to know when to administer it and so these are things that the community…having an understanding that these are basic things that need to be done at all times. This understanding really can go a very long way.
MELANIE: So, Dr. Pistiner, if you're having a child over to a birthday party that has this food allergy, as a parent, I want to make sure to talk with the parent, to know about, you know, that Epinephrine shot, how to use it, what I should look for, symptoms, and talk to that parent and really get full information. What about for the other children? What do you want them to know about this child with the food allergy and that cross-contamination, and inviting them just to things--to play dates, to parties?
DR. PISTINER: Yes, again an understanding, just knowing that these are things that have to be done and then making it socially acceptable to bring these things up and to help the families plan to make these a successful party, to make it a successful drop-off, so these children can experience what kids without food allergies are experiencing.
You know, I really appreciate what you just said about communicating with the other parents for the party and the play date. That is going to be, ultimately, something that has to be done. There has to be a grown-up who is capable of these pillars, the prevention and emergency preparedness at all times. In some cases, a parent of the child with food allergies may stick around, but in other cases, some of the surrounding community may want to take on this responsibility and want to learn. Ultimately, when someone is competent, this is a simple and safe thing that can be done, but again, it takes this partnership, it takes this community and the kids can play an amazing role in this.
There's something called "bottom-up teaching" where the children really oftentimes want to take on and take care of their friends, and they teach their parents, and they teach their teachers, and they teach the other children and their understanding really can go a very long way on knowing that the children with food allergies, sometimes they may say "No, thank you," when someone offers them a treat. They need to wash their hands before they eat food, rub their eyes, or pick their nose. They may be carrying a bag that has their auto-injectors in it. Having an understanding of what it is that the other kids are doing and why they do it is really going to help and this understanding and ultimately may decrease food allergy-related bullying, teasing, or harassment, which, unfortunately, is a bit of a problem. About 35% of kids over the age of 5 with a food allergy experience being bullied, teased, or harassed about their food allergy.
MELANIE: In one of my daughter's classes, the mother came the first day of school, and explained--gave a little explanation--to all the kids in the class about her daughter's food allergies and what they should know and what they should look for. I thought that that was a great way to introduce these kids, because not only can it be a little scary, but a little confusing. "Oh, you mean they can't have eggs or dairy or they can't have peanut butter? But, we can all eat peanut butter!" You know, they don't sort of get it sometimes. What would be your best advice to the children about, as you say, that these are normal children, about friending this child, but being highly aware of this child's differences?
DR. PISTINER: Well, first off, this is a very common thing, and it won't be just "this kid", and it's not because of "that one child" that these are certain rules and things that we need to think about, but this is many children all throughout the United States--about 2 kids in every classroom. So, this is something that everyone is going to see. So, one of the things is, that in some cases, it is really truly wonderful when a family comes in and teaches a class of a specific kiddo who has food allergy. But, at the same time, that may not feel that good to all children with food allergies. That may not feel that good to the specific families of kids with food allergies. They may want something more general. And that is what's so awesome nowadays. The CDC has guidelines for schools where schools can be taking this on as well. Where school nurses, where teachers, can help educate. They can teach the classroom. So, they're not necessarily teaching the children because "Joey" has a food allergy, but they're teaching the children because children these days have food allergies and this is what we do to be citizens. This is what we do to take care of our friends and make sure that they're safe.
MELANIE: And, in just the last 30 seconds, Dr. Pistiner, give the website that you want people to know about the Medical Home Chapter Champions Program on asthma, allergy, and anaphylaxis.
DR. PISTINER: Yes, this is an awesome program that is a collaboration between the American Academy of Pediatrics and the Allergy and Asthma Network where there are these champion pediatricians in allergy and asthma that are spreading education and advocacy throughout their regions and locales to other pediatricians. And, it's a way to disseminate needed information to help support families of kids with food allergies, asthma, and other allergies.
MELANIE: And we're going to put this website--it certainly is on RadioMD and you can find it on AAP.org.
This is Melanie Cole, you're listening to RadioMD. This show is "Healthy Children" thanks for listening and stay well.