How do you handle all of the birthday parties and holiday parties that occur in the classroom at your child’s school if he or she has food allergies?  It seems that with twenty to thirty kids in each class, every month has about two birthday parties with cupcakes or cake. If it isn’t a birthday party, there is a party being planned for Halloween, Thanksgiving, Christmas or Hanaka, Valentines, St. Patty’s Day or even Easter.

If you child has allergies to dairy, egg, soy, wheat, peanuts or tree nuts (almond, beechnuts, brazil nuts, cashews, chestnuts, gingko, hazelnuts, hickory, macadamia, pecans, pine nuts, pistachios and walnuts) then sharing party treats like cupcakes, cookies or other snacks can be not only difficult but downright dangerous.

I have two boys in school at this time: one is in kindergarten and the other is in first grade. Both boys have had allergies to dairy and egg pretty much since birth and we’ve avoided giving them any peanuts or tree nuts in a hope to fend off developing an allergy. (We will try those foods when they are older and hopefully outgrow the first two.) 

My younger son outgrew his dairy allergy in the beginning of his kindergarten year. His egg allergy appears to be mild enough to allow him to eat cooked eggs in baked goods. So over the past five months, after discussion and letter from his allergist, his teacher and I allowed him to participate in eating the party food prepared by other mothers. His classroom is peanut and tree nut free, so there was no risk of those allergens being included in the baked treats. Thankfully, he has been able to eat the foods and only vomited once after eating a cupcake.  I think he had a little stomach bug as well on that day, so afterward, his teacher and I decided it was probably the combination of the richness of the cupcake mixed with an already upset tummy to cause this problem.

But what if your child has full blown allergies? Well my older son remains allergic to dairy and egg and we avoid all peanut and tree nuts. Anyone who has baked a cookie or a cake knows that butter and eggs are almost always called for in these treats. I know from first hand experience that it can be difficult to make a cake rise without eggs and make a cookie stay together without eggs.  What about taste?  Butter is yummy and makes everything so tasty. 

Here’s what has worked for me:  Last year, when he was in kindergarten, I made a stash of cupcakes, frosted and put them in the freezer. Then when the teacher sent home the list of birthdates, I carefully marked each day on my calendar to remind myself to put a cupcake into his snack bag so that he did not feel left out.  Now that he is in first grade, I volunteered to be “room parent” because I have a little more freedom now that my younger son is in school too.  Room parents have the responsibilities of planning the parties.

The other room parent and I discuss and arrive at the party plan a couple of weeks beforehand.  I normally take over the communication of food items to the other parents, with special care to those who have food-allergic children.  If I am to make the cupcakes for the entire class, I will email the recipe to the parents of food allergic children and assure them that no peanuts or tree nuts come near the counter top, in fact we really don’t even have them in our house.  If a candy item is planned, I will ask the parent to communicate in email the ingredients and any allergen warnings. I often ask the allergy-parents to do the purchasing, since they are more aware of checking the labels. We always cc the teacher on the email so that she knows which children can have what. Even with a lot of planning and care, I learned the that sometimes I need to pick up the phone and call the other parents... 

Last month it was my son’s seventh birthday. So I made cupcakes for the class and emailed the recipe to those mothers whose child has food allergies. One mother said, “Great, my daughter can eat it.”  Another mother said, “No, it contains soy.” But there was no response from a third mother.  So the day of the party, the daughter of that third mother came up to me and said, “Can I have a cupcake?”  I said, “Well it has no peanut or egg, so it might be okay, but your mommy never wrote back to my email so perhaps you shouldn’t have it.” The teacher agreed through a nod of her head.  We tried to praise the little girl for being so grown up about asking.

I felt so terrible for that little girl. The other kids loved the cupcakes. One boy said it was the best cupcake he’d ever had in his whole life.  After the cupcakes were gone, the little girl came back over to me and said, “I bet those cupcakes were really good.”  Ugh!  I felt even worse.  While I wanted to be angry with her mother for not getting back to me, I realized that really doesn’t help the little girl.  So I tried to think about what I could do to prevent this from happening again.  I decided that I would call the mother in the future to make sure she got the email and decided one way or the other if her daughter could eat the cupcake. 

So now it will be Valentine’s Day in a few days and the big party at school is tomorrow.  As I promised myself, I followed up with that mother of the little girl carefully and this time she responded.  She agreed to allow her daughter to eat the dairy-egg-peanut-tree nut free cupcake I am making and I forwarded that email to the teacher.  I feel so much better about the whole thing. I still feel a bit bad for the girl because I know she has dealt with a lot of disappointment and will in the future, because her mother doesn’t put a priority on this issue, but at least in my own little way, I am making a tiny little difference in that girl’s day tomorrow. 

Making cupcakes, cookies and cakes isn’t hard. It might take a few practice attempts, but don’t despair, once you find one recipe that works, that’s all you need.  There are a lot of great recipe books out there and it is worth ordering one or two. Here are the basic rules I use:

• Never use any nut, peanut or nut extract period.
• For dairy-free items, I use the earth balance non-GMO buttery spread. It is all vegan and tastes great.
• Beware of other margerines--many contain cow's milk products. 
• For egg-free items, I will use one of the following substitutes to try to make stuff rise and stick together: 
  • 1T of applesauce for each egg (holds stuff together)
  • ¼ banana for each egg (holds stuff together and makes it moist, a little banany taste)
  • 2.5 tsp. baking powder + 3T oil +3T water mixed together (keeps stuff soft and rises)
• Beware of egg substitutes--many contain egg products, especially in the egg section. 
• Always read the ingredients carefully and the allergen warnings. There are detailed lists of ingredients that are derived (come from) the big allergens in my book in chapter 38 --too many items to list here, for instance casein is a dairy ingredient that must be avoided for those allergic to dairy because it is the protein part of the dairy--the worst part for those with allergies to dairy.

It is extra work, but work well worth the effort.  You will become a better cook, you will feel better about you child's situation and your child will really appreciate it. 

When my first son was born he had cradle cap─patchy pieces on his scalp which I tried to oil and wash off painstakingly. He also developed a rash on his stomach, then on his arms and legs. I creamed this using a prescription cream from the doctor. Had I known better then I’d would have stopped eating and drinking dairy products─as he turned out to have a dairy allergy that has lasted for seven years thus far. I breastfed him and believe that the protein from dairy irritated his body. I often also wonder what other kind of discomfort it caused him. Did it give him cramps? Gas? Make him cry more? I finally figured out he had a dairy allergy and removed all dairy before he was a year old. His eczema was greatly reduced though his skin was still a bit dry, especially in the winter. Now, for the past year, since introducing fish oil into his diet, his dry skin isn’t a problem at all. We occasionally use a little cream, but mostly just on his hands and only in the winter.

I’ve heard friends talking about the oozing red rash behind their child’s elbow or knee. Or they talk of the variety of creams they’ve tried. One of the mothers interviewed in my book was so adamant about finding the cause of the eczema or rash on her infant that kept him and her up at night for weeks from the probable burning and itching feelings that she asked herself and her doctor over and over until she found the solution herself. She found her son was allergic to dairy by removing it from her own diet and seeing his eczema “clear up by ninety percent,” in her words. Sometimes the discovery can take place by accident. In Robyn O’Brien’s book, The Unhealthy Truth, she discovered her son’s eczema cleared up when they went on vacation and he didn’t drink the many cups of milk that he normally consumed. Upon returning home and to his old habits, the eczema returned, as well as his cough and earaches. Eventually Robyn weaned him from milk, yogurt, cheese and other dairy products, which healed him.[1]

Over the years, I read a lot about itchy, red, bumpy rashes to try to understand why eczema and food allergies are created. I developed the following layperson’s understanding: Eczema is caused by the inability of the infant’s immature digestive system (or a child's or adult's digestive system) to digest certain proteins, such as the dairy proteins, which can be hard to break down. These hard-to-digest proteins travel through the digestive system and go into the blood stream undigested. The liver then tries to cleanse the blood stream of this undigested protein. This works for a while, but then the liver becomes overloaded and cannot clean the bloodstream sufficiently. As a result, the immune system comes to the rescue and builds antibodies to attack the foreign proteins. Once the immune system creates antibodies, the allergic reaction is in place. The immune system’s antibodies tell the body to attack that foreign substance as if it were a virus or disease, which can cause the body to go into overdrive, possibly resulting in anaphylactic shock, or less severe yet equally devastating delayed allergic responses that can contribute to asthma, ADHD or autism. In the meantime, this foreign substance still needs to be excreted from the infant’s body, so the skin is used for excretion rather then the digestive system. Thus the skin becomes the cleanser of the body and shows a rash as the foreign substance comes out.[2]

I am sure that other things can irritate the skin. Environmental factors such as pets, dust mites, pollen can all contribute and make eczema worse, not to mention that there are other unrelated rashes caused by things like poison ivy─my worst nightmare. But I think people often overlook the fact that much of eczema can be caused by the food allergies to dairy, eggs, wheat, soy, peanuts, tree nuts, fish and shellfish. No matter how old you are or your child is, it can be a worthwhile experience to try to eliminate on of these foods for a week and see what happens. If nothing seems to change, try eliminating a different food for the next week. You may be pleasantly surprised at what problems you can solve without any medication or cost.

[1] Robyn O’Brien, The Unhealthy Truth, Broadway Books, NY, 2009, p 147-150.

[2] A. Anderson, Flourishing with Food Allergies, Papoose Publishing LLC, CT, 2008, p. 35.

As parents, we face many difficult challenges and I know many parents who feel they could do more for their child which creates a feeling of guilt. This guilt can lead to frustration because so many of us are busy trying to balance caring for our children, with caring for our finances (working), with caring for our homes, with caring for ourselves, as well as maintaining some relationships with family and friends outside of our homes. With the economy in a seemingly constant state of chaos, the financial burden and stress can compound each of these factors. Then if you factor in food allergies or related disorders of ADHD, autism or asthma, the fear, anxiety and frustration can often feel overwhelming to even the strongest parent. The impact of these problems on families when the children attend day care, school, social events or extra curricular activities can be immense.

Many of us try to make New Year’s resolutions. Consider this one if you are dealing with food allergies for your child: Stop feeling guilty. Stop assuming any blame for your child’s allergies. If you fed them the peanut butter cracker or the almond when they were “too young” stop thinking that you made some sort of mistake. There isn’t enough conclusive evidence in the world of food allergies to know for sure what the right thing is to do. Specifically, do you avoid peanuts or dairy while you are pregnant to avoid creating food allergies in your child? Or do you eat those foods with the hope that those foods will desensitize your baby to a possible food allergy?

In addition to not feeling guilty about what has happened in the past, consider an additional New Year’s resolution of accepting what is. I.e. accept the reality of your situation and recognize that it could be worse. Specifically, once you accept the food allergy in your child you can (1) learn all the names and ingredients that are made from that food allergen (e.g. casein is made from milk protein or arachis is made from peanut); then (2) take the next step and clean cupboards of all foods containing any ingredient to which your child is allergic. Toss out garbage foods that contain more than five or ten ingredients including corn syrup. To that point, did you hear that most corn syrup contains mercury─a heavy metal that can lead to various disorders such as ADHD and autism? 

According to Institute for Agriculture and Trade Policy, “Mercury was found in nearly 50% of tested samples of commercial high fructose corn syrup. Ben Lilliston of The Institute for Agriculture and Trade Policy (IATP) reports that in a follow up study they detected mercury in ‘nearly one-third of 55 popular brand-name food and beverage products where HFCS is the first or second highest labeled ingredient─including products by Quaker, Hershey’s, Kraft and Smucker. In his report Lilliston claims that the average American consumes about 12 teaspoons per day of HFCS and some kids and teens can be consuming up to nearly 80% more than that. Many parents of children suffering from neurological disorders have found that the removal of high fructose corn syrup from their child’s diet has been beneficial. These alarming studies prove that perhaps the reason moves beyond the argument that fructose sugar is bad for your metabolism or that a corn allergy is present in all kids who benefit from removing high fructose corn syrup from their diets. Perhaps the real underlying problem for some is a metal toxicity issue. We all want what is best for our children, and the recent spike in cases of children suffering from multiple allergies, autism, ADHD, and chronic multifocal tic disorders really proves that there is something rotten in our food chain.”[i]

In short, for the New Year, if you are dealing with food allergies, autism, ADHD or asthma stop feeling guilty and start helping your child by clearing out your cupboards of foods that contain the thing he or she is allergic to, as well as high fructose corn syrup. If you think your child who has ADHD, autism or asthmatic doesn’t have food allergies, consider the information in the blog entry titled, Delayed Food Allergies: Autism, ADHD, Asthma.  In that blog entry there are references to resources that explain how and which foods tend to aggravate these disorders making symptoms worse.  Remember, it takes about three weeks to clear out the body of these foods.  In some cases, the food allergies can be mitigated to the point where the disorders are not apparent.  That is truly something to celebrate in the New Year!

[i]Caryn Talty, Editor of Healthy-family.org, “Dangerous Levels of Mercury found in Products Made with High Fructose Corn Syrup,” http://healthy-family.org/caryn/1186/dangerous-levels-of-mercury-found-in-brand-name-products-made-with-high-fructose-corn-syrup, January 2009.

Most of us want to partake in celebrations of Christmas, Hanukah, Easter, Halloween and other family and friend based traditions such as birthdays, graduations and other religious celebrations. From these events, we gather memories that carry us through our day-to-day lives and make us feel part of a bigger picture giving us a sense of belonging and happiness.

As expected, there is a lot of work for the host to prepare a gathering--food preparation often a large part. When food allergies enter the picture, then a level of stress can surround the event for both the parents and the host. If not addressed, this stress can erupt into anger, friction or even family fights. Don’t let the event be ruined for you--there are things you can do so that your family can attend and do so safely. Attending these events is important for the social development of your child, as well as his or her happiness and emotional health, not to mention yours and your spouse's.

Unexpected, offending, allergen-laden foods can be the most difficult to handle. Here is a situation that caused one of the parents interviewed in my book a great deal of frustration. "Karen and her husband often have conflicting views on how to protect her son from an accidental ingestion of peanuts…Another example of contention is during the holiday season while at her mother-in-law’s house one relative brought a plate of peanut butter cookies. Karen asked everyone not to eat them because the crumbs could fall to the floor and Max could ingest them. Rather than agreeing, her mother-in-law said, 'We’ll just put them in the kitchen and eat them in there.' Karen was angry. Peanut could still fall to the floor in the kitchen, plus peanut traces would be on the fingers and lips of anyone who ate them and then might touch or kiss Max. She says, 'I felt unsupported by my husband as well because when I told him what his mother said, he didn’t confront her.'"

I think there are two main things you can do to ease the stress and plan for a relaxed and safer event.  One of the things I have learned to do with my husband is to talk about the upcoming event as soon as I can. For instance, this past Thanksgiving we had plans to travel to my husband’s brother’s house. His wife is quite aware of food allergies as her mother had celiac disease (intolerance to gluten) for a few years before her death. So, it is easy for me to communicate with her about the menu. She advised me what she was planning and I advised her what I think the boys would eat. We also decided what foods I would bring to allow safe and familiar foods for our boys. Together, we planned the meal over email about a week before the big day.  

As soon as some of these details were worked out between my sister-in-law and me, I summarized them to my husband. I also advised him that I told her it was unnecessary for her to make all foods dairy-free, egg-free as she has offered to try to do in the past. Our boys are old enough (five and six) now to know they cannot just take whatever they want. I wanted my husband to be prepared when he saw the variety of foods on Thanksgiving Day. I also discussed the upcoming holiday with our sons and made sure to ask them what they really wanted to make their Thanksgiving Day special. In this case they wanted a homemade apple pie with some vanilla soy ice cream. So I advised my sister-in-law that I would also make and bring those for everyone to share.

Previously, I tried to avoid tension by waiting until that morning or the day before to discuss the event with my husband. This tended to not leave enough time for any concerns that he may have had and so I would find myself feeling annoyed that he had any concerns at all. Over the years, I have found that his concerns are reasonable and actually helpful. But again, to address these concerns in a relaxed way, i.e. to avoid stress and any conflict between us, there must be plenty of time between the initial discussion and the event, specifically at least a week. This leaves enough time to communicate again with the host or make a trip to the grocery store as needed, or even order something safe off of the Internet if I felt too busy to make it myself, like there are some dairy-free cookies I know I can get that are yummy and fun for the boys to open since each is individually wrapped.  They are a little expensive, but sometimes it is worth it to avoid problems.

Another recommendation that I have when discussing upcoming events with either your spouse or your family member is to proactively address the specific concerns that you believe they have and you have. For example, I remember how important it was for me to feel that our boys did not feel different at birthday parties. Despite the fact that they had their own cupcakes, I wanted to give them those with ease, perhaps even laughter and lightheartedness at the party. I remember the tension I could feel emanating from my husband at a particular birthday party when we found that peanut butter and jelly sandwiches and cheese and crackers were being served. It was important for me that his tension didn’t affect the children’s enjoyment of the party. Since I know my husband’s mannerisms so well perhaps caused me to over react to his feelings--perhaps they were not noticeable to others, I do not know. At any rate, all went fairly smoothly, but I took something away from it.

Specifically I learned that I needed to discuss with him that I didn’t want to feel tension nor did I want the boys to feel tension during the event. So well before the next event, I would say something along the lines of, “I know how concerned you are about the boys coming into contact with allergy foods at parties. I am too. (Trying to show agreement.) But I also feel equally strong that it is important for the boys to not feel our tension at these gatherings.” Then I’d be sure to listen to him. If he had specific concerns that I could address, I would do so, and get back to him as soon as I could.

I think this strategy can work for relatives as well. For instance, I have found that many people in the grandparent generation are so unfamiliar with the relatively new onslaught of serious food allergies in our children, that they often find it unbelievable. Their beliefs then translate into actions, words, tones of voices, facial expressions, etc. that may cause us to feel that they think we are over reacting, are silly or are downright crazy. If possible, a parent might try to say something along these lines to the grandparent host of an upcoming event, “I know that you feel Johnny’s allergy might not be all that bad. But the doctor assures us that we should be very careful. My spouse and I would really appreciate it if you could not serve peanuts (or seafood or tree nuts, etc.) at your home that one day. We are really looking forward to the event. We just want to have a good time and not have to worry about Johnny. Is there anything I can do to help with organizing this?”

For instance, you could specifically offer to contact the host’s guests to request that they not bring foods that contain the allergy-ingredient. This might take the social burden and time burden off of the host. If you can get a list of phone numbers or email addresses, it may only take a short time to write a brief email explaining the allergy and how you’d appreciate it if people could help you in this way. I can’t imagine that anyone would want to knowingly harm a child, so I am sure that most people will be happy to comply. But, not addressing this beforehand and waiting for the guest to arrive with dishes in hand, creates complications and hurt feelings with which no one wants to deal. Imagine Aunt Abby walks in with fifty dollars worth of shrimp cocktail only to find out that it will be put into the backroom. Or imagine Great Uncle Bob who spends hours making his famous peanut butter cookies the day before only to learn little Johnny is severely allergic.

There are many difficult tasks in the job of being a parent. Getting up at two o’clock in the morning for months on end is one of them. Caring and worrying over a child sick with a fever, cough or pneumonia is another. Even speaking up for the sake of your child when it feels uncomfortable and unnatural is a difficult task. Know that you are not alone in the stress that you feel. Then, try to put a smile on your face and proactively talk to your spouse and relatives or friends well in advance (i.e. one or two weeks ahead of time) about the situation to address your concerns, their concerns and solutions. You can even pretend you are “at work” if that’s what it takes to remain nice and calm. It will make the event much better for your child, you, your spouse, the host and the other guests.

I am pleased that the book has received much praise and that there has been a relatively small amount of criticism.  Even so, I’d like to address the criticism.  I believe it falls into two areas. 

It appears that the first main reason is that the discussion of hypotheses, studies and non-traditional forms of medicine outside the officially-already-accepted-and-published set of information was not agreeable to some. A hypothesis is defined as "a proposed explanation for an observable phenomenon."  Here are a few from Flourishing:

• There have been no studies that prove probiotics will help cure food allergies, but there was a study that showed probiotics can help prevent food allergies when taken by infants and pregnant women.
• There have been no studies that prove reducing stress in a child’s life and improving their immune systems may help them outgrow their food allergies, but there is information in the book about how this may help. 
• There are no studies that prove delayed IgG food allergies are linked to ADHD, autism and asthma, but there are a lot of stories from various physicians and parents who have found success in reducing symptoms and behavior related to these problems, even world class athletes will swear by it.

My response to this criticism is that if a person or their organization will only accept the already-accepted-officially-proven studies, then that person or organization may be limiting themselves and the possible ways to help those dealing with food allergies and the probable related disorders of ADHD, autism and asthma.  I can understand that from a liability perspective many professionals are legally obliged not to deviate from the standard. But, I wanted to explore new ideas, theories and studies in my book. I feel it helps people think out-of-the-box, learn, grow and have some hope that in the future there may be cures or treatments for food allergies above and beyond life-long food avoidance.

It appears that the second main reason for criticism of the book is the frustration that many parents felt while trying to figure out “what was wrong” with their child. Why was their child having a cough that would never stop? Why was their child crying all night from eczema that wouldn’t subside? Why was a child being offered intestinal biopsies, brain scans or many medications, when the problem or cause of the problem was food allergy?  Parents who I interviewed were frustrated and even angry at times, about how their child was diagnosed, how they were treated and the misinformation that they were given such as an “adult” epi-pen prescription when an epi-pen junior prescription was in order.

My response to this criticism is that I set out to write a book to help parents feel they were not alone and that they could handle food allergies successfully in their child.  I randomly selected parents to interview and turned no one away who offered an interview. As the interviews were done, I began to notice a trend─most parents were indeed frustrated with the facts that the physician wasn’t able to diagnose the problems as caused by food allergies in a relatively quick way (some took over a year) and during that period of time a lot of medications were prescribed that would often have undesirable side effects. It was not my intention to make doctors “look bad” by any means.  But, I believe that until more research is done and physicians have more official-proven-accepted studies on which to base their beliefs and thus diagnoses, then we have a problem that results in frustrated parents and sick children, not to mention a lot of wasted cost for unnecessary tests and medications that ultimately affect everyone’s health insurance premiums.

For instance, Dr. Fausnight, Assistant Professor of Pediatrics, Allergy and Immunology, Penn State Children's Hospital wrote, “I have just finished the book. I found it very easy to read and it had a pleasant, warm, friendly approach to a scary problem. The personal stories are helpful because readers can find parts with which they identify. However, I did find parts of it a bit frustrating...I would have liked a story about a family that had an encounter with a compassionate allopathic physician, board certified in allergy and immunology, who helped them understand food allergy, navigate the school system, where to vacation…”  I think she clearly states the goal that all parents with food-allergic children would like.  Although there are many doctors who have these skills, especially those trained in allergy and immunology as is Dr. Fausnight, we need to work together to tip the scales in the direction of having more rather than fewer, especially in the non-specialized more general areas of medicine.

As a community of parents we need to ask the hard questions of our pediatricians to ascertain the correct diagnosis of our children’s symptoms. In doing so, we may need to question them a bit further than we might normally if we don’t understand why our child is having a symptom─sometimes that can take courage. Perhaps we don’t just want a medication to cover up or heal the rash, but rather we want to know the cause of the eczema, cough or asthma for example. In this way, by asking questions, being persistent and getting to the bottom of our children’s issues, together with the physicians we can help the children get better by healing their little immune systems so they can hopefully outgrow their food allergies. In the bigger picture, by raising physician awareness as well as our own, we will hopefully trigger more funding for research on food allergies which will in turn provide more answers, safer testing procedures and perhaps even a cure.

Thank you to everyone who provided feedback. I am most appreciative.