Test your knowledge about food allergies and learn some ways you can better protect your child from serious reactions like anaphylaxis.

True or false: Allergic reactions get worse with each exposure to a certain food.

False! A variety of factors can influence the onset, severity and symptoms of an allergic reaction including:

• the amount of the food ingested
• whether the individual is already sick, exercising or menstruating
• their normal dietary intake, caffeine usage
• other factors

Typically, allergic reactions to specific foods do not worsen over time. Yet, because of the variety of factors listed above, reactions likely won’t be the same each time.

Don’t wait for hives to occur before treating your child’s allergic reaction. Talk to your child’s clinical team to make a food reaction/anaphylaxis plan, then discuss it with your child so they know what to expect and who is available to help when or if needed.

Make sure your child (or the adult supervising them) always has access to an epinephrine auto-injector wherever they are – at home, at school, on a ball field or a friend’s house. Partner with your child’s school and other organizations or individuals who will be overseeing your child’s activities.

True or false: Peanut, tree nut and shellfish allergies are the most common types of food allergies.

False! While peanut, tree nut and shellfish allergies are common in adults, they are just a partial list of the most common food allergies in children.

Most allergic food reactions in children are due to these foods:

• Milk
• Wheat
• Egg
• Soy
• Peanut
• Tree nuts
• Sesame
• Fish
• Shellfish

True or false: In a classroom or school bus, parents do NOT have to worry about food allergies being airborne.

True! Your child would have to eat the food or stick it in a mucus membrane (like their eyes or nose – which we strongly discourage) to trigger a reaction.

In some places that boil peanuts, there is the potential to trigger a reaction but that’s rare. If you are cooking the food allergen (like an egg) and the child puts their head over the stove (again, not recommended), there is also the potential for symptoms. But, in day-to-day activities, airborne allergies should not be a concern. Be mindful of activities like home economics/cooking.

Additional thoughts on airborne concerns:

• The risk of a systemic or serious reaction to a food due to casual contact (i.e., touching or being close by) is low.
• In two leading studies, researchers applied peanut butter to intact skin on children with a history of reported inhalation reactions and found:
  • Less than 1/3 developed redness and/or itch at the exposure site (the same as the placebo group).
  • There were no systemic reactions.

True or false: Washing hands with hand sanitizer will not remove allergens.

True! Hand sanitizer does not remove food protein from the hands. That’s why it’s so important to have children with food allergies wash their hands with soap and water BEFORE meals.

All children in the classroom should also wash their hands with soap and water AFTER meals. Commercial hand wipes can also remove peanut protein from the skin.

True or false: Peanut-free schools will keep kids with food allergies safer from having reaction.

False! In a 5-year review of Massachusetts schools, there was no difference in epinephrine use between schools that allowed children to bring peanuts or peanut butter to school, and those that banned the substances. There’s just no guarantee that restrictions will or can be enforced/implemented to ensure allergens will not enter the building.

In studies of peanut-free schools, researchers found:

• No difference in epinephrine use.
• No difference in quality-of-life scores for children allergic to peanuts.
• The most common allergic reaction in school was triggered not by peanuts, but by milk!

Questions? We’re here for you.

If you have questions about your child’s food allergies, please reach out to your CHOP allergist by calling 215-590-2549.

Contributed by: Megan O. Lewis, MSN, CRNP and Gita Ram, MD