What Every Parent Should Know About Kids & Food Allergies

It’s up to ALL of us to keep kids safe. Here are six important things all parents should know about food allergies.

A jar of peanut butter with a spoon in it sits on a white counter.

What happened to open my eyes

A few summers ago we were on a family vacation, sharing our first dinner in a rented beach house, when something went terribly wrong.

A teenage family member had recently been diagnosed with a poultry allergy. The take-and-bake pizzas we’d made had no poultry on the ingredient lists, but after dinner, he started to feel itchy. He took some Benadryl, yet his lips began to swell. Then he said he was having trouble swallowing.

Our house was in a sleepy shore town. We had no idea where the nearest urgent care center or hospital might be. His parents called 911. Though they’d never had to use an EpiPen before, they had packed two. They gave him the first one and waited for the ambulance.

What I realized in that moment

The paramedics asked someone to stand at the end of the dark driveway, so they knew where to turn. My husband and I volunteered. As we waited for what seemed like too long for help to arrive, I was scared.

I knew that fear was something so many parents live with every single day as they send their kids off to school–that along with the usual worries about disappointments and heartbreaks, some parents also carry a fear that their child will have a life-threatening reaction to something as seemingly benign as a slice of pizza or a cookie. I already knew this. But in that moment, I felt it. (Happy ending: He was taken to the hospital and fully recovered.)

As a mom, I have empathy for parents who have children with food allergies. And as a dietitian, I understand how tricky it can all be: confusing food labels, complicated ingredient lists, risks of cross contact. But when a loved one has a severe allergic reaction right in front of you, it really hits home.

A cereal bar sits partially unwrapped on a white surface.

Why it matters to all of us

Even if your own child doesn’t have a food allergy, chances are one of their friends or family members does. One in every 13 children in the U.S. has a food allergy—that’s the equivalent of about two kids in every school classroom!

Even if you’re not personally touched by food allergies, your actions can impact families who are. Truth is, it’s up to all parents to understand the basics of food allergies so we can keep ALL children safe. Here’s what all parents should know about kids and food allergies:

A child with a stomach ache has his hands over his tummy.
Stomach pain and nausea can be red flags of a mild allergic reaction.

1. What an allergic reaction looks like

Even if a child has never experienced symptoms before (or very mild symptoms) it can quickly turn into a severe reaction. So it’s key to take action at the first sign of allergy.

Symptoms of a milder allergic reaction include:

  • hives
  • redness of the skin
  • itchy mouth or tongue
  • sneezing
  • stomach pain
  • nausea and vomiting

Symptoms of a severe allergic reaction include:

  • swelling of the lips, tongue, and throat
  • troubling swallowing
  • wheezing
  • feeling faint
  • chest pain
An Epi-Pan sits in a woman's open hands.
It isn’t hard to use an Epi-Pen, and it can save someone’s life!

2. How to use an EpiPen

Epinephrine auto-injectors like EpiPens contain medicine that treat an allergic reaction, and they can save lives! If you have a child at your house with a food allergy, be sure the parents leave an EpiPen with you (or for older kids, that they’ve brought it themselves).

The pen is actually simple to use—and knowing how to use it will save precious time and stress in case of emergency. Take a few minutes to watch this quick video to learn how.

If you’re alone with someone having a reaction, give the pen first, then call 911. If you’re with others, have someone call 911 while you give the pen. Keep in mind that an EpiPen buys you time until the person can get treated. Even if a pen is given, the child still needs to go to the hospital because the reaction may return and they may need additional medicine.

3. How to keep kids safe

If you have a child with a food allergy in your care, make sure you know exactly what they’re allergic to and what they can and can’t have. Older kids will obviously be better at reading labels and speaking up, but young kids may not. When in doubt, always call the child’s parents–or ask in advance about what’s safe to have.

The side of a cereal box shows the allergen statement.
The allergen statement is below the ingredient list on packages.

4. How to read a food label for allergies

The FDA requires that food manufacturers call out the major food allergens: milk, eggs, fish shellfish, tree nuts, peanuts, wheat, and soybean (and starting next year, sesame). These must be shown on labels in one of two places:

  • In parentheses following the name of the ingredient like this: “whey (milk)”
  • Right after or next to the list of ingredients in a “contains” statement like this: “Contains wheat, milk, and soy”

You may also see statements like “may contain wheat and soy” or “processed in a facility that also uses peanuts”. Those statements are meant to warn about cross-contact, which happens when a food or drink becomes contaminated by an allergen because they’re processed on the same equipment (or simply in the same area). Some people will food allergies avoid products with those warnings, while others don’t.

Three lunch boxes sit on a wood table filled with a variety of foods such as a sandwich, crackers, blueberries, hard-boiled egg, and raspberries.
If your camp or school is peanut-free, pack peanut-free lunches.

4. What your school & camp rules are

Schools, camps, and other places where kids gather have policies in place to protect kids. Before packing a lunch or snack–or sending in a treat for a birthday or class party–be sure you know whether there are restrictions around what you can pack or send. If there are, take them seriously.

A platter of cupcakes frosted with naturally pink frosting
Homemade treats for classrooms may not work for kids with allergies.

5. How to include ALL kids

All kids should feel included and part of the fun. If you’re hosting an event, check with parents about food allergies and find out what you can provide–or give them advance notice so they can send a safe treat for their child (and don’t be offended if they’d rather bring something themselves!). If you’re getting goodies from a local bakery, ask them about any allergens they use in their facility. For class parties or Trick or Treat, use this list of 20 Treats That Are Free From Top Allergens. Or consider celebrating with nonfood items like stickers or other other tokens. 

A Food Allergy Mom's Call For Empathy -- Real Mom Nutrition
Having empathy for families with food allergies is so important.

6. That families deserve understanding and empathy

All parents worry about their child’s safety. But imagine that your child’s life could be in danger by a small, accidental bite of the wrong food. So if you feel inconvenienced by your school’s peanut policy or annoyed by the mom asking for the ingredients in the cupcakes you brought to the party, put yourself in their shoes. Here’s a powerful essay my friend wrote about how it feels having a child with life-threatening food allergies: A Food Allergy Mom’s Call For Empathy

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29 Comments

  1. I have a ton of food sensitivities. My reactions are mostly GI but on occasion I get a wicked case of the hives. My guess is:

    1. Cross contamination. When making pizzas some chicken or chicken juices got in/on the other ingredients or prep space. This is a huge issue when restaurants claim to be gluten free compatible. Also the sausage or pepperoni, it is possible that poultry was use as a filler… Unless they show you the ingredients, never assume… American processed food is littered with weird additives and chemicals. It is also possible a stray piece of chicken got on the pizza and dumb luck, that is the piece eaten by your cousin.

    2. It is possible your cousin is allergic to something else… I know I discovered my triggers one by one…

    1. Susan–yes, it’s all those weird additives and chemicals that have me concerned. The pizza contained preservatives and I’m wondering if it’s possible that he’s allergic to something that commercial poultry is injected with that also appears in packaged food. It is so complicated!

  2. I am allergic to shellfish. When I arrive at a party and someone is serving it, I just want to turn around and leave, because there is no way I will risk eating or drinking anything due to cross contamination.

    I have had four reactions in the last two years, all due to cross contamination. I am betting this is what happened to your family member. I am so glad they had the Epis.

    1. Yes, I’m starting to think cross contamination may have been the issue. That’s such a tricky thing to control, and it’s a shame that it has to negatively impact people who are allergic. Thanks for your comment!

  3. Companies are only required to list the major 8 allergens (ex.may contain nuts.. etc). I agree with the others that it was likely cross contamination- I doubt that they are overly concerned about allergies to poultry since it is relatively rare. I would recommend just calling the company to see how they make their pizzas. Share your experience in a non-accusative way and the y will likely be able to pinpoint the ingredient. I doubt you’ll get any more than a concerned apology, but it might serve as an FYI for their kitchen staff to be more careful about cross contamination.

    Also, my other thought was that it might be something with chicken broth or possibly another related allergy. Is he also allergic to eggs?

      1. Sally, I found after my second baby that I am allergic to 12 components. One of them in Peru Balsamic and it is not listed in the ingredients. Peru balsamic is in everything that enhance flavors and odors. Natural and artificial. I can’t even to touch it.
        My point with allergies is educacion, to know where to find it and what to do if you get exposure. As you see it is in everything. If in the ingredients has more than 5 ingredients or ingredients that you can’t pronounce. Don’t buy it. I have a rule. At list half of my groceries needs to be fruits and vegetables. Right there is one ingredient in each.
        And I have my exceptions. Yes I have birthday cake and I be sure to take my medicine. Or I bake my own cake .

  4. I’m so sorry to hear about the very scary incident for your family member. I also have a poultry allergy (was diagnosed 26 years ago at age 19) and this is the first time I have ever heard of someone with the same allergy! Somewhat validating for me as no one ever believes me and they think I just have an intolerance. I feel they need to sometimes tell people I went into anaphylactic shock 3 separate times and almost died the 3rd time until we could diagnose the allergy. The other thing I was diagnosed with was an allergy to raw eggs. Cooked eggs are fine though which is strange. It explains all the times as a kid when I would eat raw cookie dough and get itchy ears and throat – luckily for me it never escalated beyond that back then. You may want to have your family member tested for raw eggs as well – not that many people eat raw eggs but they are lurking out there where you least expect it! Wish I could give more insight in what may have happened to him but I agree it sounds like cross contamination. Thank goodness for epi pens!

    1. Thanks Kris. So interesting that you were diagnosed during your teenage years as well–and so scary that you had so many severe reactions before you were diagnosed. Thanks for sharing your experience.

  5. You can’t trust anything made buy anyone, but yourself. We learned the hard way too many times. People mean well, but unless you are used to dealing with allergies, life happens, people get distracted, and accidents happen. We carry our own food every place we go.

    We allow no food, that anyone is allergic to in my family, into our home. Life is so much easier that way. I’m too busy to worry about what fork or spoon touched what.

    We have had no reactions once we started doing this. All our reactions were out to eat, or events outside of the house. After one too many reactions, we stopped eating out (love it- my food taste better. lol) And when invited to a party we pack our own food, and most of the time we stand and eat, because we don’t know what was on the table, or what was on the sponge that was just wiped across the table. I recommend this child eat only real food like a Palio diet. One ingredient foods made by himself or the parents.

    I know that sounds scary, but it is the best thing you could do for this child. You can’t trust any labels on food these days. Again, we learned the hard way. There could be something in that packaged food, that is not on the label, because it’s a small amount, and they don’t have to put it on the label. That small amount can kill someone with an allergy. Happened to us many times, lucky for us it didn’t kill anyone.

    You are welcome is check out my website, to learn how we get our food, and some helpful video’s that helped us along the way. I had no support in the beginning so please support these parents. They are going to need help.

    http://www.healthyhabithomestead.weebly.com you can follow us on Facebook to get free Paleo cookbooks and helpful health information.

    I wish your family well, and hope this child NEVER has another reaction. <3

    Take care,
    Chris

  6. It is not cross contamination, which typically deals with pathogen/microorganism growth when raw product is in contact with food prep surfaces (include the food service handler) and that surface then comes in contact with ready to eat foods. What you are looking at is cross-contact – when high-allergenic foods come in contact with non-allergenic foods and cause an allergic reaction. It can be as simple as a food handler who is prepping the pizzas touching cooked chicken and then touching other products that also go on the pizza without changing gloves. Traces of poultry could potentially be in any of the other ingredients in their mise en place. If your take-and-bake was at a place that preps the pizza to order (or in some other non-factory setting), I would say that this is the culprit. I would also say that this practice is a pretty standard thing as the food handler is working with all cooked ingredients…and it puts folks with rare allergies in a difficult situation.

    Sorry to be a stickler on semantics, but I teach ServSafe and food safety as a part of my work, and this is one that some of my students have trouble with. I’ll remember your family’s experience the next time I have a class.

    1. Thank you Amanda! Very helpful. I likely learned the difference between those long ago in a foodservice class as well, but, embarrassingly, have since forgotten. 🙂 Good to re-learn them!

  7. My son was diagnosed with peanut and dairy allergies when he was five months old. He is now 2 1/2 and we’ve made three trips to the ER for severe allergic reactions. The hardest part for us is educating other people on allergies because there’s this misconception that you can build an immunity to allergies if you keep exposing the person to whatever he/she is allergic too in small amounts. We can’t trust food provided by other people and that sometimes means we offend well meaning hosts.

  8. My son is allergic to sesame, eggs and almonds, and is intolerant to dairy and soy. We learned of half of his allergies the hard way by ending up in the ER with facial swelling two times his normal size. I go into a party and see sesame seed buns, or hummus and feel like the whole place is made of poison. A party we were at a few weeks a go, I did not even let my son go inside due to the allergic party food on the table. It’s very frightening and its hard to know how hyper careful we have to be

  9. @Amanda:
    Definition:
    Cross-contamination is a phenomenon that occurs when a food that does not itself contain any allergens is tainted with an allergen during food preparation, cooking, storage, or serving.
    Examples:
    Cross-contamination could occur in these and many other settings:
    • When food is chopped on a cutting board on which allergens have previously been cut;
    • When baked goods are baked on a cookie sheet that hasn’t been thoroughly washed after baking cookies containing allergens;
    • When foods are cooked on a grill on which foods marinated with allergens are also grilled;
    • When spoons on a salad bar are used to serve both allergenic foods and safe foods;
    • When knives are used to cut allergenic foods and safe foods without washing in between
    http://foodallergies.about.com/od/glossary/g/xcontamination.htm

    Definition: Cross contamination is what happens when bacteria from one food item are transferred to another food item, often by way of unwashed cutting boards or countertops, as well as knives and other kitchen tools, or even unwashed hands. Cross contamination can in turn lead to food poisoning.
    http://culinaryarts.about.com/od/glossary/g/Cross-Contamination.htm

    Cross contamination can be either food allergy related or food safety related.

  10. Actually Amanda– I am going to disagree with you. In my case and everyone else with an allergy or intolerance, it is contamination. When food we react to gets into our meal, it is like poison. You can dress it up with crazy semantics all you want. That is just another way of making those of react seem crazy. We aren’t. The foods that trigger us are read as poison by our bodies and our bodies react accordingly.
    I am tired of people making light of that and using semantics to make less of a big deal. Talk me after you have spent a night with your head in the toilet…

    1. Susan–I don’t think Amanda was trying to make light of allergies or the severity of the issue. She was simply clarifying the official definitions of these terms as they relate to food safety and the foodservice industry. Of course these allergens feel like poison or contamination to you, because your body does treat them that way, and these substances can end someone’s life. No one is minimizing that.

  11. Thanks @Amber, I was going to post that also. When we sub the word poison for the pretty word allergen, I think then more ppl would STOP making light of this issue. For me– gluten, corn, soy, and nuts are no different than poison. Just as damaging and just as dangerous.

  12. Terrifying, Sally. So sorry for all of you that you had to endure that. Chicken is a tough one, I’m sure, because it is so unusual.
    I have anaphylaxis to nuts and fish. I’ve had so many reactions because kitchen staff are not as careful with surfaces and utensils as we hope they would be and as they should be. I’d probably place a call to the restaurant and let them know what happened. Ask them if there are any ingredients that are not obvious. Perhaps the tomato sauce has chicken bouillon or broth.
    Epi pen is a life saver. I am alive today because of it. It might be a good idea for your family to practice using the epi pen on a grapefruit to get the hang of it. There’s a book that I thoroughly enjoyed called Feeding Eden by Susan Weissman. I highly recommend it to parents of allergic kids.
    Best of luck to everyone.

  13. Thanks Sally. I most definitely did not mean to make light of allergies and their severity. Since I do work in several aspects of the food service industry, from training to production to meal service with a non-profit organization that serves high-risk populations, we are very aware of what we serve. My staff, volunteers and I take allergies very seriously, taking special care with high allergen foods and checking with our partners before we serve them to guests at our various meal sites. When we start a new partnership, we always check with our site contacts and the guests directly to be aware of any allergies. We keep track of our regular guests with allergies and take all the necessary precautions to prevent cross-contact with their allergenic foods (like the special non-seafood boxed meal that was prepared, stored and transported separately from the seafood salad sandwiches everyone else at the site received).

    The semantics are not to minimize the effects that allergens have on the body. It is just that this is one topic where the specifics of the definitions are frequently a challenge to my ServSafe students (my organization partners with another nonprofit to teach culinary job training to unemployed and underemployed individuals in our community); since it is something that I am used to explaining and clarifying, my inner teacher had to comment. I had actually made a note of this blog post in my lecture notes to share as a part of the next class I get to teach later this fall.

    I did not mean to make it sound like I was minimizing your allergies (as someone who also suffers from severe allergy of my own). I just wanted to give a little insight from the industry side because if you approach a food service establishment asking about cross contamination, they will go directly to the pathogen definition. For those with allergies, that food is just as much a contaminant to their body as an overgrowth of dangerous microorganisms.

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  15. My 8yr old son has life-threatening food allergies to all nuts, eggs, soy, and wheat. If there’s anything that he/we need as we navigate the school scene, it is more understanding that this is a real, dangerous, life-threatening situation. Like any parent, if keeping my kid alive means a slight inconvenience to others, I humbly suggest the inconvenience. Thank you for your post.

  16. I realize this post is old, but just discovered your site. Great info!

    I wonder if your mystery was ever solved.

    In our case, my son had an allergic reaction after eating butter pecan ice cream. (He was 8 years old at the time, in 2013. And had never had any sort of food allergies prior to this.) We managed it with Benadryl and a fretful night full of calls to the doctor and a friend whose son is allergic to many foods.

    After testing him, my son tested positive for allergies to pistacios, hazelnuts, almonds…pretty much every tree nut. Except pecans. Pecans seemed fine, according to the testing. Lesson learned. Like others have said. Unless the food is made 100% under your watch, there are no guarantees. The reality is a facility that makes butter pecan ice cream, also makes ice creams with other nuts in them.

    In the end, we know we have to keep an Epi-pen handy and never assume that a food may not cause a reaction.

    1. Thank you Belle! The mystery was never solved, though we assume the pizza had cross-contact with poultry somewhere along the line. Cross contact is scary because you just never know–and obviously with something like poultry, which is not a common allergy like peanuts, they’re not going to list it on the label (i.e.: “made in a facility that also processes…”). You are right–having the dpi-pen and never assuming something is 100% safe (unless homemade) is the only way to stay vigilant. Thanks for your comment and glad your son is okay!

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  18. Hi! I LOVED this article! My son who is almost 11 months, shows strings signs of being allergic to soy and sesame! So glad it is being added to the list! I try to make sure to check everything I feed him for those ingredients. I actually use soy and sesame a lot to cook with and I’ve had trouble finding a substitute for that. The doctor won’t test him for those allergies until he has an anaphylactic reaction, so anytime we try new food I make sure my husband is home he’s a paramedic but my son starts daycare soon and as much as I’d love to send his lunches and snacks he HAS to eat what every one else is eating! He’s a very adventurous eater! He is not even a little bit picky which is a relief because my daughter is incredibly picky! I’ve followed you for a long time and own both of your cookbooks and love them! They have helped my daughter to try new things! I just love this article though! I will be making anyone in my family who cares for him read it because they aren’t always thinking of his potential soy and sesame allergy! As of now when he has it he gets very raspy and fussy, when he was a baby the doctor wanted him on soy formula but he would throw it up constantly. So thank you for the many ways you have helped my family!

    1. Holly–I’m so glad this article will be helpful to people in your family–and thank you for your kind words about my books too. I really appreciate that. I’m so glad they are adding sesame to the major allergens, so people like your son will be better protected. Your son is the perfect example of why that sesame labeling is so critical. All the best to your family!