Making Room at the Inn: Helping Those With Food Allergies Celebrate -- and Stay Alive

When most of us think of the coming holiday celebrations, we look forward to a table of special, traditional foods. That holiday meal is usually one of the holiday's most satisfying elements. But when a child or adult has life-threatening food allergies, the holidays can be mortally dangerous -- making them even more emotionally fraught. That's especially true when friends and family members refuse to believe the food allergy is genuinely that dangerous.

I fully understand the widespread disbelief in food allergies, which in just a few decades seem to have appeared everywhere. When my son was young, like so many children, all he wanted to eat was peanut butter and jelly sandwiches. When his school restricted peanuts because of other children's allergies, we had to make adjustments. It wasn't easy -- but we did get him to enjoy food substitutes like soy butter and sunflower butter and jelly sandwiches.

Then my daughter was diagnosed with life-threatening food allergies, and I got to experience the whole thing from the other side. As a pediatrician I had previously counseled families with food allergies; as a researcher I had studied food allergies; but I did not grasp its true impact until I experienced it first-hand. It was a scary diagnosis, and oftentimes I did not want to believe it. Our lives changed. My daughter lives a different life than my son. She cannot have playdates freely. She carries her epinephrine auto-injector everywhere. She is her own advocate at age six. Adults ask her if it is okay for her to eat something and she must make a decision. Already, I cannot always protect her as she is away from me most of the day.

Food allergy is now a part of everything I do, as a physician, a parent, and a researcher. As much as I wish it wasn't, food allergies are real. For reasons no one fully understands, they are increasing in the U.S. The most common allergens are peanuts, tree nuts, shellfish, finfish, eggs, milk, wheat, and soy; an individual child might be allergic to one or to many. When the allergen is ingested, the body has an immune reaction. The body's defense system starts fighting the food, which it perceives to be dangerous. This can cause symptoms such as hives, swelling, throat closing, trouble breathing, and a drop in blood pressure. Unfortunately, no medications can prevent an allergic reaction. The best that medicine can offer is something to slow -- and hopefully stop -- the reaction from progressing. That comes from epinephrine, a natural hormone adrenaline, via auto-injector. Anyone who has a life-threatening allergy should carry one at all times.

With joyful food-based celebrations everywhere during the holidays, children and adults with food allergy have an especially stressful time. No parent would knowingly subject a child to a near-death experience just for a social meal or party. And so if family or friends refuse to allergy-proof a special holiday meal, parents of allergic children may be effectively banished from the holiday table. I recently spoke to parents of children with food allergies at a support group meeting where I was invited to speak on my research. Interestingly enough, what they wanted to talk about was a particular effect that food allergy was having on their lives: They would not be able to spend the holidays with their loved ones. The reason: family members had said it would be too difficult to try to make the meals safe. These families' emotional response was intense with anger and sadness. As one parent put it, "This year we will not be celebrating with our family, because they don't believe in my son's allergy and refuse to make their home safe. We can deal with this but my five year old son will not see his grandparents, uncles, aunts and cousins. How do we explain this to him?"

Someday, I hope families with allergies won't need to make such choices. Current ongoing research show some promising treatments that may help kids tolerate the foods they are allergic to in small quantities or possibly even completely. Until then, fortunately, many substitute foods have been developed for the most common food allergies. All that's needed is a little extra time, willingness to help, and a desire to make it happen.

My wish for the holidays is simple: that all adults and children who have food allergies may enjoy their celebrations to the fullest -- without having to live in fear of food. And my humble request is for those near and dear to them to show their loving support and protection -- by taking a few simple steps to allergy-proof their holiday home, while educating themselves on what to do in an emergency.

An allergen-free gathering for a child and their loved ones: now, that would be some genuine holiday magic.