Helping Kids Avoid Food Allergens at Holiday Gatherings

There are a seemingly endless number of holiday celebrations between Thanksgiving and the start of the new year. While the holiday events brighten up these colder, darker days, they also pose challenges to children who have food allergies.

Rushani Saltzman, MD, an attending physician with the Division of Allergy and Immunology who works at CHOP Specialty Care & Surgery Center in Voorhees, NJ, offered the following tips to help your child manage their allergies and advocate for themselves – whether the celebration takes place at home, at a loved one’s home, or school/community event.

“Kids are really well-trained if they’ve been diagnosed with a food allergy from a young age. They generally won’t be shy to advocate for themselves, so hopefully, that isn’t as much of an issue,” said Dr. Saltzman. But, she added, the easiest situations to control are those when your family is hosting.

Control what you can, prepare for what you can’t

Hosting every event in your child’s life won’t always be an option, but when families can provide their own food, it significantly reduces the chances of the child being exposed to a trigger food.

Tips to better protect your child from food allergens:

• Be vigilant about checking labels for any ingredients that can trigger your child’s food allergies.
• At private events, ask the host in advance if each dish can be labeled with ingredients so families can avoid potential allergens.
• Ask for details about any homemade or unlabeled dishes. That may mean speaking with the kitchen staff at a restaurant or the person who made the dish at a private event.
• Use extra caution at buffet or family-style meals — these can pose a very high risk of cross-contamination if serving utensils are inadvertently moved between dishes.

Children with food allergies should learn how to read labels to identify all versions/names of the ingredients to which they are allergic. For young children still learning to read, they need to be comfortable asking an adult for help reading and understanding the labels.

Children (or their caregivers) should also always have easy access to their medications, typically diphenhydramine and epinephrine, in case an exposure takes place despite their best efforts.

Communicate with hosts

Families with children who have food allergies are used to thinking carefully about all the foods they buy and prepare, but other people may not realize the seriousness of food allergies or how to avoid triggering them.

When attending a holiday meal at someone else’s home, it’s always a good idea to plan ahead as much as possible to create a safe environment for the child with food allergies.

Speak with the hosts ahead of time to explain the relevant allergens and see if it’s possible to either avoid the allergen or have dishes with those ingredients labeled.

The best-case scenario is to avoid the allergen completely, for example, if your child is allergic to dairy, hosts could use a dairy-free recipe for mashed potatoes or serve something else in its place. But especially at the holidays, people expect — and can even be emotionally attached to — certain dishes and traditional recipes. If the host balks at not serving a certain dish or changing the recipe, a good compromise is to have two versions of the dish — either provided by the host or brought by the family.

In either case, each dish should be clearly labeled with ingredients. Labeling is vital because the dishes may look the same and you can’t rely on people’s memories about which serving platter is allergen-free version.

It’s also important to ensure the hosts understand what it takes to avoid contamination with a food allergen. For example, if a child has a nut allergy, you can’t just scoop out the almond slices from the green beans. The dish must be prepared from the start without almonds and served in a separate dish with separate serving utensils.

Staying safe at school and community events

The good news: Many schools and community organizations are moving away from food-centered events. But at the holidays, your child will inevitably be at some events and festivals that provide food.

The first step, as anywhere else, is to carefully check labels and ingredients and to ask questions from the vendor/event host when in doubt. Depending on the situation, your family’s best option may be to bring your own snacks so you can be certain the foods they’re eating are safe.

There’s no reason a child with food allergies can’t take part in the same activities as their friends and classmates. They just have to be vigilant about checking labels for any food involved in the activity.

Finding non-food-focused events to celebrate the holidays can go a long way for children with allergies. When food is an unavoidable part of the event, families may consider bringing their own safe foods to be assimilated into the snack/mealtime.

Having their food available is good for the child’s safety but can also make them feel like they’re different — which no child enjoys. To minimize those feelings, it’s ideal to make it as seamless as possible. Parents, teachers, etc., can help by not drawing extra attention to the fact that one or two children are eating something different.

Rushani Weerasooriya Saltzman, MD, FAAAAI, is an attending physician with the Division of Allergy and Immunology at Children’s Hospital of Philadelphia. She works at the CHOP Specialty Care & Surgery Center in Voorhees, NJ. Dr. Saltzman is also a Clinical Associate Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania.