January 31, 2013

Kissing-Induced Anaphylaxis?

She may have her first kiss a lot sooner than we want to admit.

OK, maybe you can't get anaphylaxis from kissing.  Or can you?

I consider myself far from having to worry about any of my kids being interested in kissing, as I'm sure just the thought of kissing a girl makes my 8-year-old son cringe.

"Hey Tristan, what do you think about kissing a girl?"

"It's weird."

"Remember that time that Ella kissed you?  You guys were around 3."

"Yeah, I didn't like that."

But one of these days, in the hopefully far but very really possibly near future, he will get curious.  And when that time comes, I want him to be armed with answers to any questions he might have about his food allergies and kissing.

In Mylan's recent study to understand some of the gaps in anaphylaxis awareness, where 300 families with food allergic children were surveyed:
  • One in 3 parents reported that their children had experienced a life threatening allergic reaction on Valentines Day
  • Less than half speak to their children about potential allergy risks they might face on Valentines Day, like kissing someone who has eaten something they're allergic to, or candy that may be passed out at school.
  • Less than half tell their teens to tell their dates that they have a life threatening food allergy.
  • Less than half remind their teens to bring their Epi-Pens with them before leaving the house.
Is this data at all surprising?  I don't really think so.  Conversations about dating, kissing, and risk-taking are hard enough.  We all hope that when it's time to have these difficult talks, we'll be courageous enough to speak, and our kids will be open enough to listen.  With the intermingling of the issue of serious food allergy, our task becomes only that much harder--and that much more critical.

While many of us still have young children, they will soon be tweens, then teens, and beyond.  As much as we'd like to bottle them up and keep them their 5-year-old selves, we can't.  We may feel like our allergy conversation thus far is open, honest, and clear, and maybe it is; and maybe it's not as thorough as we'd like it to be.

At this week's Food Allergy Blogger Summit in New York City, where we and 14 other inspiring food allergy bloggers met with leading experts in the food allergy field, Allergic Girl Sloane Miller talked about effective communication.  Miller stressed how vital it is to create a clear allergy action plan, starting in the allergist's office with a one-page summary of your child's medical history, and a list of questions for the doctor developed with your child.

After visiting the allergist, your child should know exactly what she is allergic to, what is to be done in the event of an accidental reaction, and that she has her medication with her at all times.  She discussed the importance of cultivating a "human relationship" between your child and her allergist at a young age.  According to Miller, it is crucial to understand that the action plan is ever evolving and changing, as new questions arise and new life stages approach. 

You and your child know exactly what she is allergic to, how to avoid it, and what to do in case of emergency...now what?  When teaching your children to communicate their food allergies, the goal is to let them understand that food allergies are simply are part of their identities, of who they are.  Miller says to teach kids to be 1) clear, 2) factual, and 3) firm (unwavering, without question, apology, or aggression) when communicating their food allergies, and to keep it to 3 sentences or less: 

"I've got severe food allergies, including egg, dairy, and nuts.  I can get hives, and even stop breathing.  I've got my Epi-Pen with me at all times, and will use it if I need to."

Help your child communicate clearly by practicing with her: have her write it down or role play to help them find their voice, and empower her with the courage she needs to face sticky situations.  Miller says to teach her never to eat for someone else--if she feels at all uncomfortable or unsure about how safe a food is.

Very importantly: a restricted diet doesn't mean a restricted life.

Once armed with the tools to communicate, make sure your child knows to create positive relationships--the people who will support him and help keep him safe.  Miller categorizes these people as: his inner circle of friends,  his food allergy allies (like a chef or server who is willing to listen to you and accommodate your needs), and online and offline resources.

So, can kissing induce anaphylaxis?  Dr. Rushi Gupta, author of The Food Allergy Experience, says a good rule of thumb would be to wait 24 hours after your kissing partner has eaten a known allergen, and make sure he brushes his teeth thoroughly before kissing (hey, that's good advice all around).  But to be sure, that's one of those questions only your doctor can answer accurately, depending on the severity of the individual's allergies.

At the same time, I think we can reduce the risk of anaphylaxis through kissing by teaching our children to be effective and confident communicators and nurture positive relationships.

So when girls no longer have cooties, I may need to broach a few new subjects with Tristan.  Until then, I will revise and clarify our allergy action plan, and keep an open line of communication with him by taking advantage of those teachable moments, those moments where he's just cracked the door open enough to let me in and be a part of his life.


  1. Oh wow! This is something I never thought of. Interesting.

  2. Great post! I actually found your blog through Sloane's :) I'm so happy this is a topic of conversation. So many people just don't think about it! I'm 31 and have had life-long food allergies but THIS wasn't something my parents (or anyone) ever discussed with me, or something I thought about ... until I had a serious reaction after kissing someone. It's very scary and a very vulnerable feeling, to have intimacy not always be safe. My boyfriend has had to cut down on how often he eats peanuts and tree nuts because of this, and he also very rarely eats them while I'm home. Now I find it funny that he says things like "Can we kiss tomorrow? I won't eat anything you're allergic to!"

    1. Thanks for shedding some insight into a subject I'd much rather avoid but know I must face sometime in the near future. It sounds like you've found a good one...perhaps it took some time to come to a clear understanding? I love that your boyfriend checks with you to see if you can kiss...so classic. And thank you so much for sharing about your reaction after kissing someone. It just shows how real the danger is, and the risks that food allergic people face.
      PS love your blog. :)