Why Do Kids Have to Eat Peanut Butter At School?

Why do kids have to eat peanut butter at school?  This is such a controversial subject in the food allergy world, though I can't for the life of me figure out why it's so heated.  I've read the reactions to food allergy parents who have given their opinions in the past.  I know what peanut butter advocates think.  I know that on the extreme side of this argument, peanut advocates think that severely food allergic children should not even be allowed in school--that they should be homeschooled.  In fact, I've heard this opinion so many times that this type of verbiage no longer fazes me.

How many times have I heard a parent say, "But she'll only eat peanut butter for lunch!"  I just can't figure this out.  Because if my kid looked at me and told me he would only eat one thing for lunch, and that one thing was something that could potentially kill another student, I'd tell him no way.  Forget that, if my kid told me he would eat only one thing for lunch, period, I would tell him no, that's not acceptable.

I just can't wrap my head around parents who insist that peanut butter sandwiches are the end all. Do their kids eat these for breakfast and dinner too?  Do they have a peanut butter sandwich waiting for them when they get home for snack?

Okay okay, I get it, I do.  People have rights.  They want to eat peanuts and they should eat peanuts.  Just not at school.  There are personal rights and then there's social responsibility.  What are we teaching our children if we're only teaching them one side of the coin?

I mean, if my son was playing in the park with friends, found a long sharp stick and proceeded to wave it around recklessly at the other kids, I would tell him to put it down.  Sure, he has the right to play with sticks, just not around other kids.  Hey, it's unlikely that he'll poke someone's eye out, but it's possible.  He could also unnecessarily scratch or puncture someone.  Wouldn't we rather avoid the risk altogether and tell the boy to put the stick down?  Or would we all sit around on the edge of our seats waiting to see what would happen?  If your child was the one with the stick pointed at her, would you just sit around and do nothing so as not to offend the rights of the stick-brandishing child or his parents?

Do we share the responsibility of helping to keep our kids safe?  Every day, my kids go to school and I pray that I don't get a phone call from the school office.  When I see the number flashing on my phone, I'm immediately filled with dread.  I'm hoping the caller is not about to describe an allergic reaction, and that I won't need to rush myself over to the pediatric ER to meet my child.

So why the peanut butter?  Of course, 99.9% of the time, peanut butter sandwiches in the school cafeteria aren't hurting anyone.  It's the less than one percent of the time, the time that after eating a peanut butter sandwich, a classmate accidentally spits into the mouth of a peanut-allergic child during a conversation they are having in line about to leave the cafeteria.

Yep, it happened to my kid, yesterday at school.

Within moments, my son developed a stomach ache, told the principal, and was whisked away to the office.  While I was on the phone with the principal (thank God I answered my cell!), my son reported trouble breathing, so I told him he needed the epinephrine injection, which my son administered himself.  I told the principal that he needed to go directly to the ER, and I would meet him there.

My 9-year-old son is officially a rock star.  He recognized his symptoms, got help, related his symptoms clearly, and administered the Auvi-Q auto-injector successfully and calmly.  He rode an ambulance alone to the ER, readied himself for a four hour stay, and worried that he didn't have his books to do his homework.

Why can't we just say that there are no nuts allowed in school?  Because we know people won't follow the rules?  Because we know people won't like it?  Because we're worried about people's right to eat what they want for lunch?

All schools have drop-off and pick-up procedures which are not to everyone's liking, and which are probably going to be challenged by a few parents, but we still have them.  We have them because we know it's the right thing to do, and because we know if we didn't, we'd have a lot more accidents.  If we could avoid just one accident with rules about how to pick up our children from school, would that help to justify their existence?  Do we even feel the need to quantify how safe we could be with the implementation of a particular rule?

How many food allergy accidents have to happen before we change our food policies at school?

I don't think most people mean to put food allergic children at higher risk of reaction at school; I just think they don't understand.  They haven't had to respond to an emergency situation--adrenaline pumping, hands shaking.  They haven't had to live through the ups and downs of managing food allergies on a daily basis, spend literally thousands of dollars every year on medications, ER visits, and specialty foods...in a constant state of worry.

I've always known that food allergy education is a slow evolution.  One step forward, two steps back.  We had our two steps back yesterday, I'm looking forward to that step forward.

Weekend Getaways: Food 101 for the Family with Food Allergies

For some, summer means travel.  I relish the lazy days close to home myself, but if we had the option to travel all summer long, I might very well consider it.  Unfortunately, for a food allergy family, traveling is a challenge with an enormous amount of planning involved.

With a severely food allergic child, I feel less and less comfortable eating out, especially when we're far from home.  I think I've got the Epinephrine to ER thing down pat when we're at home, but being on vacation with an allergic reaction is a different story all together.

So I try very hard to limit our restaurant eating and do as much preparing and cooking as I can.  We will be away this weekend for a rare mini getaway with the family, and although we will be within an hour from home, I still have a lot of planning to do.  Some tips to make the getaway more like a vacation and hopefully, less stressful:

1. If you can, book a hotel with a refrigerator at the very least, and for longer trips, some form of a kitchen or microwave is essential.  If there's no microwave in the room, there may be one available for use, like in the lobby.

2. Seek out the markets near your hotel before you go, and plan on making a few trips with a list of easy, allergy-friendly, low maintenance food options in hand.  Some forethought saves you time in the long run.

3. If there is a stove available, bring your own pots/pans and cooking utensils.  This cuts out the mystery and puts some of your cross-contamination worries at ease.

4.  Bring paper goods and disposable eating utensils.  No one likes to wash dishes on vacation, but this is especially important if all you have is a fridge.  An added bonus: kids can eat by the pool and not skip a beat!

5.  Bring drinks or water bottles and lots (and lots) of non-perishable snacks to pack for day trips, have by the pool, or satisfy a craving.  Some of our favorites are safe granola or breakfast bars, crackers, popcorn, fruit or fruit and gel cups (like Dole Fruit and Gel Cups), fruit leathers, seeds, and dried seaweed.

If you're a seasoned food allergy mama you likely already follow these guidelines religiously.  For those of you who might be starting out, know that you CAN have fun while on vacation.  And yes, we were the ones with the 8 grocery bags filled with food upon check-in, but we were also the ones who spent a fabulous 87 degree day by the pool.

Wishing you safe and happy travels this summer!

Traveling with food allergies: always an adventure!

Hanging out with Mater in Cars Land

I used to enjoy traveling.

Don't get me wrong.  I still love poring over friends' photo albums.  I reminisce with my husband about taking a Thai cooking class and finding the cheapest massage ever while exploring the streets of Chiang Mai.  And I still aspire to see more of Asia, more of Europe, and the other three continents I have yet to explore.

Once my eldest son, Ryken, was born I knew it would be a lot harder to travel with the adventurous attitude of my kidless years.  Kids need routines, not to mention good sleep and flexibility, and the confines of planes, hotels, and restaurants can throw off kids.

Little did I know that having kids with food allergies would not only make travel MUCH harder but it would make travel almost completely unattractive to me.  Now, the beautiful images of pristine blue waters and white sands are marred by anxieties over a lack of safe restaurant choices.  Ziplining through lush rainforests and sleeping among trees have been ruled out because you certainly won't find a fully equipped hotel suite with kitchen up a tree in a jungle and who knows where the nearest hospital will be.  Visiting the grandparents in China has been put off indefinitely because we do not trust that we will get clear answers on what is in our food and cross-contamination is way too risky in a country that doesn't have or deal regularly with food allergies like our own.

Despite my legitimate concerns over travel, it is sometimes necessary for us to travel.  And we do want our kids to experience fun places and activities that their peers do, too.  My husband is great about overriding my anxieties and insisting that we take advantage of spring break and take a family trip.  Since we had such a fun time last year in southern California, we decided to plan a very similar trip with days in Disneyland's California Adventure, Legoland, and the sunny, beachy areas of San Diego.

We stayed with family for the first couple of days and then took up residence at Homewood Suites (very close to Legoland) which offers accommodations with a small kitchen.  A kitchen is the #1 must-have for all of our trips.  Our #2 must-have seems to be a Trader Joe's within short driving distance.  Seriously, we ate more Trader Joe's ready-made food than we have ever eaten before.  I can say with full confidence that the kids are as sick of turkey club wraps as my husband is of eggplant wraps.  (I, on the other hand, could always go for a lentil wrap!)

Sharing a sofa bed and indulging in Cartoon Network
were other big pluses at Homewood Suites. 

Even though we had access to a kitchen, I did very little "real" cooking during on our vacation.  It's more like I use hotel kitchens for the refrigerator to store sandwiches and ice packs that we take into amusement parks for our safe lunches.   And a microwave is handy to throw together mostly already-prepared (and previously-vetted) into some semblance of a meal.  It's too hard for me to prepare any of our usual meals without a fully stocked kitchen.  And I often have no energy to spend a couple hours cooking after a full day of exploring, driving, or having fun in the sun.  Anyway, shouldn't I get to relax a little, too?  It's a family vacation, after all.

My husband's great.  He can even make grocery runs
(and there were many) good fun for the kids!

We feel very comfortable having most of our trip food come from Trader Joe's because it's familiar and safe.  However, we did try to break up the monotony.  We ate at five different restaurants during our week-long road trip, three of which we had safely eaten at before which.  Out of the five restaurants, we had problematic experiences at two of them.  And guess what?  One of them was a restaurant we have frequented many times before and the second was a restaurant chain highly recommended by many food-allergic eaters!

The first restaurant was actually our favorite local Thai spot.  We had ordered takeout the night before our drive to Southern California.  And as usual, I had spoken to one of the servers and explained the kids' food allergies which the server quickly recognized -- we must be the only "regulars" with milk/peanut/tree nut allergies.  We ordered our usual pad see ew noodle dishes with steamed tofu (never deep-fried in case frying oil is reused and contaminated with milk and nut particles).  This is a dish we've eaten over and over again without any problems.  And the kids again had no problem with the noodles.  A day later, while spooning out some leftovers for Ryken and me, imagine my panic when I discovered HALF OF A PEANUT in one of our untouched boxes of pad see ew.

My heart almost leapt out of my chest when I spotted it.

Sadly I think it might be a really long time before Ryken is comfortable eating Thai food from a restaurant again.

(Side note: Many people have questioned how I can feel comfortable ordering Thai food when a couple of their most popular dishes are made with peanuts.  The truth is we speak to the servers about how peanuts are used -- are they cooked in the pan, any peanut oil used, is peanut sauce placed on the side, are chopped peanuts only used for garnishing finished dishes?--  we carry our Allergy Translation cards, and we get a sense for how thorough the servers are in speaking with their chefs about our needs.  We have felt comfortable with this restaurant because the chef and servers know us by face.  But this accident has made me rethink restaurant-made Thai food.  The threat of an errant peanut making its way in to a cooking pan is too risky.  Plus, my wise Ryken has declared that he never wants to eat in a Thai restaurant again, the close-call clearly having an impact on him.)

Photo taken by Aranami from his/her Flickr photostream

The second restaurant that we had problems with was Chipotle Mexican Grill.  The Chipotle chain has been touted as a good option for people with various food allergies.  The company's lists major allergens in each menu item on their website and proclaims that their food is completely egg-free, nut-free, shellfish-free and fish-free.  Dairy products are limited to the cheese and sour cream so, in theory, someone with a milk allergy could get a safe meal so long as proper care has been taken to prevent cross contamination.

We tried Chipotle as I had read a lot of positive reviews from other food allergy parents.  Sadly, it wasn't a good experience for us.  Ryken developed a stomach ache a few minutes into eating.  He claims he felt a little stomach ache before dinner but it was clear to us that his stomach ache intensified after he began eating.  We monitored his symptoms and kept our EpiPen Jr. packs close by while we rushed back to the hotel.  His stomach started feeling better after about half an hour from when we ate.  I can't say for certain what Ryken reacted to -- cross contamination of milk or maybe he has an undiagnosed allergy to a less common ingredient (maybe a spice) used in the cooking process?  All I know is that we had big hopes for being able to add another safe restaurant to our very short list but it was not meant to be.

I don't regret the decision to try eating out with the kids but I am very grateful the reactions were under control.  And despite those two incidents, we still had a fantastic time.  But I can't tell you the enormous sense of relief I felt to come back home -- forget sleeping in my own bed, I was relieved to cook our meals again in the safety of our milk-free, nut-free kitchen!   Phew.  I sure could use a vacation after the vacation.

Until we meet again, gorgeous San Diego beaches!

A Successful Marin Overnight

When Tristan left in the morning with his big duffle filled with sleeping bag, toiletries, and layering pieces--for which I had specific instructions lest he go out everyday in a t-shirt--I was in pieces.  There was never a doubt in my mind that we would make it happen, and figure out a way for him to be included in his class' first overnight stay.  I just hadn't anticipated how nerve-wracking it would be.  And little did I know how much of a learning and growing experience it would be, for the both of us.

Eighty third graders stayed two nights at the Point Bonita YMCA.  It is a clean facility, with separate boys' and girls' dorms.  Bunks are divided into several smaller rooms and one meeting room, and large bathrooms.  Their spacious dining hall includes a buffet and plenty of long cafeteria-style tables.  All the children were given an orientation about how the dining hall works, with an emphasis on composting and taking only what you can eat.  The food is mostly organically grown and healthful, with basic ingredients, which simplified things for us.  On top of it all, the meals were delicious.

So how does a multiple and severely allergic child eat in a dining hall in a camp-style setting?  With a lot of planning, foresight, and a bunch of faith thrown in for good measure.  Richard Holden at Point Bonita YMCA was a pleasure to work with.  We communicated via email, with a follow-up discussion with his chef when we got there.  Here are a few things that worked for us:

1.  I emailed Food Service Director Rich Holden well in advance of the trip.  We emailed back and forth until I came up with a modified menu for Tristan.  It would have been nice for these menus to have been posted in the kitchen upon our arrival, but Tristan brought two copies of the menu with him, both of which he ended up giving to the chefs for reference.  I made sure to introduce Tristan to the chef before the first meal.

Here is the dinner menu for day 1.  Rich was willing to do a modified menu, or a combination of a modified menu and supplements, depending on the food allergies. We needed to do minimal supplementation (just soy milk boxes and Oreos), as there was lots of variety.

Point Bonita Sample Dinner Menu

Pasta and Meat Sauce
or Vegetarian Pasta
Sauteed Vegetables
Dinner Roll, Salad Bar
Fresh Baked Cookies

Tristan ate a hearty meal of pasta with meat sauce and vegetables on day 1.  His food was either separately plated by the chef, or he was allowed to plate his food first to avoid cross contamination at the buffet.  We brought a stash of Oreos for dessert, and he ate those instead of their cookies.  Although I was very impressed by the kitchen's attempt to accomodate Tristan with allergy-friendly cookies, I decided against them after reading a "traces of dairy" warning on the package.

2.  Before the trip, I gave Tristan's third grade team a refresher on food allergies and Epi-Pens.  I used some of the materials from our Food Allergy Summit in NY (and later improved the presentation with a food allergy quiz).  Each teacher tried out a trainer pen, and I answered everyone's questions as best as I could.  We agreed that Tristan would carry his Epi-pen in his pack.  It was really valuable to reconnect with the teachers about the severity of Tristan's allergies.  During his stay, Tristan was grouped with the male teacher in the group for hiking and bunking.  Big thanks to Mr. H and the third grade team!

3.  On the advice of his allergist, Tristan brought Claritin to take nightly.  In an unfamiliar place with allergens all around, it was smart to have some antihistamine in his system.

4.  The naturalists were alerted of kids who had special needs or medications, so they were made aware of Tristan's allergies and medications in his pack.

5.  I tried to prep Tristan about managing his food allergies with a balance of trust and caution.  I needed him to trust that I had prearranged a safe menu for him, but I also warned him that adults could make mistakes, and that he needed to make sure he was getting what was on his menu.  I asked him to look at his copy before each meal, and make sure he knew what he was supposed to be eating.  I think that helped empower him and give him a sense of confidence.

6.  I packed safe granola bars in his pack, in case he wasn't comfortable with a meal, snack, or just got hungry.

When I went to pick Tristan up from school on day 3, he looked relieved to see me. In the car, he told me that he "just missed us so much."  I was so proud of him for having such courage and stamina to collect his worries and gain such a valuable experience.  Three days without him at home gave me a glimpse into the future, with a bit of worry, but a lot of optimism, too.

The day I was there, we hiked around and down to the beach, then back to the Y. The kids would approach the trail as a group, each with different responses and ways of coping.  Some would charge straight down the hill, without looking back.  A few would sidestep down, cautiously taking each step.  Others would look straight down, as not to brush against poison oak, or step into a hole.

My hope for Tristan is that he is cautious, but confident through life, and that he take the time to explore and take in his surroundings.  I hope that when he needs to, he will grab my hand for some extra support, and that he will let go when he's ready.  I may never be ready, but knowing that he will be is an awesome feeling.

Dai Fat Go--Cakes for a Prosperous New Year

Most of our mothers and grandmothers have literally perfected a few to several dozen specialty Chinese dishes; but most do very little home baking.  This is not to say that they are immune to the wonderful smells wafting out of the doors of the Chinese bakeries on Stockton, Clement, or Irving Streets--the don tats (egg custard tarts), char siu baos (steamed pork buns), and the gai mei baos (cocktail buns).  But let's just say that my mother-in-law's oven is most popularly used to store over-sized pots and pans--not for baking.

It's nice to have a big wok with a lid for steaming.  It will fit a 6 muffin tin.

So it was fun to see how her eyes lit up when she realized she could make a simple cake using equivalent amounts of just four simple ingredients, after a friend gave her the recipe.  The "fat" in the name of the little cakes means prosperity [think: gung hay fat choy], so, they are typically made around Chinese New Year.  This year, the first day of the year of the snake lands on Sunday, February 10.

I rivaled my mother-in-law's excitement with the realization that the recipe is naturally egg and dairy free, two of the main food allergens in our household. My mother-in-law has been making the cakes all week, and the kids have been enjoying fresh muffins for breakfast.  I've found they go especially well with my afternoon cup of coffee.  They are really moist, spongy, and slightly sweet.

What gives these cakes their pretty flower shape is that they are steamed, not baked, so I guess my mother-in-law will be keeping her pots and pans tucked safely away in her oven for the time being.  Steaming muffins was a first for both of us.

Before I give you the recipe, you should know a few things about my seldom-baking mother-in-law. When someone says to add 1 cup of something, she uses a dry measuring cup, not a liquid one.  And when someone says to add brown sugar, packing the sugar is optional.  So even though the original recipe said to add one cup of brown sugar, packed it was equivalent to 3/4 of a cup.  This recipe couldn't be easier.

Logan had a blast helping his grandmother with the cakes.  Way too much fun for a sick day.

Dai Fa Go--Big Prosperous Cake  (No Egg or Dairy)

1 cup flour

1 cup water

1 cup dark brown sugar, unpacked (or about 3/4 cup dark brown sugar, packed)

1 cup Bisquick

Stir the ingredients together, pour into lined muffin pan, and steam on a plate in a large pan or wok covered for 15 minutes.

Makes 6-8 little cakes

A big prosperous Chinese New Year to all of out Get Allergy Wise families!  Time to go clean the house...

Party Time -- Tips to remember for preventing allergic reactions and anaphylaxis

Bringing the family to a party can be a worry-filled outing when you are managing food allergies.  There will be party foods that your food-allergic loved ones cannot eat.  And even if there are options with safe ingredients, with so many people handling and grazing around the buffet table there is a high chance that cross contact will occur rendering even those safe items that you brought unsafe for your loved ones.

Education your loved ones and yourselves on your food allergies and safe practices is first and foremost key to keeping them safe.  Families and friends dealing with food allergies get better at understanding what their allergies mean and how to avoid risks with more time, practice, and dialogue.  Here are additional party tips to help keep your loved ones reaction-free and, hopefully, lower your anxiety level.  Here's hoping we can all enjoy the big game and catch up with good friends a bit...instead of keeping a constant vigil over the buffet table.

1. Bring your medication.  Yes, this statement is a no-brainer but let me elaborate.  If you have been prescribed an epinephrine auto-injector, always carry it in its correct form, as a two-pack.  Sarah and I recently attended a food allergy blogger summit in which Ruchi Gupta, leading doctor and advocate on food allergies, shared with us that there is still a misconception that the EpiPen auto-injectors can be separated to cover more area -- to keep one at school and one at home, for example.  Keeping the twin pack together is absolutely necessary.  Sometimes one shot of epinephrine is not enough as Sarah discovered recently and there is always the chance that one auto-injector fails to function properly as with the case in the tragic anaphylaxis death of Tyler Davis.  Know and keep a copy of your food allergy action plan with your life-saving medication so that you and fellow guests know what to do in case of a reaction and how to identify signs of anaphylaxis. 
2. Bring your own safe foods.  Even if you know the hosts, have talked to them about the menu, have checked food labels and recipes, always have a collection of tried-and-true safe snacks for your food-allergic loved ones.  Bring a variety and bring more than you need. 
3. Bring safe cups.  At kid-friendly parties, there is often a sea of juice boxes that "decorate" the party venue almost as much as beer bottles at a frat party.  On two occasions at such parties, I have seen kids accidentally taking sips from my kids' juiceboxes.  (Yes, said boxes then went straight to the trash.)  I like to bring reusable lidded cups with straws like these to stand out and to protect against the wrong-drinker.  Besides being cheap and BPA-free, I can easily change out the straws if they get gross, I can write my kids' names on them with a Sharpie and easily wipe/scratch them off when I'm done.  Feel free to pop a sticker on the lids, too, to further distinguish your family's cups. 
4. Keep those hands clean!  If it hasn't become a family routine yet, make sure that you and your kids wash before and after each time you take a food break.  Carry plenty of wet wipes, too, for those places where a sink isn't accessible.  I am not shy about offering wet wipes to friends' kids also along with a friendly reminder that my kids can develop rashes or worse if they are touched by their food allergens.
5. Bring a Sharpie.  A Sharpie is also great for writing our names on our disposable plates (assuming we are not at a sit-down, fine china kind of gathering).  You don't know how many friends, living with food allergies or not, have commented on the brilliance of marking our plates to avoid mix-ups.
6. Tote your loved one's safe foods separately from the food you will share.  Bringing something for a potluck?  Pack your child's portions in their own containers.  That way you can avoid the risk of cross contact from accidentally shared or mixed-up utensils or dropped-foods at a buffet table. 
7. Always honor the instinct and feelings of your food-allergic loved one.  I was lucky enough to hear food allergy advocate Allergic Girl Sloane Miller speak about living a confident life with food allergies.  She told us about a time when a meal was completely catered to her specific allergies. However, with so much going on, she did not get a chance to personally talk to the servers and food preparers ahead of time to double check about ingredients and food handling.  Sloane felt uneasy about eating the meal and decided not to eat and take it back to her hotel room instead. 
8. Never eat for someone else.  Even when a host has gone through great lengths to provide allergy-friendly foods for your child, if your child doesn't want to try something unfamiliar to them, be okay with that.  Do not ever force your child to eat to "be polite" or because you are afraid of disappointing your well-meaning host.  Again, this goes with honoring your loved one's gut feelings on how to keep themselves safe. 

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.

After Thanksgiving Soup

It's Sunday after Thanksgiving, the perfect lazy day to reflect on a weekend spent with family and friends, and ending with an easy, hearty meal to fill our stomachs for back-to-school.

By 1 pm Thanksgiving day, I'd handed the kids off to my brother for some incredible summer weather playground time, picked up the toys off the floor, and even set up the tables and chairs for a party of 16 with a 4 o'clock reservation to feast.

With a mix of relief and dread, I sat down to several huge mounds of clean laundry covering two-thirds of my living room rug, and started folding, sorting, and putting away baskets of clothes that had forced me to send the kids to school in mismatched and ill-fitting outfits for the past week.  I pulled my Honey Baked Ham out of the oven by two, and with an hour to spare, I prepped my quick and easy allergy-friendly desserts--Semi-Homemade Vegan Chocolate Pumpkin Bread Pudding and Apple Cranberry Crisp.  Soon after, the guests started arriving and pouring wine--the party had begun!

Regardless of how much help and support I have before and during these parties, it's hard to ever completely put my guard down and relax.  This year, most of the food was allergy-friendly and safe for my kids to eat, but you are never 100 percent sure, especially when you're hosting a potluck.  One unsafe ingredient in one dish is enough to send a food allergic person to the ER, which is definitely the last place anyone wants to be on Thanksgiving night.

But I managed to sit back with a glass of wine and take a bit of time to enjoy a few small moments and conversations from the evening.  And thankfully, tummies were full and satisfied without incident.  There may even have a been a dance performance and a bit of karaoke thrown in for some good old family fun.

It would've been nice to sleep in the next day, as there were still a couple of dishes in the sink and some crumbs to wipe up, but we had other plans.  We were off for an overnight in old Sacramento--via Amtrak--destination...the Polar Express!  All of the pre-made pasta, leftovers, cold cuts, bread, fruit, and snacks, and an in-room fridge and microwave allowed me to create a safe menu of foods for Tristan during our trip.  Perfectly sunny weather, hanging out with friends, and trains everywhere contributed to a memorable weekend.  Such fun!

Whew!  Finally today, a day of rest.  We are cleaning house and I have our after Thanksgiving Soup on the stove, with a ham hock base, Honey Baked Ham The Soup Solution Green Garden Soup Mix, potatoes, carrots, celery, fennel, and yellow onions.  Containing no dairy, egg, or nuts (note: does contain wheat and soy),* Honey Baked Ham not only allowed me to contribute a hands-off crowd pleasing Thanksgiving day main dish, it is giving me a--quite possibly even better--hearty and delicious soup for our Sunday night dinner.  Paired with a few other leftovers, including our desserts, we will feast again tonight with very little effort.  What fun things do you do with your Thanksgiving day leftovers?

The soup hit the spot--so delicious, I want to eat it for days.  Thank you Honey Baked Ham!

We hope all of our GAW families had a warm and wonderful Thanksgiving, and a little break from the norm.

*Honey Baked Ham's ingredient and allergen information is not published on their website.  Please contact them at 866-492-HAMS for specific questions and up-to-date ingredient information.

Happy Girl Makes a Boy Happy

We sort of accidentally stumbled upon Pacific Grove, California as our summertime home away from home.  We love the slow-paced lifestyle of a kid-friendly small town with our big market chains just a mile and a half away for convenience.  The weather is perfect for the kids--similar to San Francisco summers and not too hot for eczema prone skin.  We get foggy mornings, sometimes clearing in the afternoons, making treks to the beach a popular choice for otherwise lazy days.  The local library, natural history museum, plenty of friendly shops, and playground all within walking distance means I don't need to deal with the headache associated with piling kids in and out of the car on a daily basis.  We've been very content playing tourists for almost a month now:

We flew a kite at Asilomar Beach

Riding the glass-bottom boat, we saw otters, sea lions, and jelly fish!

We rode a surrey from Lover's Point Beach to Fisherman's Wharf

A rare sunny morning got us to the beach at low tide.

Biking and scooting along the trail.

There's always something new to see and learn at the Monterey Bay Aquarium.  Their new Jellies Experience is especially fantastic!

But as this is our second summer here, we've had to start doing as the locals do.  Participating in the local activities leading up to the festival at the beach for the Feast of Lanterns, religiously hitting the Monday afternoon farmer's market in downtown PG (four short blocks away), getting a Pacific Grove library card, and a must on every local's weekly list of to do's--frequenting our favorite cafe--Happy Girl Kitchen Co.--for Blue Bottle Coffee and allergy-friendly treats.

Last year, I connected with Stephanie Stein, creative baker and sweetest person from Happy Girl Kitchen Co.  She generously shared her scone recipe and words of wisdom about baking without egg with our readers.  I adapted her recipe to make it dairy-free, and armed with Stephanie's baking advice, experimented with my own scone variation, Coconut Chocolate Chocolate Chip Scones.

So you know I was thrilled when I last visited Happy Girl and noticed a new pre-order form for Stephanie's baked goods.  I promptly placed my order for a dozen berry scones and a chocolate ganache birthday cake for Tristan, all egg, nut, and dairy free.

Stephanie was happy to take a break from her busy morning baking duties to discuss Tristan's food allergies and my specifications, even adjusting the cake to make it less sweet.  The result: a wonderful scone breakfast shared with friends and an even more fabulous birthday celebration for a delighted 8-year-old boy!  As he opted out of a full-blown birthday party with friends this year, having his first store-bought cake more than compensated.  His verdict: "Yummy and chocolately!"  His siblings were equally overjoyed about the allergy-safe cake, both announcing they wanted the same cake for their birthdays!

Eight candles...plus one for good luck!  

Stephanie Stein's chocolate ganache cake was the star of the show!

A dozen berry scones, hot out of the oven--no egg, nuts, or dairy!

Couldn't resist picking up some carrot muffins--all allergy-safe for the kids!

Happy Girl Kitchen Co. at 173 Central Ave, Pacific Grove, CA--stop by before your  Aquarium visit!

As a chocoholic and self-proclaimed sweets critic, the cake was delicious--moist, with a rich dark chocolate taste.  And unlike my egg and dairy free creations, this one held up well and wasn't crumbly.

See you soon Stephanie, and thanks SO much!

Zachary's Pizza - milk-free options and a dream come true!

One thing that had always saddened me about my kids' milk allergy was missing out on Zachary's Pizza.  For those of you who aren't familiar with Zachary's, it is a Berkeley fixture, a Bay Area landmark that many diners believe serves the finest deep dish pizza west of Chicago.

Zachary's is celebration food for me.  It's one of my favorite treats that holds a lot of great memories for me.
I remember having Zachary's for the first time during a visit to the Cal campus in my senior year of high school.  Zachary's deep dish had won me over to Cal just as much as the beautiful campus, laid-back alternative vibe, and cast of crazy characters (including my favorite).  In subsequent years I shared many laughs with my brother, my college sweetheart husband, and friends as we dined on Berkeley's finest pizza amidst the colorful customer-made posters and constant chatter of college students.

My husband and I have always hoped to share the Zachary's love with our kids.  But with their severe milk allergies, it just wasn't meant to be.  We continued to visit Zachary's on date nights (I know, I know -- I am a simple gal.)  I have even tried my hand at making Zachary's-styled pizzas with mixed results: they were tasty but compared to the restaurant's impressive Zagat food score of 24 out of 30...well, there is no point in comparing.

When I found out earlier this year that Zachary's was now offering Daiya Vegan Shreds as a cheese alternative, I almost screamed out with joy!  Was it possible that my kids could now experience my favorite food in the world?  My excitement was soon muted when I talked to a server about cleaning practices.  She shared that Zachary's only washes their pans thoroughly twice a week (ewww) and she couldn't guarantee that cheese wouldn't bubble over from one oven rack and spill onto our pizza below.  I decided it was just too risky for the kids to try.

Last week we were expecting guests from out of town.  When we have visitors, I immediately think of the must-dos and must-eats for their trip.  My mind came to Zachary's because I truly feel that no visit to the Bay Area is completely without it.  I decided to call and inquire about their practices, just in case things had changed.  I spoke at great length with Christo in two separate conversations -- once for my initial questions and a second time for ordering -- about my kids' milk, peanut, and tree nut allergies.  Christo patiently and enthusiastically answered all my questions.  At times, he would put me on hold to run into the kitchen and make sure the staff could go the extra milk to avoid cross contact with cheese and milk.  (He was certain that nuts weren't a concern for the pizzas we ordered.)  I really appreciated that if he didn't just write down my order or concerns but he personally went over everything with the kitchen staff.

Here were my concerns and how they were met:

Are the pans safe to use?  I heard they are only washed twice a week.
Normally greased with butter, the pans are used repeatedly throughout the day for various pizzas.  (The server I had spoken with a few months ago was mistaken.  The pans are wiped and washed every night.)   Zachary's will thoroughly clean the needed pans if its staff is made aware of a severe food allergy.

How can you make sure the ingredients used in my pizzas haven't come into contact with milk?
This was a biggie for me.  Christo explained that Zachary's "encouraged its employees to wash their hands after preparing each pizza" but there was no guarantee this would be done.  Here is what worked for us:

(1)  Have the staff who took your order (hopefully, you can get a manager) explain to kitchen staff of your food allergies.  The pizza makers should thoroughly wash up and only use ingredients from their new stock-- chopped and sliced ingredients that can go straight from refrigerator storage to your pizza without touching cheesy surfaces.
(2)  Ask if your pizza can be baked on the highest rack to avoid any melted cheese dripping into your pizzas' pans.
(3)  Ask that your pizza not be cut along with the other pizzas.  I had completely forgotten about this but good ol' Christo remembered and had asked the kitchen staff to leave it whole.  We easily cut our pizza at home.  If you are dining at one of Zachary's three locations, ask for a clean pizza cutter and do the slicing yourself right at your table.

Is there milk in any of the other ingredients?
We ordered the Chicken Special which normally does not have any milk products except for the pizza's cheese.  We also wanted a milk-free Spinach and Mushroom, which is trickier as it is made with a pre-made mix of three dairy cheeses plus the two main vegetables.  Spinach, in fact, isn't even listed as a regular topping choice.  If your heart is set on the Spinach and Mushroom, ask if they can create a milk-free mix with Daiya Vegan Shreds, fresh mushrooms (from the new stock), and the chopped spinach that's usually reserved for their spinach salad.  This is what Christo had employees do, and the pizza still turned out delicious!

If you plan to order sausage, pepperoni, salami, or other meat, ask if the staff or you can check the label.  Deli meats may contain milk products such as nonfat milk powder, whey, or cheese.  We learned this the hard way!  If there is no ingredient label, please take precaution and order something else.
 
How can I be sure the people prepping the pizzas understand that this is a pizza for milk-allergic diners, not just people who eat dairy-free by choice? 
It is of utmost importance to thoroughly explain your child's milk allergy.  Just ordering a vegan pizza alone will not do because of the risk of cross contamination from the cheesy hands reaching into other fresh ingredients, the shared cutting boards, pizza pans, and pizza cutters.  I always pull out my food allergy alert cards.  These are handy for enabling wait staff to show kitchen staff exactly how serious the allergies and the great need to check labels and avoid cross contact.

Have other milk-allergic people eaten had the Daiya substitute and emerged unscathed?
We have!  I am so excited to report that my kids had no problems eating their Zachary's deep dish pizzas.  While veggie-abstaining Callan couldn't reconcile with the tomato topping, Ryken enjoyed the pizza more and more with each slice.  We had some extra slices that lasted us three days.  Woo hoo!

I make it a point to share with my kids all the details of how I make food or choose food in restaurants to prepare the safeguard against accidents and cross contamination when we eat out.  Start getting them involved in what they eat when they are young -- it will help build this awareness so that they can ask the right questions and make safe choices when they are adolescents and beyond!  After my initial conversation with Christo, I shared with Ryken the steps that Zachary's would take to avoid cross contamination with milk.  I told him I felt comfortable with trying it -- we have our Benadryl Allergy and Epi-Pen Jr. set at the ready should things look bad.  Ryken felt okay with this so we placed the order. 

Remember, though.  It was not so simple to get a truly "vegan pizza".  Being completely upfront about the kids' allergies and asking many, many questions -- these were key to ensuring that the safest practices were used.  We are so grateful to Zachary's enormously responsive staff and our personal pizza guardian angel Christo!  We definitely will order milk-free Zachary's again.

Take and go placemat tutorial by Michelle T.

Summer is around the corner and there will undoubtedly be some perfect picnic days ahead.  In lieu of eating out in restaurants, which can be risky for food allergic children, we are big picnic people.  And isn't it just a little more fun to spread out a blanket wherever you are and start digging in?

I challenged Get Allergy Wise contributor and awesome seamstress extraordinaire Michelle T. to make a travel placemat, perfect for food allergic children or anyone eating on the go! 

I found oilcloth at Fabrix on Clement St. for $2.39 a yard, gave some to Michelle, and here's what she came up with.  Awesome.  (I especially like the use of binder clips to hold the oilcloth together for sewing!).  Happy picnicking!

~Sarah

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This placemat will hold your utensils and napkin and roll up in a nice, convenient bundle.  It's not hard to make, but some sewing experience would be helpful.

You'll need

1/2 yard oilcloth

22 inches of ribbon

sewing machine

thread

Here, you'll want to sew from the top arrow to the bottom one, starting

1/4 inch from the top of the pocket piece and stopping 1/4 inch from the bottom 

of the pocket piece.