Recently, my daughter called me from college and told me that she had taken one sip from a friend’s water bottle after asking her friend if she ate anything that she is allergic to (peanuts, tree nuts, sesame, and mustard). Her friend thought about it and said she had not, but had forgotten that she had a peanut butter pretzel earlier that afternoon. Almost immediately, my daughter felt a tightening in her chest. She administered an Epipen but the chest tightening did not go away. She ended up in the ER and was released a few hours later.
As a mom and an AllerCoach™, I wanted to dissect the above paragraph for both of my food allergic children, my clients, and anyone who has a food allergy.
For those of us who are parents or relatives of food allergic children, you can lose count of how many times you teach them what to do and what not to do regarding their food allergies, and how many times your words go unheeded especially as children enter their teenage years and young adulthood. But I would make the case that those “mistakes” are really teachable moments. Many times, kids who have not had a reaction since they were young can grow up forgetting what anaphylaxis felt like, and how the experience(s) affected them. In addition, teenagers and young adults often take more risks (like not checking ingredient lists, trying foods that they have not had a reaction to in a long time, forgetting what their parents and caregivers had told them about sharing utensils, cups, foods).
First and foremost, I reminded my daughter that sharing water bottles, cups, utensils, etc., is too risky and as the food allergic person, it is not up to her friends to remember what they ate but for her to keep herself safe (This advice will be different if in a relationship where personal intimacy is involved. More on that later). As I mentioned, allergens can linger in saliva for roughly 4 hours, so the simple act of brushing your teeth, chewing gum, and/or rinsing your mouth after ingesting food(s) that a person is allergic to will not necessarily keep them safe. That is why a peanut butter pretzel caused an anaphylactic reaction hours later. In fact, caregivers who eat an allergen and give a child a simple kiss on the cheek can see hives develop, which can worsen. It’s important to remember that Ingestion alone is not a cause of anaphylaxis. An allergic reaction can occur even if the food allergic person does not ingest the food protein.One much overlooked risk factor is kissing. In the moment, it’s easy to forget that food proteins can stay in saliva for up to four hours.
So, what is a food allergic person and their friends, family members, and significant others to do to avoid food allergic reactions?
First, we need to understand that food allergies and other types of food hypersensitivities affect millions of people. Food allergies occur when the body’s immune system reacts to certain proteins in food. Food allergic reactions vary in severity from mild symptoms, such as hives and lip swelling, to life-threatening symptoms (anaphylaxis). It is important to know that any food can pose a risk to people and that peanuts and tree nuts are not the only foods that cause allergic reactions.
The eight major allergens in the U.S. are peanuts, tree nuts, dairy, eggs, soy, wheat, shellfish, fish, and sesame (which has now been included as the ninth allergen with the passage of the FASTER Act of 2021), but it has been estimated that more than 160 foods have been identified to cause food allergies in sensitive individuals.
It is important to ask what the food allergic person is allergic to and not to question their sensitivities just because you haven’t ever heard of a person being allergic to something before. Remember to:
Be open and honest. Communication is vital.
The best way to avoid mishaps is avoidance of the allergen.
Always read ingredient labels, don’t just guess.
Brush teeth and rinse thoroughly to help remove food proteins, wait about 4 hours, and then repeat brushing, rinsing.
Eat a safe meal or snack to reduce allergens in saliva after the 4-hour mark.
Avoid sharing water bottles, utensils, etc.
If you, or anyone you know with food allergies has any questions, please feel free to reach out to me.