Content Warning: This article discusses a detailed account of anaphylaxis.
Disclaimer: This article does not constitute medical advice. Always consult your doctor about food allergies or other medical concerns.
My child has food allergies. What comes to mind when I say that? The peanut-free table at school? The no nuts policy that prevents you from sending a PB&J sandwich for your child’s lunch, even though they love it? An overbearing mother who won’t let her kid eat anything and doesn’t care about your child’s preferences? Entitled children or adults, who might get a little sick or itchy or even just don’t like foods and want sympathy?
Maybe that’s not what comes to your mind. Perhaps you, a family member, or a friend are affected by food allergies, or perhaps you simply are one of those awesome, knowledgeable people out there. But unfortunately, many people still view food allergies as an inconvenience at best, and a byproduct of overdramatic parents or even completely fabricated at worst.
What about if I told you my child could have lost his life on Christmas Eve because of something as simple as a kiss from his grandmother? What would you think then?
On Christmas Eve, my family returned home from church, much like any other family might. My little one stayed home with another family member because he was a bit young to sit through services, and was greeted with a kiss by my mother. That was all it took. Within minutes I noticed a hive.
Our allergy plan calls for us to administer an antihistamine for localized, single system responses, so I did. By that time, there was a fair number, but not so many that I felt epi was 100% necessary (epi for hives? Read on). I watched and waited. The hives stopped growing, stopped spreading. And then, just like that, they were bigger and angrier. And there were more of them. And then even more. I administered epi.
You see, contrary to common knowledge, anaphylaxis does not always look like someone gasping to breathe, or with a face swollen up like a balloon. Of course, it can and does present like this. But it can also look like all-over hives, vomiting, headaches, or a combination of symptoms over two or more bodily systems (skin, respiratory, cardiac, gastrointestinal, and so on). These signs indicate a systemic response rather than a localized one, and that requires administration of epinephrine (commonly sold under brand names such as EpiPen® or AuviQ®). Failure to promptly administer this medication early enough is associated with an increased likelihood of complications and hospitalization due to an allergy attack. One of those complications is death.
Using the term “allergy attack” makes many think of runny noses, itchy eyes, and sneezing. I admit, even I used to think of these things when hearing the term. I have a food allergy but have never required epinephrine. I also have seasonal allergies. And don’t get me wrong, seasonal allergies are miserable, and if they trigger asthma, they can also be life-threatening. Sure, both food allergies and seasonal allergies are a result of the body’s immune system mistaking a benign substance as a threat. But the image the term “allergy attack” conjures up for many severely misrepresents what one can look like in food allergies.
Christmas Eve was the first time my child had a life-threatening reaction to food and required epinephrine. The prior reactions had been mostly localized and had always consisted of hives that responded to an antihistamine (meaning the hives would quickly dissipate after administration of medication). When the hives spread after being given an antihistamine, I knew it meant that the reaction was system-wide and would continue to spread without epi.
My father called an ambulance while my mom helped restrain my toddler so he wouldn’t move while I jabbed his tiny body with a needle to administer medication that could save his life. My little one was an absolute trooper, hardly a tear. I regret to admit that’s a lot more than I can say for myself. A police officer arrived first, within minutes of administering epinephrine, and my kid promptly vomited. It was clear this reaction was systemic, and I knew at that moment I had made the correct decision to epi. A paramedic arrived next, followed by our amazing volunteer ambulance corp. No one once questioned my judgment to epi, despite the horror stories I had heard from other allergy mamas (“What do you mean you epi-ed? They’re just hives!”). One EMT noted, kindly, “You did the right thing.”
On the ambulance ride to the hospital, my toddler started to cough. Luckily his lungs were clear. At the hospital, the hives receded some, then started to return. This time they were less angry, at least. Then the cough turned into wheezing. My child’s upper lip started to swell. An additional dose of epinephrine was discussed. Ultimately, the hospital administered oral steroids, a nebulizer treatment, and another antihistamine. My child finally started to stabilize.
Nearly six hours after the first hive, we were discharged with a book from the box of goodies Santa left at the hospital as a token of the visit. I would have refused it (who wants to remember that), but my little one was so happy to receive it and loves to read. And ultimately, this is about him, not me. My child more than deserved the gift after all he went through. His first hospital memento. Something no kid should ever have, but with food allergies, the reality is it likely won’t be the last. But my little one is alive to read that book this time, thank goodness.
The culprit that tried to steal my child was my mother’s lip gloss. I read the label before she even applied it, and it didn’t contain any of my child’s allergens (sesame, the 9th most common food allergy in the US, cashews, and pistachios, both in the Top 8 allergen group under tree nuts). Instead, it turns out the company had acknowledged to another family there was likely cross-contamination between items that do and do not contain sesame oil at their facility. I only found out after the reaction when I thought to look up the product on one of my resource groups. As an allergy mama, online Facebook groups become your best friend, a compilation of documented contact with a variety of companies to cross-reference safer products.
The mom guilt surrounding this whole situation is real. The “what ifs” and the “should haves.” Ultimately, we all do the best we can as parents. I’m working on letting the guilt of that night go. Maybe one day I will be able to.
My child didn’t lose his life because we have an amazing allergist who educated us about red flags for anaphylaxis and therefore knew to administer epinephrine early. I don’t say this to give myself a pat on the back. I say it because allergy myths are still prevalent. I say it in hopes that, if faced with the same scenario, someone reading this won’t hesitate to epi. If it makes you feel more confident, know that the Elliot and Roslyn Jaffe Food Allergy Institute (a leading research and clinical center in the field) deems epinephrine “extremely safe in children and healthy adults” (it should go without saying, but never administer any prescription medication, except under explicit instruction of your physician).
While current circumstances mean my child is spending less time away from home and encountering fewer unknown products that could cause a reaction (something that has greatly reduced my anxiety, at least temporarily), it is only a matter of time until life goes back to normal. When that happens, I hope those around us will be understanding. Unfortunately, that hasn’t always been the case. And I hope you will remember my family when social distancing measures rollback, too.
The next time you find yourself wanting to roll your eyes at the notion of an allergen-free table at school (or perhaps, the food allergy parents concerned about CDC recommendations to eat lunch in the classroom), or maybe a no nuts policy for the entire school, I hope you think of my child. I don’t say this to guilt you. I say this because children with food allergies didn’t choose this life. But as adults, we can make a difference and help keep children with allergies safe from harm.
With Food Allergy Research and Education (FARE) estimating approximately 32 million Americans are affected by food allergies (including 1 in 13 children, e.g., approximately 2 per classroom), chances are your kindness and understanding will have an impact on children and adults in your immediate community. Perhaps it will even have an impact on a friend or family member.
Sure, allergies can be a runny nose and a sneeze attack. But they can also be a child stuck in the hospital on Christmas Eve, having difficulty breathing, all because his grandmother adores him.
If you are concerned you or your child may have food allergies, please speak with your physician or a qualified allergist.
For more information on food allergies, please see the following evidence-based resources: